Erectile Dysfunction – Overview

Erectile Dysfunction, Advanced Urology InstituteErectile dysfunction (E.D.), a condition that affects at least 30 million American men, is defined as the inability to achieve an erection sufficient for intercourse. Erectile dysfunction is not a normal part of the aging process. Nevertheless, half of all men between the ages of 40-70 experience some degree of E.D. Approximately 17% experience minimal and 25% experience moderate difficulties, while some men are unable to achieve any erection.

Over 90% of E.D. cases are organic (not in your head). Common causes of organic E.D. include medications (especially blood pressure, heart, and antidepressant medications) and medical diseases such as diabetes, heart disease, vascular disease, elevated cholesterol, and high blood pressure.

Psychogenic E.D. is due to non-organic causes such as “fear of failure.” Regardless of the cause, it is still possible to have a satisfying love life even if the underlying cause of E.D. cannot be corrected.

Risks

Apart from occurring frequently among the elderly, ED is often a consequence of poor emotional and physical health. It is common in men with high cholesterol, diabetes, obesity, cardiovascular disease, hypertension, prostate disease, anxiety, damage from surgery or cancer, injuries, stress, depression, performance anxiety, relationship problems, alcohol use, smoking, and drug use. Typically, ED is caused by vascular disease (such as atherosclerosis) that prevents blood supply to the penis, a neurological disorder (like multiple sclerosis) that cuts transmission of nerve impulses to the penis, chronic medical disorders such as Peyronie’s disease, stroke and diabetes, trauma, and operations for bladder, colon and prostate cancer which may affect blood supply to the penis. These risk factors may work singly or in combination.

Causes

Stress, fatigue, or relationship problems are all factors that can contribute to erectile dysfunction. Certain medicines like tranquilizers, antihistamines, diuretics, high blood pressure medication, and medication for depression can also lead to impotence. The use of alcohol and tobacco can be contributing factors as well. Impotence might also occur because of diabetes or atherosclerosis, which can block the blood flow to the penis. In younger men, psychological problems tend to more commonly be the cause of impotence, though other causes should to be considered in consultation with a physician.

Prevention

  • Eat a healthy, balanced diet that avoids saturated fats and increases the intake of vegetables, fruits and whole grains.
  • Reduce cholesterol levels through exercise, medication and diet.
  • Maintain a healthy body weight.
  • Exercise regularly.
  • Seek prompt treatment or professional help for conditions such as stress, depression, hypertension, heart disease and diabetes.

Treatment

Men who suffer from erectile dysfunction have a number of treatment options. If it is a symptom of an underlying illness, treatment should be focused on the underlying illness. When erectile dysfunction appears with no underlying cause, the following treatment options are available and are highly successful.

  1. Oral Medication. These are pills given to increase blood flow to the penis, thus causing an erection. The most common ones are vardenafil or Levitra, Cialis or tadalafil, viagra and avanafil. Oral medication is most successful in patients with mild cases of erectile dysfunction.
  2. Penile injections. The most common injectible drug is alprostadil. Using a very fine needle, a patient injects the drug into the base of the penis. The drug increases the size of the arteries that supply blood to the penis. Alprostadil also can be administered by placing a small alprostadil suppository at the opening of the penis, rather than by injection.
  3. Vacuum erection device. This is a tube with a hand or battery powered pump. The tube is placed over the penis and the pump is used to draw air out, creating a vacuum. The vacuum thus draws blood into the penis, causing an erection.
  4. Penile implants. A minor surgical procedure is used to introduce bendable rods at the sides of the penis. These rods give the penis a firmness that allows for intercourse. An alternative of the rods is the insertion of fluid filled cylinders connected to a pump placed in the scrotum. Engaging the pump inflates the cylinders which causes the penis to firm up.