What's in this article?
About Erectile Dysfunction
Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It is also sometimes also referred to as impotence.
Occasional ED is not uncommon. Many men experience it during times of stress. However, frequent ED can be a sign of health problems that need treatment. It can also be a sign of emotional or relationship difficulties that may need to be addressed by a professional.
Not all male sexual problems are caused by ED. Other types of male sexual dysfunction include:
- premature ejaculation
- delayed or absent ejaculation
- lack of interest in sex
Symptoms of Erectile dysfunction
Erectile dysfunction symptoms might include persistent:
- Trouble getting an erection
- Trouble keeping an erection
- Reduced sexual desire
Why does erectile dysfunction happen?
Erectile dysfunction can have a range of causes, both physical and psychological. Physical causes include:
- narrowing of the blood vessels going to the penis – commonly associated with high blood pressure (hypertension), high cholesterol or diabetes
- hormonal problems
- surgery or injury
Psychological causes of ED include:
- anxiety
- depression
- relationship problems
Sometimes erectile dysfunction only occurs in certain situations. For example, you may be able to get an erection during masturbation, or you may find that you sometimes wake up with an erection but you are unable to get an erection with your sexual partner.
If this is the case, it is likely the underlying cause of erectile dysfunction is psychological (stress related). If you are unable to get an erection under any circumstances, it is likely that the underlying cause is physical.
Erectile dysfunction can also be a side-effect of using certain medicines.
How common is erectile dysfunction?
Most men have occasional times when they cannot get an erection. For example, you may not get an erection so easily if you are tired, stressed, distracted, or have drunk too much alcohol. For most men it is only temporary, and an erection occurs most times when you are sexually aroused.
However, some men have persistent, or recurring, ED. It can occur at any age, but becomes more common with increasing age. About half of men between the ages of 40 and 70 have ED. About 7 in 10 men aged 70 and above have ED.
What are erectile dysfunction risk factors?
The common risk factors for ED include the following:
- Advanced age
- Cardiovascular disease
- Diabetes mellitus
- High cholesterol
- Cigarette smoking
- Recreational drug use
- Depression or other psychiatric diseases
Treatment for erectile dysfunction
There are many treatments for erectile dysfunction. These include:
- changing your prescription medications if they are the cause
- psychotherapy and counselling
- oral medications (tablets) such as viagra®, cialis® and levitra®
- external vacuum penile pump devices to create blood flow
- injections directly into the penis (such as Caverject Alprostadil®)
- penile prosthetic implants
- hormone therapy (rarely given)
- vascular surgery (rarely undertaken).
The first approach is to treat the underlying cause if one has been identified, or if not, to use treatments to promote a better erection.
Doctors usually start with the least invasive treatment, such as tablets. If that fails, they may suggest more complicated injection treatments or surgery.
Sometimes, treatment of the cause may restore erectile function, for example, testosterone replacement, resolving substance abuse problems or withdrawing medications that may be causing the erectile dysfunction. Mostly, treatment aimed at directly restoring erectile function is necessary.
There are many treatments aimed at restoring erectile function. These can be grouped according to their level of invasiveness, being:
- non-invasive treatments
- minimally invasive treatments
- surgical treatments.
