Erectile dysfunction affects the ability of millions of men to have sexual intercourse. An estimated 30 million American men have experienced chronic problems achieving or maintaining an erection. While erectile dysfunction is most common in older men, younger men experience it too. According to the American Urological Association, up to one half of men over age 40 have dealt with some form of erectile dysfunction. The condition has many possible physiological and lifestyle causes. Fortunately, men have several treatment options available to them.
Symptoms of Erectile Dysfunction
Erectile dysfunction, commonly known as ED, is the inability to achieve or maintain an erection for sexual intercourse. It is normal to have occasional erectile problems or lack of sexual desire. However, ED is characterized by persistent issues getting or keeping an erection.
Men experiencing ED should consider seeing a doctor for treatment and also to rule out any underlying medical conditions. Most causes of ED are physical and treatable. ED is a common symptom of many conditions including diabetes, kidney disease and vascular problems. The earlier a medical problem is caught, the sooner a man can regain his overall health including sexual health.
Causes of Erectile Dysfunction
ED has many possible physical causes and requires accurate diagnosis. Some are disease-related, and ED may actually be an early symptom of an underlying condition. Particularly as men age, ED shows up as an early marker of cardiovascular disease. Vascular problems are also seen among middle-aged and younger people as obesity and inactivity take their toll. Men with diabetes are twice as likely to experience ED due to nerve and artery damage that inhibits erections. Neurological disorders such as stroke and multiple sclerosis can disrupt signaling between the brain and penis and trigger ED. Some men receiving treatment for prostate cancer may find that the regimens interfere with sustaining an erection. Surgeries to treat genital or urinary cancers may result in temporary or permanent ED due to the need to cut related nerves and tissues.
Other physical causes are unrelated to illness. Hundreds of common prescription drugs list ED as a possible side effect, so patients should make sure to find out any risks. Smoking causes blood vessel damage, and long-time smokers often experience ED. Drug and alcohol use also restricts blood flow. An enlarged prostate, which is common in older men, can interfere with erections. Low testosterone levels can cause issues for some men.
ED can also have psychological causes. Stress, depression and anxiety can all interfere with achieving or maintaining an erection. Often psychological and physical causes are intertwined, and a man can work with his physician on determining lifestyle changes. For example, a man under high job stress may be in the early stages of cardiovascular disease and also skimping on sleep and exercise.
Pictures of Erectile Dysfunction
Pharmaceutical Treatments for ED
The first line of erectile dysfunction treatment is to address any underlying medical problems such as diabetes or high blood pressure. Treatment may need to be started for a newly discovered condition or modified to reduce the likelihood of ED.
ED is commonly treated with oral medications such as the prescription drugs Cialis, Viagra and Levitra. These medications work by improving blood flow to the penis so that a man can achieve an erection with normal stimulation. They all boost the body’s production of nitric oxide, a substance that relaxes penis muscles to allow greater blood volume. However, they differ in side effects and use guidelines. Finding the best medication and dosage may require some time. Men with certain health conditions or who are on certain other medications cannot take this class of pharmaceutical.
One alternative medication is the prostaglandin alprostadil. Prostaglandins are compounds in the body that can dilate blood vessels and increase blood flow. Alprostadil may be appropriate for men who cannot take oral medications or who have better results with direct application. A man administers alprostadil by using an ultra fine needle to inject it directly into the penis. Alternatively, he can place a suppository in the urethra. Both methods tend to produce an erection within 10 minutes that can last up to an hour. Drug brand names include Edex and Caverject Impulse for the injection and MUSE for the suppository.
Other Treatments for ED
Sometimes a low testosterone level triggers ED. Testosterone declines gradually in men as they age, and some may benefit from hormone replacement therapy. This usually resolves the ED issue.
For some men, the most effective or medically sound treatments do not involve medication or hormones. One mechanical option is the penis pump or vacuum erection device. A man places his penis inside a tube and uses a pump to extract the air and create a vacuum. The vacuum causes the penis to engorge with blood. The man then puts on a tension ring at the base of the penis to keep it engorged until after intercourse. Pumps come in various models, so a man should choose one in consultation with his doctor.
Another physical option is the penile implant in which rods are surgically implanted on each side of the penis. Inflatable types allow a man to use a pump to inflate the rods with fluid and produce an erection a will. Malleable rod implants are semi-rigid and aid an erection. As implants involve surgery, they are considered after other options are ruled out.
When psychological factors cause or significantly contribute to ED, psychotherapy may be the best solution. Individual or couples therapy can help a man confront and manage issues that are impairing his sexual health. Common problems include depression, anxiety, stress and relationship issues.
Lifestyle factors often play a role, and a man should consider whether he could make beneficial changes. Obesity, smoking and excessive drinking all directly contribute to many cases of ED. One of the best things a man can do for his sex life is to exercise regularly. Seeking assistance to stop smoking or to deal with substance abuse is another powerful step for overall health.
Erectile dysfunction does not have to be part of aging or of managing conditions such as depression or diabetes. Men have many treatment options to help them maintain a satisfying sex life.