It's Fallen and It Won't Get Up

Erectile Dysfunction
An Overview

Erectile dysfunction. Television is full of commercials touting drugs that will help overcome erectile dysfunction and make sex better for the man and woman. But, what is erectile dysfunction, what are some of the causes, and what are the different ways to treat the problem. This discussion is not intended to be all-inclusive. Rather, it will provide some information that can be used to start a discussion with your doctor if you believe you are having trouble with erections.

This Thing Called Erectile Dysfunction
The term erectile dysfuntion is a medical one that states there is a problem getting and/or keeping an erection through the sex act. In essence, the penis does not spring to life during sexual stimulation or, if it does, it wont’t sty that way for long. The condition is often referred to as impotence, but impotence can also imply there may be a lack of sexual desire or a problem with orgasm or ejaculation. So, to specify the problem and label the condition that is the total or inconsistent ability to achieve and sustain an erection we use the term erectile dysfunction.

How Common Is It?
The exact numbers are difficult to obtain, but according to the National Ambulatory Medcial Care Survey (1999), the prevalence is about 2.2 percent or 22 men in 1,000 have sought treatment for erectile dysfunction. Other findings suggest the following incidence:

Chronic erectile dysfuntion

• Approximately 5% of men aged 40-50
• Up to 25% of men 65 and older
• Temporary erectile dysfunction
• Up to 50% of men between 40 and 70 years

Another study conducted by the Massachusetts Male Aging Study (2000) found that 52 percent of men between 40 and 70 experience some degree of erectile dysfunction. Complete inability to achieve an erection was found to be 5% at age 40, gradually increasing to 15% among men aged 70 years.

What Causes It?
There a lot of causes of erectile dysfunction such psychological, physical, and some medications.

Psychological – The effect of stress can cause anxiety leading to reduced ability to achieve an erection. Some of the stresses include:

• Depression
• Problems in the marriage
• Financial problems
• Fears about sex including those generated by religious beliefs
• Effects of a bad sexual experience such as sexual trauma

Physical

Other than diseases that effect the nervous or cardiovascular (heart and blood vessel) system, physical things such as smoking, drug abuse, alcohol abuse, or morbid obesity can reduce the ability to achieve or sustain an erection.

Diseases – There are a number of diseases that can cause erectile dysfunction incluing:

• Spinal cord injury
• Stroke
• Parkinson’s disease
• Multiple sclerosis
• Alzheimer’s disease
• Prostate removal (radical prostatectomy) due to prostate cancer in which the nerves were not spared
• Diabetes
• Heart disease
• High blood pressure
• Low hormones (testosterone)

Medications – Many medications can effect a man’s ability to achieve or sustain an erection. Categories of these medications include:

• High blood pressure medications such as diuretics and beta blockers
• Antidepressants includling tricyclic antidepressants and selective serotonin reuptake inhibitors
• Stomach (antacid) medications such as cimetidine
• Lipid lowering drugs (gemfibrozil, pravastatin, lovastatin)
• Heart medications such as digitalis
• Anti-seizure medications

Can It Be Treated?
While erectile dysfunction cannot be cured per se, it can be treated. Erectile dysfunction is not a disease in an of itself. Rather, it is the result of an underlying disease or the treatment for that illness. Thus, the first step is to discover the underlying cause of the problem. This may lead to changes in lifestyle including cessation of smoking, weight loss, blood pressure control, or control of diabetes.

There are several areas of treatment for erectile dysfunction including:

• Medication therapy with tertosterone Viagra®, Cialis®, or Levitra®
• Herbal remedies and dietary supplements such as yohimbine, arginine, DHEA, maca root
• Injection therapy in which the man injects the penis with medications such as Caverject® or Edex®
• Urethral therapy in which the medication Muss® is inserted
• Mechanial therapy such as the use of a vacuum pump to pull blood into the penis and constricting band to keep it there
• Surgical therapy including implants in the penis as well as surgery on the arteries have been performed

Again, if you think you are having trouble achieving and keeping an erection, please consult your doctor. Do not try to correct the problem on your own, especially do not take any medications before checking with your doctor.

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