Male erectile dysfunction is the consistent inability to achieve
or maintain a penile erection sufficient to permit satisfactory
sexual intercourse. Medical professionals often use the term "erectile
dysfunction" to describe this disorder and to differentiate it from
other problems that interfere with sexual intercourse, such as lack
of sexual desire and problems with ejaculation and orgasm.
What are the risks of ED?
ED is a problem whose frequency increases with age. Yet, it is not
an inevitable part of aging. About 5% of men at the age of 40 and
between 15%-25% of men at the age of 65 experience ED. ED is considered
a medical problem if it lasts more than 3 months.
What are the causes of ED?
Since an erection requires a sequence of events, ED can occur when
any of the events are disrupted.
Conditions that affect the nervous system:
- Multiple sclerosis
- Alzheimer's disease
Conditions that cause changes in the way blood flows to the penis:
Psychological conditions and social problems:
- Depression
- Stress
- Unhappy relationships
- Low self-esteem
- Fear of sexual failure
Endocrine and hormone imbalances:
- Diabetes, caused by abnormalities in the production or use
of insulin in the body
- Hyperthyroidism, or a high level of thyroid hormones
- Hypothyroidism, or a low level of thyroid hormones
- Hypogonadism, or a low level of testosterone
Trauma or injury to the pelvis:
- Spinal cord injury
- Prostate surgery
Habits that make blood flow worse:
Some prescription medications:
- High blood pressure drugs
- Antihistamines
- Anti-depressants
- Tranquilizers
- Appetite suppressants
- Cimetidine (an ulcer drug)
How is ED diagnosed?
Patient history including medical and sexual histories, physical
and psychological examination, and laboratory tests are done to
rule out other diseases. Sometimes a test called nocturnal penile
tumescence, or erection self test, is performed. This is done to
see if erections occur during sleep. If the test shows that erections
occur, it can indicate the problem is mental rather than physical.
Another test, called color phase ultrasonography, also may be done.
This evaluates blood flow to the penis.
What are the treatments for ED?
First, any underlying conditions that may cause the ED should be
treated. Treatment may include counseling or sex therapy for men
whose ED stems from emotional problems. Treatments for physical
causes of ED should progress from less to more invasive.
Treatment may include:
- Using a vacuum pump device to draw blood into the penis
- Using oral medications
- Hormone treatments, namely testosterone
- Injecting medications into the penis
- Surgery to improve blood flow to the penis
- Implanting an inflatable prosthesis into the penis.
