- What Is
- Is ED Normal?
- Signs and Symptoms
What is erectile dysfunction?
Formerly known as impotence, erectile dysfunction (ED) is the ongoing inability to have an erection that is hard enough for penetration. Another symptom is an erection that does not last long enough for the completion of sexual activity. ED can have a significant impact on the sex life of a man and his partner.
Many men experience erectile dysfunction intermittently, especially during times of stress. If it is a recurring event, however, it can signal an underlying medical or emotional issue. This should be addressed by a healthcare professional.
An erection occurs because of increased blood flow to your penis. ED can occur as a problem in any stage of the erection process. It may be related to problems with blood flow to your penis, nerve damage, or stressors and emotions.
Symptoms of erectile dysfunction
The primary symptom of erectile dysfunction is the inability to get or keep an erection. This condition prevents you from having or completing sexual activity.
Causes of erectile dysfunction
Erectile dysfunction is more common in older men but can happen at any age. Causes of ED include:
- High blood pressure
- Atherosclerosis (hardening of the arteries)
- Stress, anxiety, or depression
- Alcohol or tobacco use
- Some prescription medicines
- Brain or spinal cord damage
- Low testosterone
- Multiple sclerosis
- Parkinson’s disease
- Radiation therapy to the testicles
- Some types of prostate or bladder surgery
Erectile dysfunction can be an indicator of a larger problem. It may be uncomfortable, but it is important to discuss it with your doctor. With your doctor’s assistance, you can get to the cause of the problem by pursuing treatment for your ED.
Some causes of erectile dysfunction can also be psychological:
Diagnosis for erectile dysfunction
Your doctor will be able to diagnose the cause of your erectile dysfunction and decide on what the best treatment is.
Expect your doctor to ask questions about your overall health, check your heart and blood pressure, and gather information about your erectile dysfunction. They may also draw blood for lab tests or refer you to an urologist.
Other tests that your doctor may use to assess your erectile dysfunction are:
- An ultrasound to examine the blood vessels in the penis and blood flow
- Nocturnal penile tumescence (NPT) test to evaluate the quality of your nocturnal erections
- An injection test during which medication is injected into your penis to stimulate an erection so that your doctor can see how long it lasts
- Urine tests to check for diabetes or other underlying health conditions
Treatments for erectile dysfunction
The treatment for your erectile dysfunction will depend on the cause.
Heart and vascular health
Your doctor may make suggestions to improve your overall health, including the health of your heart and circulatory system. Increasing your amount of exercise, eating well, and ensuring that you get sufficient vitamins and minerals can help with this overall wellbeing. Another recommendation may be reducing or eliminating your use of drugs, tobacco, or alcohol. Your doctor may also recommend losing weight.
Your doctor may recommend pursuing some mental health support to alleviate the impact of stress, depression, or anxiety on your ED. Seeking help from a mental health professional can help treat erectile dysfunction.
Other treatments for erectile dysfunction
There are a variety of other options to treat erectile dysfunction including medication, surgical options, injections, or vacuum devices:
- Oral drugs or pills are often prescribed for ED (Viagra, Cialis, Levitra, Stendra)
- Testosterone Therapy (if blood tests indicate low testosterone)
- Penile Injections (ICI, intracavernosal Alprostadil)
- Intraurethral medication (IU, Alprostadil)
- Vacuum Erection Devices
- Penile Implants
- Surgery to bypass penile artery damage for some younger men with a history of severe pelvic trauma (this procedure is not recommended for older men with hardened arteries)
Many men find relief through a combination of these treatments. Your doctor will help you decide the fastest and best method for curing your erectile dysfunction.
Is erectile dysfunction a normal part of aging?
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.
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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.
Health Solutions From Our Sponsors
Current Opinion in Urology: "Testosterone Therapy Improves Erectile Function and Libido in Hypogonadal Men."
Family Doctor: "Erectile Dysfunction (ED)."
Harvard Health Publishing: "All-natural tips to improve your sex life."
Harvard Medical School: "Which drug for erectile dysfunction?"
The Journal of Sexual Medicine: "Effects of Intensive Lifestyle Changes on Erectile Dysfunction in Men."
Mayo Clinic: "Erectile dysfunction."
National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center: "Treatment for Erectile Dysfunction."
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)."
Urology Care Foundation: "What is erectile dysfunction?"
Yale Medicine: "Why Men Should Not Ignore Erectile Dysfunction."
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