What is erectile dysfunction?
Erectile dysfunction is a very common condition for aging men, but is it a normal part of the aging process? Though it’s a sensitive topic, it's important to discuss any signs of erectile dysfunction with your doctor -- especially because erectile dysfunction is sometimes the first sign of underlying health conditions such as cardiovascular problems.
Erectile dysfunction, also known as ED or impotence, is defined as the inability to maintain a penile erection sufficient for successful sexual intercourse. Achieving an erection is a complex process involving the brain, hormones, nerves, muscles, and blood circulation. If something interferes with this process, the result can be erectile dysfunction.
Signs and symptoms of erectile dysfunction
Symptoms of ED include:
- Being able to achieve an erection sometimes but not every time you want to have sex
- Being able to achieve an erection that doesn’t last long enough for intercourse
- Being unable to achieve an erection at all
Causes of erectile dysfunction
It is more likely that you’ll develop ED as you get older, but aging itself does not cause erectile dysfunction. Many factors can cause erectile dysfunction, including those that affect your endocrine, vascular and nervous systems.
There are several risk factors for erectile dysfunction in aging men, including:
Depression can have many sexual side effects, including erectile dysfunction. Medications called selective serotonin reuptake inhibitors (SSRIs) that are used to treat depression can also affect sex drive, erectile function, and the ability to orgasm.
Type 2 diabetes has been shown to interfere with erectile function, and male patients with diabetes tend to have an earlier onset of erectile dysfunction. Hyperglycemia (high blood sugar) stimulates the production of chemicals that can interfere with erectile physiology.
Hypertension (high blood pressure) is associated with ED and is seen more commonly among aging men. In addition, medications prescribed for hypertension, such as beta blockers and thiazide diuretics, have been shown to have detrimental effects on erectile function.
Lack of physical activity
A sedentary lifestyle can have detrimental effects on erectile function as well as testosterone levels.
As men age, the amount of testosterone in their bodies gradually declines. Although a direct cause and effect relationship between testosterone deficiency and erectile dysfunction has not been proven, decreased testosterone levels in patients with erectile dysfunction have been observed in clinical settings.
Diagnosing erectile dysfunction
For most men with erectile dysfunction, undergoing a physical exam and answering questions about your medical history are sufficient for your doctor to diagnose erectile dysfunction and make recommendations for treatment.
If your doctor suspects that you may have an underlying condition, however, you might need further tests or a consultation with a specialist. Tests for underlying conditions can include:
- A physical exam: Your doctor will examine your penis and testicles for signs of abnormalities and will test sensation.
- Blood tests: Blood tests can show if you may have heart disease, diabetes, low testosterone levels, or other issues.
- Urine tests: Urinalysis is used to look for signs of diabetes and other health conditions.
- An ultrasound: A specially trained technician will use a wand-like device (transducer) over the blood vessels that supply the penis to analyze for blood flow issues.
- A psychological exam: Your doctor may want to evaluate you for depression or other mental illnesses that may cause erectile dysfunction.
Treatments for erectile dysfunction
Options for treating erectile dysfunction include:
It is possible to achieve an improvement of erectile function in aging men without medication. Changes in dietary habits, cessation of smoking, regular exercise, and weight loss should be the first line of defense.
Medications used to treat ED include:
There are also ED medications that can be delivered directly into the penis, either via injection or a dissolvable pellet.
In men with low testosterone, “normalizing” testosterone levels has multiple benefits, most notably improved libido and improved erectile function.
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Harvard Medical School: "Which drug for erectile dysfunction?"
Mayo Clinic: "Erectile Dysfunction."
The Journal of Sexual Medicine: "Effects of Intensive Lifestyle Changes on Erectile Dysfunction in Men."
The National Institute of Diabetes and Digestive and Kidney Diseases: "Symptoms and Causes of Erectile Dysfunction."
Truth Initiative: "3 ways tobacco use impacts your sex life."
Turkish Journal of Urology: "Erectile dysfunction in the elderly male."
University of Wisconsin Health: "Erectile Dysfunction (ED)."
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