Erectile Dysfunction

Erectile dysfunction is a consistent inability to sustain an erection sufficient for sexual intercourse. Sometimes the term impotence is used, but medical professionals use the term erectile dysfunction or ED to describe this disorder. The American Foundation for Urologic Disease (AFUD) says use of the term ED differentiates this problem from other issues that interfere with sexual intercourse, such as lack of sexual desire and problems with ejaculation and orgasm.

Causes

Basically, any disorder that impairs blood flow in the penis has the potential to cause ED. This includes:

• disease
• injury
• surgical side effects
• drug side effects
• psychological issues

Of these, disease is the most common cause. The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) says diseases--including diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, and vascular disease--account for about 70 percent of cases of ED. Between 35 and 50 percent of men with diabetes experience ED. (Read about "Diabetes" "Kidney Disease" "Alcoholism" "Multiple Sclerosis" "Arteriosclerosis & Atherosclerosis" "Coronary Heart Disease")

Surgery, for example prostate surgery, can also cause problems for the nerves and arteries near the penis, causing ED. (Read about "The Prostate") In addition, injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to ED. (Read about "The Spine")

Many medications can also result in ED as a side effect. NKUDIC says these include different types of drugs that can be used to treat high blood pressure, allergies, depression, ulcers, and anxiety. (Read about "Hypertension: High Blood Pressure" "Allergies" "Depression" "Peptic Ulcers" "Anxiety") In addition, there are psychological factors that themselves contribute to roughly 10 percent of ED cases, according to NKUDIC. Smoking is also linked to erectile problems. (Read about "Quit Smoking")

Diagnosing and treating

In determining the cause of ED, a doctor will consider the patient's medical and sexual history. A physical exam and lab tests can also be used. NKUDIC says most physicians suggest that treatments for ED proceed along a path moving from least invasive to most invasive. This means cutting back on any harmful drugs is considered first. Psychotherapy and behavior modifications are considered next, often focusing on ways to reduce anxiety.

If less invasive techniques prove unsuccessful, AFUD and NKUDIC say additional treatments can include any of the following:

• Vacuum devices - Mechanical vacuum devices cause erection by creating a partial vacuum around the penis, which draws blood into the penis, engorging it and expanding it.
• Drugs - Drugs for treating ED can be taken orally, applied or injected directly on or into the penis, or inserted into the urethra at the tip of the penis. Oral medications include sildenafil citrate, tadalafil and vardenafil hydrochloride (which increase blood flow to the penis) as well as testosterone (used for men affected by low testosterone levels). Oral medications that increase blood flow to the penis have been linked to vision loss and hearing loss. (Read about "The Eye" "The Ear & Hearing") As with any medication, consult your doctor about potential side effects. (Read about "Medicine Safety") Injected medications also work to increase blood flow to the penis, but can result in side effects that include persistent erection (known as priapism) and scarring.
• Surgery - Surgically implanted devices, known as prostheses, can restore erection in many men with ED. Possible problems with implants include mechanical breakdown and infection. NKUDIC says surgery involving veins or arteries is also an option.

As with any treatment, there are advantages and disadvantages to all these options. It's important that you discuss them carefully with your doctor. The Federal Trade Commission also cautions that there are many bogus treatments that claim to "cure" ED. Again, before considering any treatment, be sure to discuss it with a qualified healthcare professional.

Related Information:

    Genital Health - Male

    Medicine Safety

    Your Medicine Cabinet