Symptoms, diagnosis & treatment of Erectile Dysfunction (ED)
Erectile dysfunction, commonly referred to as ED, is the inability to achieve and sustain an erection suitable for sexual intercourse. This condition is different from other problems that interfere with sexual intercourse, such as lack of sexual desire and problems with ejaculation and orgasm.
How common is ED?
According to the National Institutes of Health, approximately 5% of 40-year-old men and between 15% and 25% of 65-year-old men experience ED on a long-term basis.
A much more frequent problem that affects the majority of men at some point in their life is the occasional failure to achieve an erection, which can occur for a variety of reasons.
What causes ED?
In order to achieve an erection, these conditions must occur:
- The nerves to the penis must be functioning properly.
- The blood circulation into the penis must be adequate.
- The veins must be able to “trap and keep” the blood inside the penis.
- There must be a stimulus from the brain.
If there is something interfering with any or all of these conditions, a full erection satisfactory for penetration may not occur.
Common causes of ED include diseases that affect blood flow, such as atherosclerosis (hardening of the arteries) or venous leakage (weak veins), neurological diseases, psychological factors such as stress, depression, and performance anxiety, and injury to the penis. Chronic illness, certain medications, and a condition called Peyronie’s disease (scar tissue in the penis) can also cause ED.
Can ED be prevented?
For people who are at risk of developing ED due to personal behavior, such as smoking, steps may be taken to prevent it. However, other causes of ED may not be preventable.
What should I do if I’m having problems achieving/maintaining an erection?
If you suspect you may have erectile dysfunction, see your doctor. He or she can perform a variety of tests to identify what is causing your problem and refer you to a specialist if needed. Once the cause is identified, there are several treatments to consider.
How is ED treated?
There are many different ways erectile dysfunction can be treated, including oral medications, psychological sex therapy, penile injections, urethral (penis) suppositories, vacuum pumps, and surgery. Each type of treatment has its own advantages and disadvantages. Talk to your doctor to determine the best treatment for you.
Poor sexual function is not always due to poor erections. Some men believe they have erectile dysfunction (ED) when their problem may really be that they have an orgasm too quickly. In this situation, drugs commonly used to treat erectile dysfunction are less likely to help. These men have what is known as premature ejaculation (PE). Fortunately, there are effective remedies for this male problem as well.
The first step is to identify which problem is causing the trouble, PE, ED or a combination of both. This is done through a consultation, sometimes blood tests, and sometimes in-office testing to check the nerves and blood flow to the penis. Once the correct problem is identified, then a comprehensive treatment plan can be formulated including behavioral modification, topical anesthetic gel and medication designed to prolong the time to ejaculation. The majority of men with this problem should see satisfactory improvement on this program.