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Erectile Dysfunction (ED)

What is erectile dysfunction?

When a man can't get an erection to have sex or can't keep an erection long enough to finish having sex, it's called erectile dysfunction. Erectile dysfunction is also called impotence.

Is erectile dysfunction just a part of old age?

Erectile dysfunction doesn't have to be a part of getting older. It's true that as you get older, you may need more stimulation (such as stroking and touching) to get an erection. You might also need more time between erections. But older men should still be able to get an erection and enjoy sex.

Physical causes of erectile dysfunction

  • Alcoholism
  • Fatigue
  • Atherosclerosis (hardening of the arteries)
  • Diabetes · Brain or spinal-cord injuries
  • Hypogonadism (which leads to lower testosterone levels)
  • Liver or kidney failure
  • Multiple sclerosis · Parkinson's disease
  • Radiation therapy to the testicles
  • Stroke
  • Some types of prostate or bladder surgery

What causes erectile dysfunction?

Some of the following medical problems can cause erectile dysfunction:

  • Diabetes (high blood sugar)
  • Hypertension (high blood pressure)
  • Atherosclerosis (hardening of the arteries)

If you can't keep your blood sugar or your blood pressure under control, you can get erectile dysfunction. It's important that you take your medicines for these problems just the way your doctor tells you.

Sometimes your hormones get out of balance and this causes erectile dysfunction. Your doctor will decide if you need blood tests to check your hormones.

Some medicines can cause this problem. If this is true for you, your doctor may take you off that medicine or give you a different one.

Drinking too much alcohol, smoking too much and abusing drugs can also cause erectile dysfunction.

Problems in your relationship with your sexual partner also can cause erectile dysfunction. You might try therapy to see if improving your relationship helps your sex life. Therapy will probably be most effective if your sex partner is included. Couples can learn new ways to please one another and to show affection. This can reduce any of your anxiety about having erections.

Feelings that can lead to erectile dysfunction
  • Feeling nervous about sex, perhaps because of a bad experience or because of a previous episode of impotence
  • Feeling stressed, including stress from work or family situations
  • Being troubled by problems in your relationship with your sex partner
  • Feeling depressed
  • Feeling so self-conscious that you can't enjoy sex
  • Thinking that your partner is reacting negatively to you

How is erectile dysfunction diagnosed?

Your doctor will probably start by asking you some questions and doing a physical exam. Samples of your blood and urine may be tested for diseases and disorders. Other tests may also be needed. Your doctor will determine which tests are right for you.

How is erectile dysfunction treated?

How erectile dysfunction is treated depends on what things are causing it. After your doctor checks you for medical problems and medicines that might cause erectile dysfunction, he or she may have you try a medicine to help with erectile dysfunction. Some of these medicines are injected into your penis. Other medicines are taken by mouth. Not everyone can use these medicines. Your doctor will help you decide if you can try them.

What other options do I have?

If the medicines aren't right for you, you could also try using vacuum pump devices, or you could have surgery. Your doctor may send you to an urologist to talk about these options.

Source

Newer Pharmacologic Alternatives for Erectile Dysfunction (American Family Physician September 15, 1999, http://www.aafp.org/afp/990915ap/1159.html)

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