Erectile Dysfunction

What Is Erectile Dysfunction?

Erectile dysfunction (ED), also known as impotence, happens when you can't get or keep an erection of the penis that's adequate for the sexual satisfaction of both partners. While almost all adult males have ED once in a while, as many as 30 million American men have it regularly. Nearly all men who seek treatment for ED find some relief.

Erectile Dysfunction Causes

In the past, doctors tended to blame erectile dysfunction on psychological problems or, with older men, on the aging process. Medical opinion has changed. While it takes longer to get aroused as you age, regular erectile dysfunction deserves medical attention. Also, the problem isn't usually psychological. Urologists now think physical problems contribute to most long-lasting cases of ED in men over 50.

Erectile dysfunction in older men. Erections mainly involve the blood vessels. And the most common causes of ED in older men are conditions that block blood flow to the penis. These include hardening of the arteries (atherosclerosis) and diabetes. Another cause may be a faulty vein that lets blood drain too quickly from the penis. Other disorders, as well as hormonal imbalances and certain operations, may also cause ED.

The blood vessel processes that lead to an erection are controlled by your nervous system. Some medications can interfere with the nerve signals that make an erection happen. They include certain stimulants, sedatives, diuretics, antihistamines, and drugs to treat high blood pressure, cancer, or depression. But never stop taking a medication unless your doctor tells you to. Alcohol, tobacco, and illegal drugs, such as marijuana, may also contribute to ED.

Erectile dysfunction in younger men. In younger men, psychological problems are the most likely reason for ED. Poor communication with your partner, or differences in sexual preferences, can lead to tension and anxiety. The problem may also be linked to these things:

• Depression
• Fatigue
• Stress
• Feeling that you're not good enough
• Sexual fears
• Rejection by your parents or peers
• Childhood sexual abuse

Erectile Dysfunction Symptoms

The symptoms of erectile dysfunction can vary from person to person. If you have ED, you might:

• Be unable to get an erection at all
• Get an erection sometimes
• Have trouble keeping an erection long enough for sex
• Lack desire for sex

Erectile Dysfunction Diagnosis

When you see a doctor for ED symptoms, they'll try to find out whether you have another health condition that could cause the problem. They'll ask about your medical history, including questions about your sex life. You might have:

• A physical. It will include an examination of your penis and testicles.
• Blood and pee tests. These check for problems like diabetes, heart disease, and low testosterone.
• A mental health exam. This can reveal whether you have stress, depression, or other issues that could lead to ED.
• An ultrasound. This allows your doctor to see whether blood flow problems are affecting your penis.

Erectile Dysfunction Treatment

The treatment for your ED will depend on what's causing it, as well as what you and your partner think will work best. Your doctor can help you decide. Treatments include:

Medications. You take drugs like sildenafil (Viagra), vardenafil (Levitra, Staxyn) and tadalafil (Cialis, Adcirca) as pills before you have sex. They work by increasing blood flow in your penis. This helps you get an erection once you're sexually excited.

Your doctor might prescribe testosterone if your levels of this hormone are low. It won't help if circulation or nerve problems cause your ED.

You can inject an ED medicine called it alprostadil into your penis to help it fill with blood and quickly cause an erection. It's sometimes used in combination with other drugs. You may also insert alprostadil into your urethra (the small hole in your penis where urine comes out) as a suppository. That's a solid form of the medicine that gets dissolved by your body heat.

Lifestyle changes. Your doctor might suggest that you lose weight or start an exercise routine to improve your ED symptoms. They might also recommend that you stop smoking, drinking alcohol, or using marijuana or other drugs.

Counseling. If stress, depression, or relationship problems contribute to your ED, talking to a counselor could help.

Vacuum device. Also called a penis pump, this is a tube that fits over your penis. It includes a pump, which you use to suck air from the tube. This pulls blood into your penis to make it erect. You place an elastic ring around the bottom of your penis to keep it erect, and take off the vacuum tube. After sex, you remove the ring to end the erection.

Surgery. Most men don't get surgery for ED. But in some cases, doctors will do an operation to repair your arteries to boost blood flow to your penis. Or they can implant a bendable or inflatable rod inside your penis that you adjust to make it erect.

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