Erectile Dysfunction

Erectile dysfunction, commonly referred to as ED, is the inability to achieve or maintain an erection suitable for sexual intercourse. It is estimated that ED affects up to 30 million men in the United States, including over half of men between the age of 40 and 70 years old.

Symptoms

Symptoms may include persistent:

  • Trouble getting an erection
  • Trouble keeping an erection
  • Reduced sexual desire

 

Causes

A successful erection is dependent on the following conditions:

  • Properly functioning nerves to the penis
  • Adequate blood circulation into the penis
  • The veins must be able to “trap and keep” the blood inside the penis
  • A stimulus from the brain

If something is interfering with any or all of these conditions, a full erection will not be achieved.

Causes of ED can be either physical or psychological in nature

Physical Causes

  • Heart disease
  • Diseases that affect blood flow, such as atherosclerosis or venous leakage
  • High cholesterol
  • High blood pressure
  • Diabetes
  • Obesity
  • Parkinson’s disease
  • Multiple sclerosis
  • Low testosterone
  • Peyronie’s disease (scar tissue in the penis)
  • Certain medicines
  • Tobacco use
  • Alcoholism and other forms of substance abuse
  • Prostate surgery or radiation treatment for prostate cancer
  • Surgeries or injuries that affect the pelvic area or spinal cord

Psychological causes

  • Depression, anxiety or other mental health conditions
  • Stress
  • Relationship problems

When to see a doctor for ED

Occasional failure to achieve an erection can occur for a variety of reasons. Failure to achieve an erection less than 20% of the time is not unusual and typically does not warrant treatment. However, a failure to achieve an erection more than 50% of the time is indicative of a problem than may cause stress, relationship problems and self-confidence issues and requires medical attention

 

Diagnosis

In addition to reviewing your medical history and performing a thorough physical exam, the doctor will ask you a multitude of questions about your personal and sexual history.

The following tests may also be administered if deemed necessary:

  • Blood tests to check for signs of heart disease, diabetes, low testosterone levels and other health conditions.
  • Urinalysis to look for signs of diabetes and other underlying health conditions.
  • Ultrasound to check blood flow to the penis.
  • Overnight erection test to determine whether the cause of the ED is most likely psychological.