What is erectile dysfunction?
An erection involves the brain, nerves, hormones, muscles, and circulatory system. These systems work together to fill the erectile tissue in the penis with blood. A man with erectile dysfunction (ED) has trouble getting or maintaining an erection for sexual intercourse. Some men with ED are completely unable to get an erection. Others have trouble maintaining an erection for more than a short time.
There are many possible causes of ED, and many of them are treatable. Read on to learn more about ED’s causes and how it’s treated.
How prevalent is ED?
ED is more prevalent among older men, but it also affects younger men in large numbers. The University of Wisconsin reports an approximate correlation between the percentage of men affected by mild and moderate ED and their decade in life. For example, approximately 50 percent of men in their 50s and 60 percent of men in their 60s have mild ED.
You may feel embarrassed to discuss ED with your healthcare provider. However, having an honest conversation is worth it, as facing the problem head-on can lead to a proper diagnosis and treatment.
ED in young men
A study in the July 2013 Journal of Sexual Medicine suggests that ED is more common among younger men than previously thought. Researchers found that ED affected 26 percent of adult men under 40. Almost half of these young men suffered from severe ED. That rate is comparable to what is experienced by older men. Researchers also noted that younger ED patients were more likely than older men with ED to smoke or use illegal drugs.
Causes of ED
There are several potential physical and psychological causes of ED. In some cases, ED can be an early sign of a serious health condition.
Getting and keeping an erection requires healthy circulation. Clogged arteries — a condition known as atherosclerosis — is one possible cause of ED. High blood pressure can also lead to ED.
ED can be a sign of diabetes. This is because high levels of blood glucose can damage blood vessels, including those responsible for supplying blood to the penis during an erection. Obesity is a risk factor for diabetes and hypertension. Overweight young men should take steps to lose excess pounds.
Hormonal disorders, such as low testosterone, may contribute to ED. Another possible hormonal cause of ED is increased production of prolactin, a hormone produced by the pituitary gland. Additionally, an abnormally high or low thyroid hormone level can result in ED. Young men who use steroids to help build muscle mass are also at a higher risk for ED.
The feelings of sexual excitement that lead to an erection start in the brain. Conditions such as depression and anxiety can interfere with that process. One major sign of depression is withdrawal from things that once brought pleasure, including sexual intercourse.
Stress related to jobs, money, and other life events can contribute to ED. Alcohol and drug abuse are both common causes of ED among young men. Relationship problems and poor communication with a partner can cause sexual dysfunction in both men and women.
Treatments for ED
Treating the cause of ED may help resolve the problem. Lifestyle changes make a positive difference for some men. Others benefit from medications, counseling, or other treatments. Ignoring ED isn’t wise, particularly because it can be a sign of other health problems.
Healthy lifestyle changes
Healthier eating, getting more exercise, and losing weight may help minimize the problems posed by ED. Quitting cigarettes and cutting back on alcohol use is not only wise but may also help with ED.
Communication with your partner is essential. Performance anxiety can compound other causes of ED. A therapist or other mental health professional may be able to help you. Treating depression, for example, may help resolve ED and bring about additional benefits as well.
Oral phosphodiesterase-5 (PDE5) inhibitors can help treat ED. These medications are recommended before more invasive treatments are considered. PDE5 is an enzyme that can interfere with the action of nitric oxide (NO). NO helps open the blood vessels in the penis to increase blood flow and produce an erection.
Three of the most widely used ED medications are:
All of these drugs require a prescription.
Vacuum constriction devices
Other treatment options may be considered if medications aren’t entirely successful. Vacuum constriction devices are generally safe and effective.
The treatment involves placing a cylinder over the penis. A vacuum is created inside the cylinder. This leads to an erection. A band is placed around the base of the penis to preserve the erection, and the cylinder is removed. The band must be taken off after about 30 minutes.
A last resort for men with ED is the implantation of a penile prosthesis. Simple models allow the penis to bend downward for urination and upward for intercourse. More advanced implants allow for fluid to fill the implant and form an erection. There are risks associated with this operation, as there are with any surgery. It should only be considered after other strategies have failed.
ED can be an uncomfortable topic to discuss, especially for younger men. Remember that millions of other men are dealing with the same issue and that it’s treatable.
It’s important to seek treatment for ED because it may be a sign of other health problems. Addressing the condition directly with your doctor will lead to faster and more satisfactory results.