Erectile dysfunction, also referred to as impotence, is a man’s inability to get or keep an erection suitable for sexual activity.

While many men have occasional trouble maintaining an erection due to factors like stress or alcohol consumption, erectile dysfunction is an ongoing problem. This condition can lead to several complications—both mental and physical.

Symptoms and Complications

The symptoms of erectile dysfunction include:

• Difficulty getting or keeping an erection
• Reduced desire for sex

Make an appointment with your doctor if you notice other signals of erectile dysfunction, such as premature or delayed ejaculation, or if you have diabetes, heart disease, or other health conditions that may be linked to erectile dysfunction.

Erectile dysfunction can affect your social and mental health just as much as your physical health:

• Stress or performance anxiety, often coupled with embarrassment and low self-esteem
• Limited or unsatisfactory sex life
• Depression
• Relationship problems
• Inability to get a partner pregnant

Causes

Both physical and psychological factors can cause erectile dysfunction. In many cases, men experience a combination of factors that contribute to impotence. Physical causes of erectile dysfunction can include:

• Heart disease, high blood pressure, or high cholesterol
• Diabetes
• Obesity
• Parkinson’s disease
• Multiple sclerosis
• Metabolic syndrome
• Tobacco use, alcoholism, and other forms of substance abuse
• Prostate cancer treatments
• Surgeries or injuries in the pelvic area or spinal cord
• Peyronie’s disease (formation of scar tissue inside the penis)
• Some prescription medications
• Certain sleep disorders

Psychological causes of erectile dysfunction can include:

• Depression or anxiety
• Stress
• Relationship issues

Risk Factors

Erectile dysfunction involves several other factors, which varies from person to person:

• Tobacco use: Using tobacco can restrict blood flow in important areas, and cause health conditions that lead to erectile dysfunction
• Previous psychological or medical conditions
• Prolonged bicycling: Men who bike often may experience compressed nerves and limited blood flow to the penis, which can cause temporary or even permanent erectile dysfunction
• Weight: Obesity is linked to some cases of erectile dysfunction
• Injuries: Injuries that damage nerves or arteries related to erections can cause dysfunction
• Drug or alcohol use: Especially over longer periods of time, drug and alcohol consumption can increase your risk of erectile dysfunction
• Medications: Antidepressants, antihistamines, and certain other medications can lead to erectile dysfunction.

Treatments

Treatment for erectile dysfunction depends on specific details that vary case by case. Factors in treatment decisions may involve both your preferences and your partner’s preferences. Medications used to treat erectile dysfunction include:

• Sildenafil (Viagra)
• Avanafil (Stendra)
• Vardenafil (Levitra)
• Tadalafil (Cialis)

These medications are meant to strengthen the effects of nitrous oxide, a natural chemical that helps relax the penis muscles and increase blood flow to the penis to help you get an erection. These medications may have side effects, or may take a period of time to work correctly. They also don’t always work for everyone, and you should consult your doctor before taking them. Some situations, however, may make these medications dangerous if you:

• Have abnormally low or high blood pressure
• Have severe liver or kidney disease
• Take nitrate drugs for chest pain

Your doctor may also recommend other medications including:

• Alprostadil urethral suppository: This involves placing a suppository—a small round or cone-shaped object used to administer medication—in the penis to help stimulate erections.
• Self-injections: Medications can be injected directly into the penis, helping produce an erection lasting 20 to 40 minutes.
• Testosterone replacement therapy: In some cases, low testosterone is a primary cause of erectile dysfunction. Replacing testosterone can help reverse the effects, though there may be side effects you should discuss with your doctor.

Your doctor may recommend a different solution if medications aren’t the appropriate treatment for you:

• Penis pumps: This is a hollow tube with a pump that is placed over the penis, creating an air vacuum to draw in blood. After an erection is achieved, you will place a tension ring around the penis to hold in the blood. If successful, it will allow an erection long enough for sex.
• Penile implants: These are surgically placed devices in both sides of the penis, either with inflatable or semirigid rods. They allow you to control when you have an erection.
• Surgery: Blood vessel surgery is rarely used to bypass obstructed arteries to the penis, but it can be used to treat erectile dysfunction.

In some cases, men find counseling beneficial to deal with the mental aspects of erectile dysfunction.

Prevention

Preventing erectile dysfunction involves healthy lifestyle choices that help you manage current health conditions. Preventive methods include:

• Manage diabetes, heart disease, or other conditions properly, including coordinating with your doctor
• Exercise regularly
• Stop smoking, drinking heavily, or using illegal drugs
• Reduce stress levels—often including therapy for anxiety or depression.

If you notice signs of erectile dysfunction, or have a condition that relates to it, speak to your doctor.

Our staff offers a variety of services, including in-office PSA testing, a screening for prostate cancer. We work with you and your primary care physician to develop an individualized care plan for you based on the latest technology and research.

Sources:

“What is Erectile Dysfunction?” Urology Care Foundation. http://www.urologyhealth.org/urologic-conditions/erectile-dysfunction

“Erectile dysfunction.” The Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/basics/definition/con-20034244