INTENDED AUDIENCE
Urologists, primary care physicians, endocrinologists, sexual medicine specialists, and other healthcare professionals interested in the management of hypogonadism and erectile dysfunction.

STATEMENT OF NEED
Evidence-based guidelines have sought to define the appropriate assessment of exercise ability and use of stress testing to ensure that a male patient's cardiovascular health is equal to the physical demands of sexual activity before erectile dysfunction (ED) therapy is prescribed and to underscore the link between sexual dysfunction and cardiovascular disease (CVD), which may be asymptomatic and benefit from reducing cardiovascular risk. Mounting evidence indicates that low testosterone levels are associated with premature CVD, cardiovascular events, and cardiac death, as well as increased all-cause mortality. Despite compelling evidence, many clinicians are not aware of the connections between ED, low testosterone, comorbid conditions, and overall health.

Based on the underlying pathophysiology linking metabolic syndrome, hypogonadism, ED, and CVD, evaluating the importance of diagnosis and treatment of sexual dysfunction and related cardiometabolic disease is pressing. In this program, we will consider whether treating men with exogenous testosterone and/or phosphodiesterase type 5 (PDE5) inhibitor therapy may mitigate cardiometabolic risk, examine practical strategies to improve adherence and satisfaction with PDE5 inhibitor therapy and testosterone therapy, and focus on the concomitant management of ED, benign prostatic hyperplasia/lower urinary tract symptoms, CVD, and hypogonadism to define how the management of these conditions may improve cardiometabolic parameters and overall cardiovascular health. Finally, we will examine the importance of consistently integrating women's perspectives on the management of sexual concerns into clinical practice to optimize adherence and treatment outcomes.

EDUCATIONAL OBJECTIVES
At the conclusion of this activity, participants should be better able to:

  1. Discuss with patients the importance of continuous treatment with phosphodiesterase type 5 (PDE5) inhibitor therapy and testosterone therapy to improve health outcomes
  2. Evaluate up-to-date, clinically relevant guidelines for the management of erectile dysfunction (ED), hypogonadism, and related comorbidities
  3. Demonstrate that hypogonadism is related to ED and may be an early indicator of serious cardiovascular disease (CVD)
  4. Recognize that metabolic syndrome, which predicts diabetes and CVD, may be a consequence of hypogonadism
  5. Evaluate data demonstrating systemic improvements in hypogonadal symptoms and cardiovascular risk factors with PDE5 inhibitor therapy and testosterone therapy
  6. Determine the optimal PDE5 inhibitor and testosterone formulation to address the needs of the patient and partner
  7. Examine how women's perspectives on the treatment of sexual concerns need to be consistently integrated into clinical practice to optimize adherence and outcomes for each couple

ACCREDITATION AND CERTIFICATION
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Dannemiller and Cognimed. Dannemiller is accredited by the ACCME to provide continuing medical education for physicians. Dannemiller designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™

Physicians should claim only the credit commensurate with the extent of their participation in the activity. Statements of Credit will be provided by web-certification or mail following activity participation and upon completion and return of the evaluation form to CogniMed Inc. via submission at the end of the activity; by mail to CogniMed Inc., 70 South Orange Avenue, Suite 230, Livingston, NJ 07039; or by fax to 973-758-0052. Please allow 4 to 6 weeks for the delivery of your statement. If you have any questions about your certificate, please e-mail cme@dannemiller.com.

CONTENT REVIEW STATEMENT
To resolve identified/potential conflicts of interest, the educational content was fully reviewed by a physician member of the Dannemiller Clinical Content Review Committee who have no financial relationships with commercial interests. The resulting certified activity was found to provide educational content that is current, evidence based and commercially balanced.

DISCLOSURE STATEMENT
It is the policy of Dannemiller to ensure fair balance, independence, objectivity, and scientific rigor in all programming. All faculty and planners participating in sponsored programs are expected to identify and reference off-label product use and disclose any significant relationships with those supporting the activity or any others whose products or services are discussed. The faculty for this activity have disclosed that there will be discussion about the use of products for non-FDA-approved indications.

In accordance with the Accreditation Council for Continuing Medical Education standards, parallel documents from other accrediting bodies, and Dannemiller policy, the following disclosures have been made:

Dannemiller
Mark T. Nadeau, MD, MBA, FAAFP, Clinical Content Reviewer, has nothing to disclose.
Gordon Ringler, Project Manager, has nothing to disclose.

CogniMed Inc. Staff
Estelle Perera, Senior Director, Scientific Affairs and Program Design, and Medical Writer, has nothing to disclose.
Al Saint Jacques, Editor, has nothing to disclose.

Faculty
Culley C. Carson III, MD, receives research support from, is a consultant for, and serves on the speakers bureaus of American Medical Systems; Auxilium Pharmaceuticals, Inc.; Eli Lilly and Company; and GlaxoSmithKline.

The ideas and opinions presented in this educational activity are those of the faculty and do not necessarily reflect the views of Dannemiller and/or its agents. As in all educational activities, we encourage the practitioners to use their own judgment in treating and addressing the needs of each individual patient, taking into account that patient's unique clinical situation. Dannemiller disclaims all liability and cannot be held responsible for any problems that may arise from participating in this activity or following treatment recommendations presented.

Sponsored by Cognimed.
This activity is supported by an independent educational grant provided by Lilly USA, LLC.

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© 2014 CogniMed Inc. All rights reserved.            TU15144             January 2014