You are seeing a 52-year-old male patient, who presents to the clinic for concerns about sexual health.

· He reports he’s been experiencing difficulty achieving and maintaining erections sufficient for satisfactory sexual activity for the past year. He states that the issue has become progressively worse and is now occurring in most sexual encounters.

· Patient reports gradual onset of symptoms, but they are becoming more frequent, though he does not notice changes in libido or desire for sexual activity.

· He denies any pain during intercourse, penile deformity, or premature ejaculation.

· He does report fatigue and decreased energy over the past year and also notices some increase in urinary frequency at night (getting up one to two times per night).

· He has past medical history of Type 2 diabetes mellitus (last A1C 8.2%); hypertension, and hyperlipidemia.

· He is currently taking metformin 1000mg twice daily, amlodipine 5mg daily, and atorvastatin 20mg daily.

· Patient does not smoke, drinks alcohol once or twice a month, and has a sedentary lifestyle.

· Upon examination today his BP is 138/84, HR 78, and BMI is 32. Cardiovascular exam reveals normal S1/S2, no murmurs, and peripheral pulses are palpable but diminished bilaterally. Neurologic examination reveals normal sensation to lower extremities bilaterally. Genital examination reveals normal testes and penis without deformities or plaques. Physical exam is otherwise unremarkable.

Please develop a discussion post that responds to each of the following prompts. Where appropriate your discussion needs to be supported by scholarly resources. Be sure to include in-text citations in the context of the discussion and provide a full reference citation at the end of the discussion post:

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· Provide your diagnosis.

· Discuss how you would manage the patient’s current presentation and provide a rationale supported by scholarly reference for your treatment plan.

· Include your specific prescription(s) for the patient. (This must include the medication name, dose, route, and frequency as well as any special instructions that apply as you would include when writing a prescription).

· Describe the patient education you would provide in relation to your treatment plan.

· Provide your plan for follow-up and/or referral (if indicated)