GP CCE Cases · mens-health
Erectile dysfunction — CCE clinical encounter
CCE-style clinical encounter: a 47-year-old asking for 'the blue tablet', embarrassed and time-pressed. The candidate must take a respectful sexual history, reframe ED as a cardiovascular signal, prescribe safely with nitrate screening and lifestyle co-prescription, and agree follow-up.
On this page
Study tools
Target exams
RACGP CCEFRACGP oralsCFPC SOOs
Prompt
A 47-year-old warehouse manager attends at the end of a busy session: 'I just need the blue tablet, mate.' Eight months of failing erections with his new partner; morning erections still occur. Smoker, no regular doctor, father died of a heart attack at 61. He is embarrassed and keeps glancing at his watch.
Objectives
- Earn permission for a sexual history from an embarrassed, time-pressed man without losing him. [2]
- Take a focused history distinguishing organic versus psychogenic contributions (morning erections preserved). [2]
- Reframe ED as a cardiovascular signal and complete risk assessment — family history, smoking, BP, lipids, glucose. [6] [10]
- Prescribe PDE5 inhibitor safely: screen nitrates explicitly, set expectations (stimulation required), quote realistic efficacy. [3]
- Co-prescribe lifestyle change as ED treatment with trial numbers, not as a lecture. [8] [15]
- Safety-net and arrange review of both erection and cardiovascular outcomes.
References11ShowHide
- [1]Feldman HA, Goldstein I, Hatzichristou DG et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. The Journal of urology, 1994.PMID 8254833
- [2]Rosen RC, Riley A, Wagner G et al. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology, 1997.PMID 9187685
- [6]Thompson IM, Tangen CM, Goodman PJ et al. Erectile dysfunction and subsequent cardiovascular disease. JAMA, 2005.PMID 16414947
- [10]Vlachopoulos CV, Terentes-Printzios DG, Ioakeimidis NK et al. Prediction of cardiovascular events and all-cause mortality with erectile dysfunction: a systematic review and meta-analysis of cohort studies. Circulation. Cardiovascular quality and outcomes, 2013.PMID 23300267
- [8]Gupta BP, Murad MH, Clifton MM et al. The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis. Archives of internal medicine, 2011.PMID 21911624
- [15]Sahin MO, Sen V, Gunduz G et al. Effect of smoking cessation on sexual functions in men aged 30 to 60 years. International braz j urol : official journal of the Brazilian Society of Urology, 2020.PMID 32374127
- [3]Goldstein I, Lue TF, Padma-Nathan H et al. Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. The New England journal of medicine, 1998.PMID 9580646
- [11]Yang M, Ni X, Sontag A et al. Nonresponders, partial responders, and complete responders to PDE5 inhibitors therapy according to IIEF criteria: validation of an anchor-based treatment responder classification. The journal of sexual medicine, 2013.PMID 24125113
- [12]Corona G, Rastrelli G, Morgentaler A et al. Meta-analysis of Results of Testosterone Therapy on Sexual Function Based on International Index of Erectile Function Scores. European urology, 2017.PMID 28434676
- [14]Duncan C, Omran GJ, Teh J et al. Erectile dysfunction: a global review of intracavernosal injectables. World journal of urology, 2019.PMID 30895359
- [18]Zhang F, Luo Z, Xue Q et al. Efficacy of vacuum erectile device in refractory erectile dysfunction: a systematic review and meta-analysis. International journal of impotence research, 2026.PMID 40542251