Common Causes and Treatments for Erectile Dysfunction

At Advanced Urology Institute, we see a lot of men with erectile dysfunction. Also called ED, or impotence, erectile dysfunction is the inability to achieve or maintain an erection that is adequate for the sexual satisfaction of both partners. In the United States, as many as 30 million men suffer from ED on a continual basis, though transient episodes affect almost all adult males. Erectile dysfunction can adversely affect the self-esteem of a man or his partner, but nearly all men who opt for treatment find some measure of relief.

Causes of Erectile Dysfunction

While aging is the most common factor in erectile dysfunction, the problem is often an indicator of other health problems. Male sexual arousal is a complex process involving the brain, nerves, hormones, emotions, muscles and blood vessels. A problem with any of these functions can result in impotence. In fact, it is worth consulting a urologist about a persistent erection problem because it could be a symptom of a serious medical condition. A proper and timely diagnosis will address any underlying medical problems and usually resolve the sexual difficulties as well.

Common Causes of Erectile Dysfunction

Even though sexual arousal takes longer as a man ages, chronic erectile problems require immediate medical attention at any age. Urologists believe that a majority of persistent erectile dysfunction cases in men over age 50 are caused by physical factors such as diabetes, atherosclerosis, certain prescription medications such as stimulants, diuretics, antihistamines, sedatives and drugs for treating cancer, depression and high blood pressure. In younger men, urologists believe that most cases are caused by psychological problems such as depression, fatigue, stress, feelings of inadequacy, rejection by peers or parents, sexual abuse in childhood and personal sexual fears. At any age, common underlying causes of ED include:

  • Heart disease and the narrowing of blood vessels
  • High blood pressure
  • Diabetes
  • Obesity
  • High cholesterol
  • Multiple sclerosis, Parkinson’s disease and metabolic syndrome
  • Anatomical or structural disorder of the penis, like Peyronie’s disease
  • Hormonal disorders such as hypogonadism (testosterone deficiency)
  • Alcoholism, smoking or substance use, including cocaine use
  • Injuries in the spinal cord, pelvic area or radiation therapy of the pelvic region

Prescription medications such as anti-hypertensives, heart medications (digoxin), sleeping pills, opioid painkillers and hormone drugs are often the cause of erectile dysfunction. In younger men, psychological issues are at the root of the problem and may stem from fear of intimacy, poor communication with a partner, stress, anger, anxiety, depression or guilt.

Erectile Dysfunction and Heart Disease

Erectile dysfunction can be an early warning sign of existing or future heart problems. Similarly, a man with heart disease may no longer have erectile dysfunction after getting the right treatment for a heart condition. ED preceding heart disease is more common due to the dysfunction of the inner lining of blood vessels (endothelium) and smooth muscle. Endothelial dysfunction results in inadequate blood supply to the heart and impairs blood flow to the penis, while also aiding the development of atherosclerosis. Therefore, a man with erectile dysfunction with no obvious cause, such as trauma, and not accompanied by symptoms of heart problems should be screened for heart disease before treatment is started.

Treatment of Erectile Dysfunction

For many men, the diagnosis of erectile dysfunction simply requires a physical exam and medical history. But for men with chronic health conditions or those suspected to be having underlying medical conditions, the urologist may need further tests such as urinalysis, blood tests (for testosterone level, diabetes, heart disease and other health problems), ultrasound and psychological exam. Once the condition is diagnosed, the urologist may recommend lifestyle changes, medicines (such as Viagra, Levitra or Cialis), vacuum devices or dietary supplements. In some cases, the urologist will recommend a surgical treatment such as penile implant or vascular surgery.
At Advanced Urology Institute, we recognize erectile dysfunction as an embarrassing and bothersome issue for men and their partners. This is why we provide a patient-friendly environment for discussing performance issues with a competent and experienced physician. We also offer effective treatments for erectile dysfunction and associated conditions, helping men to regain their confidence and self-esteem. If you or someone you know has a problem with achieving or maintaining an erection, visit the Advanced Urology Institute.


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