American Board of Internal Medicine (ABIM) Certification Practice Exam

What is considered first-line therapy for erectile dysfunction?

1. Phosphodiesterase type 5 inhibitors only

2. Surgical options only

3. Lifestyle modification and phosphodiesterase type 5 inhibitors

4. Hormonal therapy only

The correct answer is: Lifestyle modification and phosphodiesterase type 5 inhibitors

First-line therapy for erectile dysfunction typically involves a combination of lifestyle modifications and phosphodiesterase type 5 (PDE5) inhibitors. PDE5 inhibitors, such as sildenafil, tadalafil, and vardenafil, are well-established treatments that enhance erectile function by increasing blood flow to the penis. These medications are effective, well-studied, and generally well-tolerated, making them a primary choice in the management of erectile dysfunction. In addition to medication, integrating lifestyle modifications is crucial as they can significantly impact erectile function. These modifications may include weight loss, increased physical activity, smoking cessation, and managing conditions such as diabetes and hypertension, which can contribute to erectile dysfunction. Addressing these underlying lifestyle factors can lead to improved sexual health and overall well-being. Surgical options and hormonal therapy represent other treatment avenues but are typically considered when other methods have failed. They are not the first step in therapy, particularly as the majority of cases can be effectively managed with lifestyle changes and the use of PDE5 inhibitors alone. Thus, the combination approach of both lifestyle changes and the use of PDE5 inhibitors is recognized as the most comprehensive and effective first-line therapy for erectile dysfunction.