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HomeHealth A-Z Erectile Dysfunction
Erectile Dysfunction
Erectile Dysfunction

Most cases of erectile dysfunction are due to physical causes and indicate a more serious underlying medical condition.

Erectile Dysfunction

(i-REK-tl dis-FUNK-shen)

Definition of Erectile Dysfunction

Erectile dysfunction is the persistent physical inability of a man's body to achieve and/or maintain an erection sufficient enough to have sexual intercourse even when there is the desire and stimulation to do so. Also referred to as ED or impotence.

Description of Erectile Dysfunction

Fortunately, it is no longer taboo to talk about or seek treatment for sexual problems. Men should not be afraid to talk to their doctors about erectile dysfunction (ED) or think they have to live with this condition. Doctors are learning more about the causes of erectile dysfunction and are better able to help men overcome this problem than in the past.

The term erectile dysfunction (ED) has been used to describe several varying degrees of erection problems, from the tendency to sustain only brief erections, an inconsistent ability to achieve an erection, or the total inability to get or keep an erection. Because of these varying definitions, it is difficult to accurately estimate the incidence of erectile dysfunction (ED). Estimates have widely ranged from 15 million to 30 million, but no matter the definition used, it is known that the rate of ED incidence increases with age.

Most men experience occasional erection problems from time to time and this is normal. Most men also notice changes in erectile function with age and this is normal too. Common changes men notice as they age include more time needed to get an erection, the erection may not be as firm, it may take more direct stimulation to get an erection, climax may not be as intense, ejaculate amount is less, or more time is needed between erections.

When the inability of getting and/or maintaining an erection becomes persistent, however, this is the condition clinically referred to as erectile dysfunction, or impotence. Erectile dysfunction does not have to be accepted as an inevitable part of aging, however. Because ED is very often a sign of another underlying health condition, it is very important for a man to be seen and examined by a doctor. New and better treatments are currently available which are able to help most men with ED.

Causes and Risk Factors of Erectile Dysfunction

Age is a common risk factor of ED, most commonly affecting men older than 65. It is estimated that chronic ED affects about 10% of men in their 40's and about 20-40% of men by the age of 65. Occasional ED and inadequate erection affects about 50% of all men between the ages of 40 and 70.

Approximately 80% to 90% of ED are due to physical causes and approximately 10-20% of ED cases are due to psychological factors.

Physical causes include anything disrupts the series of events necessary to erection, from nerve impulses in the brain, spinal column and penile area, to the muscle, tissue and vascular response in the corpora cavernosa (chambers in the penis). Physical causes include:

  • Physical diseases and disorders - diabetes, cardiovascular disorders, high cholesterol, atherosclerosis (hardening of the arteries), hypertension (high blood pressure), multiple sclerosis, stoke, Parkinson's disease, male hypogonadism (low testosterone levels)
  • Surgery or trauma - brain injuries, spinal cord injuries, nerve damage, prostate cancer surgery, radiation therapy to the testicles, even prolonged bicycle riding may cause a temporary problem
  • Medications - such as antidepressants, antihistamines, blood pressure medicine, pain medicine, cancer medicine, tranquilizers, sleeping aids
  • Lifestyle Choices - chronic smoking, excessive use of alcohol, marijuana, other non-prescription drugs, being overweight, lack of exercise

A small percentage of ED cases are due to psychological factors including stress, anxiety, depression, guilt, fatigue, low self-esteem, fear of sexual failure, relationship problems, and negative feelings towards your partner.

Symptoms of Erectile Dysfunction

Erectile dysfunction is the repeated inability to get or keep an erection. While occasional and isolated erection problems can be normal, the concern is when the problem is repeated and persistent over a two month period. It is important to seek treatment not only to benefit your sex life, but to determine the underlying cause. Many times erectile dysfunction is the first sign indicating another medical problem.

Diagnosis of Erectile Dysfunction

To diagnose for erectile dysfunction, your doctor will do a physical exam and ask questions about your symptoms. The doctor will want to know about any known health conditions, medications, recent physical injuries, and/or emotional changes. Tests to diagnose ED or the cause include:

  • Blood Tests - to check for conditions such as diabetes, high cholesterol or low testosterone levels
  • Ultrasonography - to test amount of arterial circulation in the genital area
  • Neurologic Evaluation - to test for nerve damage in the genital area
  • Cavernosometry - to measure penile vascular pressure
  • Cavernosography - to look for any blood flow abnormalities to the penis

To determine if the cause is not physical in nature, the doctor will want to know if an erection can be reached during masturbation or while sleeping. To determine if medications are the cause, changes may be made in prescriptions.

Treatment of Erectile Dysfunction

ED can usually be treated, however the best treatment can vary from man to man. Treatment for each patient will be based on the causes, severity of the condition, personal preferences, and cost. Treatment for ED includes:

  • Oral Medications
  • Injection Therapy
  • Intra-urethral Therapy
  • Vacuum Pump
  • Surgical Implants
  • Vascular Surgery
  • Hormone Replacement Therapy
  • Psychological Counseling

Prevention of Erectile Dysfunction

While not all cases of erectile dysfunction can be prevented, making healthy lifestyle choices is an important aspect of ED prevention. Many of the underlying causes of ED can be avoided by eating healthy, exercising on a regular basis, and maintaining a healthy weight. Other lifestyle choices affect the incidence of ED, such as smoking, excessive drinking, and drug use. Avoidance of these activities can reduce the risk of developing ED. Certain medications can also cause ED, so it is important to talk to your doctor about erection problems associated with a new prescription. Another medication may be available or the dosage may be adjusted to alleviate ED side effects.

External Resources

National Institutes of Health

American Urological Association

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