Erectile dysfunction or ED is a common and important medical problem. It is defined as the partial or total inability to obtain or maintain erections sufficient for sexual performance. This problem is highly age dependent. The prevalence of erectile dysfunction rises from 20% at age 40 to 50% at age 70. It affects up to 30 million men in the United States.
While having erection problems once in a while is not necessarily a major concern, erectile dysfunction that is progressive and occurs regularly is not normal and should be treated. Commonly reported symptoms are difficulty getting or maintaining an erection with or without reduced sexual desire. Despite its increasing occurrence in older men, erectile dysfunction is NOT considered a normal part of the aging process.
Male sexual arousal is a complex function that requires good physical and psychological health. It involves emotions, hormones, healthy nerves, and permeable arteries that can signal and pump blood into the cylindrical chambers of the penis. Erectile dysfunction can result from any disease or disorder that can affect the function of nerves or the circulation in the arteries.
The physical causes of erectile dysfunction are heart disease, high cholesterol, high blood pressure, diabetes, and clogged arteries. Additionally, men who have undergone treatment for prostate cancer or lower spinal cord injury may suffer from erectile dysfunction. The most often overlooked causes are medications for diabetes, high blood pressure, heart disease, and depression, which can also cause erectile dysfunction as a side effect.
Lifestyle factors such as smoking, obesity, sedentary behaviors and excessive alcohol consumption are important risk factors that play a major role in the progression of erectile dysfunction. If you look closely, these are the same risk factors for high blood pressure and heart disease.
A symptom of erectile dysfunction can be an early indication of heart disease, such as a heart attack. Additionally, erectile dysfunction can be a warning sign that can help identify and prevent serious illness in the future. Discussing the symptoms of erectile dysfunction with your doctor and addressing the risk factors can help prevent a catastrophic event. Often we find that erectile dysfunction is related to something else, such as poor control of diabetes, use of narcotic painkillers, or an underlying neurological disease.
Erectile function is a condition with profound psychological consequences and can interfere with a man’s general well-being, self-esteem and interpersonal relationships. Normal erectile function requires mind and body to work together. Depression, anxiety, workplace stress, social and cultural conflict, and worry about sexual performance are all strongly associated with erectile dysfunction.
ED is a treatable problem. Options include a wide range of therapies ranging from medications to surgery. Drugs such as Viagra and Cialis, intraurethral suppositories, vacuum erection devices, penile injections and implants are among them. Recently, wave therapy has become popular for treating erectile dysfunction; however, there is currently not enough data to support that it works effectively compared to other standard treatments. Additionally, these newer treatments are not FDA approved for the treatment of erectile dysfunction.
Preventing erectile dysfunction is easier than treating it. Exercising regularly, reducing stress, quitting smoking, limiting or avoiding alcohol, regular checkups, and well-controlled diabetes are the secrets to avoiding erectile dysfunction.
I always encourage patients to talk with their doctor about healthy living and goal setting, which can help reduce the need for prescription medications. Often many medications can be discontinued once you optimize your health with good lifestyle habits.
Dr. Raj Ayyathurai is board certified in urology and specializes in all aspects of genitourinary surgery with a particular focus on prevention and management of kidney stones, minimally invasive treatments for BPH and female urinary incontinence . He is a robotically trained surgeon and urologist who practiced at the Lecanto and Dunnellon Advanced Urology Institute. Dr. Raj is known for his humility and patient friendly approach. He believes and practices that great results are achieved through effective communication and understanding patients of their condition and treatment options. He is a firm believer in the saying “I dressed your wounds, God healed them”.