Erectile dysfunction, sometimes known as ED or by the older term impotence, occurs when a man is unable to maintain an erection that is firm enough to have sexual intercourse. The complexity of the male sexual response, which includes emotions, hormones, nerves, muscles, blood vessels and the brain, means that there are many possible reasons for ED.
Erectile Dysfunction Causes
There is no specific age at which erectile dysfunction appears, but it is more common in older men. One study, published in the 2003 issue of “Annals of Internal Medicine,” indicated that sexual function usually decreases dramatically in men after age 50. By age 80, 90% of the men in the study had ED. Erectile dysfunction in young men under certain conditions, such as excessive alcohol intake, substance abuse or injury. The complexity of the male sexual response means that anything which interferes with the physical, neurological, chemical or emotional aspects can cause ED. The major categories of erectile dysfunction causes include medical conditions, medical treatments, medications, recreational drugs, emotional disturbances and injury.
• Medical conditions or physical problems that may cause ED include heart disease, vascular disease, high blood pressure, diabetes, obesity, Parkinson’s disease and multiple sclerosis.
• Medical treatments for enlarged prostate or prostate cancer, especially surgery, may cause ED.
• A wide variety of medications have been implicated in ED: antihypertensive drugs, diuretics, antidepressants, antihistamines, non-steroidal anti-inflammatory medications (NSAIDs), heart medications, muscle relaxants and chemotherapy drugs.
• Recreational drugs, both legal and illegal, may cause ED or make it worse. Alcohol, tobacco and most recreational drugs negatively affect the male sexual response.
• Emotional disturbances may cause ED. Depression, stress, fatigue and anxiety may affect the brain and cause disturbances in the ability to feel sexually excited.
• Injury to the pelvic area or the penis can cause ED because it affects the blood vessels that cause erection. Riding a bicycle for a long time may cause pressure on the nerves in the perineum and cause temporary ED.
Erectile Dysfunction Treatment
The first step in erectile dysfunction treatment is to determine the cause. Your doctor will conduct a physical examination and perform blood and urine tests to check for chronic disease such as diabetes. Other tests may include testosterone levels or diagnostic tests for heart disease. An ultrasound of the penis can determine whether there is adequate blood flow to the penis, and an overnight erection test may be done to see if erections are occurring during sleep. A man who is able to have nighttime erections is more likely to have a psychological cause for ED.
Erectile Dysfunction Treatments
Medical treatment for ED includes medication changes, treatment for chronic health problems, ED medications, medical devices and surgery.
• If ED is due to a side effect of a medication such as an antihypertensive drug, your doctor may suggest a different medication.
• Uncontrolled diabetes and hypertension can cause ED, and the condition may improve if these diseases are treated and well-managed. Treatment may include activities such as changes in diet to promote weight loss and regular exercise, both of which may improve sexual function.
• Oral ED medications are available by prescription. They are normally taken an hour or more prior to intercourse. These medications may have side effects and usually cannot be taken if you are also taking nitrates or blood thinners. Other ED medications include a self-injection into the penis with a very fine needle, a penile suppository or testosterone replacement therapy.
• Medical devices include penis pumps and penile implants. A penis pump uses a hand or battery-powered vacuum pump to pull blood into the penis and a ring at the base of the penis to keep blood from flowing out. Penile implants can be inflatable devices or semi-rigid rods; both are surgically implanted into the penis.
• Occasionally, blood vessel surgery is necessary to improve circulation or repair a leaking vessel.
Erectile Dysfunction Natural Cures
Natural treatments for ED include acupuncture, Panax ginseng, yohimbine, DHEA, gingko, L-arginine and zinc supplements. There is little research on the effectiveness of these therapies.
• Acupuncture is thought to regulate the nervous system
• Panax ginseng is thought to increase sexual function
• Yohimbine is the bark of an African tree that increases libido but can be dangerous in even small doses
• DHEA is needed to manufacture testosterone
• Gingko relaxes smooth muscle and increases blood flow.
• L-arginine is an amino acid used by the body to make nitrous oxide, which make the blood vessels dilate and can increase blood flow.
• Zinc deficiency can cause erectile dysfunction.