Asking private Questions but totally confidential : 1- What’s exact problem do you face inn your intimate relation ship? 2-Since when it started? Sudden onset or Gradual? 3-Do you feel the mind is willing but the body is not? 4-Do you have a problem in sustaining erection? 5-Do you notice Morning Erection? 6-How do you feel inside your self? ———————————————– Based on the rapid screening, If it occurs sudden onset so mostly it’s Psychological rather than medical cause…. Management : 1- Education and counselling about the problem 2- Counselling about the importance to be compliant on HF medications for survival improvement despite the fact that may be some medications may be implicated in Erectile dysfunction (Especially Beta blockerr ) with empathy and sympathy 3-We can selectively prescribe Nebivolol rather than any other Betablocker as it’s known to improve endothelial NO system 3-Prescription of PDi (Sildenafil or Taladafil) would be helpful 4-Correct other Modifiable risk factors for atherosclerosis (Like DM, HTN , Obesity, Hyperlipidemia, Smoking) 5-Check androgen levels to exclude secondary Hypogonadism associated with Cardiac patients and if low replacement would help after Consulting Andrologist. 6-involve Psychiatrist to assess the patient mood because depression also one of important causes of ED in such patients.