Erectile dysfunction (ED) is…
Erectile dysfunction (ED) is the inability to achieve or maintain an erection firm enough for sexual activity. ED, also referred to as impotence, may involve the total inability to achieve an erection, or only brief erections, or not being able to reliably get an erection.
Causes of ED may include diabetes, high blood pressure, heart disease, nerve disease or nerve damage, multiple sclerosis, or hardening of the arteries (atherosclerosis). Treatment for ED depends on the cause.
Erectile dysfunction (ED) can be caused by both physical and psychological conditions.
Achieving an erection is a complex process that involves signals from the brain, the male sex hormone testosterone, a functioning nervous system, and healthy vascular tissue in the penis. Erectile dysfunction can be caused by factors that are medical, physical, or psychological. This can include three main problems:
- Insufficient blood flow to the penis
- Inability to store blood in the penis during an erection
- Nerve signals from the brain or spinal cord do not reach the penis.
Other factors that could influence ED include medicine, alcohol, or drugs.
Aging is one of the causes of erectile dysfunction.
While erectile dysfunction is more common as men age, aging itself is not the cause of ED. Most cases of ED have a physical cause, and ED can also be a warning sign of a more serious illness including heart disease, high blood pressure, or diabetes. Often treating the underlying condition can restore erectile function.
How many men in the U.S. suffer from erectile dysfunction?
About 30 million men in the U.S. are affected by erectile dysfunction. Most men have difficulty getting or maintaining an erection on occasion, but some men have the problem more frequently or severely. In these men, ED can impact marriage and intimate relationships, it can cause low self-esteem, performance anxiety, depression, and stress.
Which of these is not a cause or risk factor for erectile dysfunction?
Erectile dysfunction is not inherited and is not caused by genetic risk factors. Risk factors for developing ED include:
- age over 50
- high blood pressure
- high cholesterol
- cardiovascular disease
- excessive alcohol use
- being overweight
- lack of physical activity
What remedies or medications are available to treat erectile dysfunction?
The most popular treatments for erectile dysfunction include oral medications that help increase blood flow to the penis resulting in a more rigid or longer-lasting erection. These drugs include sildenafil citrate (Viagra®), vardenafil HCl (Levitra®), and tadalafil (Cialis®).
For patients who cannot tolerate the oral medications, alprostadil (Caverject®, Edex®, Muse®) is another drug that comes in two forms, one where the patient injects it directly into the side of the penis, or as a suppository inserted into the urethra at the tip of the penis.
For men who cannot or do not wish to take medications, external vacuum pumps are available, which help draw blood into the erectile tissue, resulting in an erection.
Which of these statements about ED is true?
Many different types of medications can cause erectile dysfunction as a side effect. High blood pressure medications can cause ED as a side effect. Drugs of abuse such as marijuana, heroin, and cocaine, along with alcohol can also result in ED.
Other causes of ED include surgery, depression, anxiety, stress, marital problems, and performance anxiety.
Surgery to remove prostate cancer can lead to ED.
A potential complication of surgery to remove prostate cancer (radical prostatectomy) includes erectile dysfunction. A newer technique called nerve-sparing radical prostatectomy can offer results in recovery of erectile function over time.
Erectile dysfunction causes low testosterone (low T).
Low testosterone (low T) can cause erectile dysfunction, but ED does not cause low T. In addition to ED, other sexual symptoms of low T include reduced sexual desire (libido), and reduced sexual activity. Nonsexual symptoms include increased body fat, reduced muscle mass, fatigue, and depression.
Erectile dysfunction can be a warning sign for which disease(s)?
Erectile dysfunction can be an early warning sign for heart disease or other vascular problems. Atherosclerosis (hardening of the arteries) in the arteries supplying the penis can inhibit blood flow needed to begin or maintain an erection.
Surgical methods for ED include artery bypass and vein repair.
Surgery is another treatment option in some cases of erectile dysfunction. Surgical intervention is aimed at repairing arteries to restore blood flow to the penis that may be cause by a blockage or leakage. Surgery for ED may involve:
- Repair of leaking veins that prevent maintaining an erection
- Bypassing blocked arteries to re-route blood to the penis
- Blocking veins that take blood away from the penis
Images provided by:
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NIDDK. Erectile Dysfunction. National Kidney and Urologic Diseases Information Clearinghouse.
Urology Care Foundation. ED: Non-surgical Management (Erectile Dysfunction).
National Kidney Foundation. Impotence.
Johns Hopkins Medicine. Prostate Cancer. Erectile Dysfunction Following Radical Prostatectomy.
Urology Care Foundation, Inc. Low Testosterone (Hypogonadism).
Harvard University. Harvard Health Blog. Erectile dysfunction often a warning sign of heart disease.
Sexual Medicine Society of North America, Inc. Vascular Surgery - Erectile Dysfunction.
Caverject® is a registered trademarks of Pfizer.
Cialis® is a registered trademark of Lilly.
Edex® is a registered trademark of Auxilium Pharmaceuticals, Inc.
Levitra® is a registered trademark of Bayer.
Muse® is a registered trademark of Meda Pharmaceuticals Inc.
Viagra® is a registered trademark of Pfizer.
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