The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) states erectile dysfunction (ED) is the inability to get or maintain an erection firm enough for sexual intercourse. Erectile dysfunction is one of the most common male sexual problems. It’s estimated between 15 to 30 million American men suffer from ED.
The American Urological Association Foundation (AUA) says achieving a normal erection is a complex process involving psychological impulses from the brain, adequate levels of testosterone, a functioning nervous system, and adequate and healthy vascular tissue in the penis. Erectile dysfunction can result from a problem with any of these.
The physical and medical causes of ED, according to AUA, include three basic problems: not enough blood flows into the penis; the penis can’t store blood during an erection; and nerve signals from the brain or spinal cord don’t reach the penis.
Mayo Clinic reports in most cases, erectile dysfunction is caused by something physical. Common causes include:
* cardiovascular disease
*clogged blood vessels
*high blood pressure
*diabetes
*obesity
*metabolic syndrome
*high insulin levels, body fat around the waist and high cholesterol
*Parkinson’s disease
*multiple sclerosis
*low testosterone
*Peyronie's disease
*development of scar tissue inside the penis
*certain prescription medications
*tobacco use
*alcoholism and other forms of substance abuse
*treatments for prostate cancer or enlarged prostate
*surgeries or injuries that affect the pelvic area or spinal cord
A number of psychological conditions can cause or worsen erectile dysfunction. These include depression, anxiety or other mental health conditions, stress, fatigue, and relationship problems.
AUA says the most common risk factors for ED are being older than age 50, diabetes, high blood pressure, high cholesterol, smoking and cardiovascular disease.
ED treatment includes lifestyle changes, psychotherapy, oral medications, drug therapy, vacuum devices and surgery.
NIDDK says quitting smoking, reducing alcohol consumption, losing excess weight, and increasing physical activity may help some men regain sexual function. Psychological treatment can help decrease anxiety associated with intercourse.
Oral medications include sildenafil, tadalafil, and vardenafil says Mayo Clinic. They enhance the effects of nitric oxide, a natural chemical the body produces that relaxes muscles in the penis. This increases blood flow and allows an erection in response to sexual stimulation.
AUA says for men who don’t respond to oral medications, another drug, alprostadil, comes in two forms: injections patients place directly into the side of the penis and an intra-urethral suppository.
Mechanical vacuum devices are another choice. NIDDK says they cause erection by creating a partial vacuum, which draws blood into the penis chambers, engorging and expanding the penis.
Surgery can be another option. AUA reports some patients benefit from reconstructive prosthetic surgery. That’s the placement of a penile prosthesis or "implant" that will create an erection.
Sources:
Erectile Dysfunction. Mayo Clinic.com by Mayo Foundation for Medical Education and Research. Web 28 Nov 2011.
http://www.mayoclinic.com/health/erectile-dysfunction/DS00162
Erectile Dysfunction. NIDDK.NIH.gov by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institutes of Health. Web 28 Nov 2011.
http://kidney.niddk.nih.gov/kudiseases/pubs/ED
Erectile Dysfunction - Overview. Familydoctor.org by the American Academy of Family Physicians. Web 28 Nov 2011.
http://familydoctor.org/familydoctor/en/diseases-conditions/erectile-dysfunction.html
Non-Surgical Management of Erectile Dysfunction. UrologyHealth.org by AUA Foundation. Web 28 Nov 2011.
http://www.urologyhealth.org/urology/index.cfm?article=60
NON-SURGICAL MANAGEMENT OF ERECTILE DYSFUNCTION (ED). THE OFFICIAL FOUNDATIONS OF THE AMERICAN UROLOGICAL ASSOCIATION. Web 28 Nov 2011.
http://www.urologyhealth.org/urology/index.cfm?article=60
Reviewed December 12, 2011
by Michele Blacksberg RN
Edited by Jody Smith