Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Health Economics and Outcomes Research, Health Services Consulting Corporation, Boxborough, MA, USA.
Am J Mens Health. 2020 Sep-Oct;14(5):1557988320965078. doi: 10.1177/1557988320965078.
Erectile dysfunction (ED) is a common, burdensome, and costly urologic condition strongly related to all aspects of general health, from physical to mental. ED has profound consequences as it may interfere physical well-being, quality of life (QoL), self-esteem, relationships, self-worth, and productivity. It is therefore important to ensure that all types of effective ED treatments are consistently accessible to patients. While federal and state mandates ensure access to treatment for women's breast health, female-factor infertility, and gender affirmation to ensure that these individuals do not experience a diminished QoL, there are no comparable mandates for men's sexual and reproductive health. The burden of ED necessitates a call to action to improve the accessibility of ED treatments. The call to action steps include: (a) coverage for pharmacological, surgical, and other ED treatments should be viewed in the same way as coverage for other health issues, whether male or female and regardless of the stages of treatment, physical dysfunction, or physical changes; (b) American Urological Association (AUA) guidelines for the management of ED should be followed, including implementation of templates in electronic medical records (EMRs) to support adherence to the guidelines; and (c) coverage criteria should explicitly state that the criteria are intended to support gender equity for sexual and reproductive health care and should not be used to prevent men from receiving medically necessary ED treatments. This call to action offers a pathway to support every man who seeks treatment for ED as a medically necessary intervention by removing systemic health-care barriers.
勃起功能障碍（ED）是一种常见的、负担沉重且代价高昂的泌尿科疾病，与身体健康的各个方面（包括身体和心理方面）都密切相关。ED 会对患者的身体、生活质量（QoL）、自尊心、人际关系、自我价值感和生产力造成深远影响。因此，确保患者能够获得所有有效治疗 ED 的方法至关重要。虽然联邦和州的法规要求确保女性的乳房健康、女性因素不孕和性别认同的治疗能够得到保障，以确保这些患者的生活质量不受影响，但男性的性健康和生殖健康却没有类似的法规要求。ED 带来的负担需要我们采取行动来提高 ED 治疗的可及性。行动呼吁的步骤包括：（a）药物治疗、手术治疗和其他 ED 治疗应与其他健康问题的治疗一样得到覆盖，无论患者是男性还是女性，无论治疗的阶段、身体功能障碍或身体变化如何；（b）应遵循美国泌尿外科学会（AUA）的 ED 管理指南，包括在电子病历（EMR）中实施模板以支持遵循指南；（c）覆盖标准应明确规定，这些标准旨在支持性健康和生殖健康护理的性别平等，而不应被用来阻止男性接受必要的 ED 治疗。这一行动呼吁为支持每个寻求 ED 治疗的男性提供了一条路径，将其作为一种必要的医疗干预，消除了系统的医疗保健障碍。
