When you think about erectile dysfunction (ED), you have visions of an old man unable to “get it up”. Surprisingly it’s more common than you think and doesn’t only affect the older generation. ED is no longer an age-related problem and affects more younger people as mental health and physical health decline.
What Is It?
Impotence means that a man’s penis doesn’t get hard enough to have sexual intercourse. The man cannot get or maintain an erection. The medical term is erectile dysfunction (ED).
ED is not the same as premature ejaculation.
The major causes of ED include:
- Vascular (blood vessel) disease — Erections happen when blood collects in the shaft of the penis. Vascular disease is any abnormal condition of the blood vessels (arteries and veins) and can limit the amount of blood flowing to or staying in the penis. Both can result in problems with erections.
- Vascular disease is the most common medical cause of impotence.
- Nerve damage — Nerves must be working normally for a man to get and keep an erection. Your nerves can be damaged by diabetes, multiple sclerosis, prostate surgery or damage to the spinal cord.
- Psychological factors — Psychological issues such as depression, anxiety, guilt or fear can sometimes cause sexual problems. These factors were thought to be the primary cause of impotence at one time. Doctors now know that physical factors cause ED in most men with the problem. However, embarrassment or “performance anxiety” can worsen a physical problem.
- Medications — Many medications cause problems with sexual function. These include high blood pressure, depression, heart disease, and prostate cancer medicines.
- Hormonal problems — Abnormal levels of certain hormones can interfere with erections and sex drive. Hormonal problems, such as a low testosterone level, are an uncommon cause of ED.
Symptoms
A man with ED has either a problem getting an erection or difficulty maintaining one. This usually interferes with sexual activity.
ED can happen suddenly or gradually. Some men slowly lose the firmness of their erections or how long the erections last.
The problem may occur unpredictably in other men, especially those whose ED is primarily caused by psychological factors. This form of ED can improve at any time.
Men with ED may continue to have normal orgasm and ejaculation without a full erection.
Diagnosis
Your doctor will ask you about your medical history. They will want to learn if any medical conditions might be causing the ED. These may include vascular, neurological and hormonal disorders.
Vascular disorders affect the entire body. Many men who have ED because of vascular disease also have a history of heart disease, stroke or poor circulation in their legs.
Neurological problems can contribute to ED in men with diabetes and spinal cord injury history. They also can cause symptoms in other parts of the body.
A reduced sex drive often accompanies ED in men with abnormal hormone levels.
Your doctor will review the medications you take. These include over-the-counter products and herbal remedies.
Your doctor will ask about your sex life. They will ask about the quality of your sexual relationships.
Your doctor may examine you to look for evidence of medical problems. This will include an examination of your penis and testes. Your blood may be tested for blood sugar, cholesterol and levels of certain hormones.
Your doctor may not be able to give you a specific reason why you have ED. But many of the treatments work well no matter what caused the problem. So extensive testing may not be necessary.
Expected Duration
How long your ED lasts depends upon what causes it and how quickly your treatment starts to work. ED is treatable in all age groups.
Prevention
You can decrease your risk of developing erectile dysfunction by making lifestyle choices that help keep your blood vessels healthy and help prevent type 2 diabetes.
The following steps may help:
- Eat a healthy diet and exercise daily
- Avoid cigarette smoking
- Maintain normal blood pressure
- Maintain normal cholesterol levels
Because certain medications cause ED, ask your doctor about possible side before you start a new prescription.
Treatment
There are many effective treatments for ED. The most popular is a class of drugs in pill form. They work in most men. But they are less effective in men with neurological causes of ED.
The pills are generally safe. However, they can interact with other medications and cause dangerously low blood pressure. Always review the risks with your doctor. For example, you should not take ED pills if you use nitroglycerin or other nitrate medications.
The most concerning side effects are sudden onset of vision or hearing loss. This occurs very rarely but requires immediate medical attention. ED pills can cause other side effects, such as flushing and headache.
If you find ED pills don’t work for you or you can’t use them because of potential side effects, your doctor can recommend other therapies.
Taking extra testosterone will not necessarily improve ED. However, for men who have abnormally low hormone levels, testosterone replacement may enhance sexual drive.
Psychological therapy can be effective in men whose ED is caused primarily by psychological factors. This might include counselling, behavioural therapy or couples’ therapy.
Men who do not benefit from medical or psychological treatment often succeed with mechanical or prosthetic devices. External products, known as vacuum erection devices, are safe and highly effective. But many men and their partners find them unappealing.
Another option is a surgically placed penile implant. Only a small number of men with ED choose this option.
Vascular (blood vessel) surgery sometimes is recommended for young, healthy men who develop impotence after trauma to the groin.
When To Seek Help
Speak to your doctor if you have trouble getting or keeping an erection over three months or more.
ED caused by psychological factors may get better on its own. But treatment is needed if the problem is caused by a physical factor.
Prognosis
In general, the outlook for men with ED is excellent.
Most cases of ED have medical causes that cannot be cured. Still, many treatment options will help restore sexual function.
Several causes of ED can be cured. These include impotence caused by psychological problems, hormonal disorders and traumatic injury to the penile arteries.
Concerned you may be experiencing ED?
Get assessed online by an Aussie doctor now with Harley
