What is erectile dysfunction (ED)?
Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It’s also sometimes referred to as impotence.
Occasional ED isn’t uncommon. Many men experience it during times of stress. Frequent ED can be a sign of health problems that need treatment. It can also be a sign of emotional or relationship difficulties that may need to be addressed by a professional.
Not all male sexual problems are caused by ED. Other types of male sexual dysfunction include:
- premature ejaculation
- delayed or absent ejaculation
- lack of interest in sex
What are the symptoms of ED?
You may have erectile dysfunction if you regularly have:
- trouble getting an erection
- difficulty maintaining an erection during sexual activities
- reduced interest in sex
Other sexual disorders related to ED include:
- premature ejaculation
- delayed ejaculation
- anorgasmia, which is the inability to achieve orgasm after ample stimulation
You should talk to your doctor if you have any of these symptoms, especially if they’ve lasted for two or more months. Your doctor can determine if your sexual disorder is caused by an underlying condition that requires treatment.
What causes ED?
There are many possible causes for ED, and they can include both emotional and physical disorders. Some common causes are:
- cardiovascular disease
- damage from cancer or surgery
- obesity or being overweight
- increased age
- relationship problems
- drug use
- alcohol use
ED can be caused by only one of these factors or several. That’s why it’s important to work with your doctor so that they can rule out or treat any underlying medical conditions.
What causes an erection?
An erection is the result of increased blood flow into your penis. Blood flow is usually stimulated by either sexual thoughts or direct contact with your penis.
When a man becomes sexually excited, muscles in their penis relax. This relaxation allows for increased blood flow through the penile arteries. This blood fills two chambers inside the penis called the corpora cavernosa. As the chambers fill with blood, the penis grows rigid. Erection ends when the muscles contract and the accumulated blood can flow out through the penile veins.
ED can occur because of problems at any stage of the erection process. For example, the penile arteries may be too damaged to open properly and allow blood in.
How does age affect incidence of ED?
Up to 30 million American men are affected by ED, according to the National Institute of Diabetes and Digestive and Kidney Diseases. The prevalence of ED increases with age. ED affects:
- 12 percent of men younger than 60
- 22 percent of men in their 60s
- 30 percent of men 70 or older
Although the risk of ED increases with age, ED is not inevitable as you get older. It may be more difficult to get an erection as you age, but that doesn’t necessarily mean you will develop ED. In general, the healthier you are, the better your sexual function.
ED can also occur among younger men. A 2013 study found that one in four men seeking their first treatment for ED were under the age of 40. The researchers found a stronger correlation between smoking and illicit drug use and ED in men under 40 than among older men. That suggests that lifestyle choices may be a main contributing factor for ED in younger men.
An analysis of research on ED in men under 40 found that smoking was a factor for ED among 41 percent of men under the age of 40. Diabetes was the next most common risk factor and was linked to ED in 27 percent of men under 40.
How is ED diagnosed?
Your doctor will ask you questions about your symptoms and health history. They may do tests to determine if your symptoms are caused by an underlying condition. You should expect a physical exam where your doctor will listen to your heart and lungs, check your blood pressure, and examine your testicles and penis. They may also recommend a rectal exam to check your prostate. Additionally, you may need blood or urine tests to rule out other conditions.
Nocturnal penile tumescence (NPT) test
An NPT test is done using a portable, battery-powered device that you wear on your thigh while you’re sleeping. The device evaluates the quality of nocturnal erections and stores the data, which your doctor can later access. Your doctor can use this data to better understand your penis function and ED.
Nocturnal erections are erections that occur while you’re sleeping, and they’re a normal part of a healthily functioning penis.
What treatments are available?
Treatment for ED will depend on the underlying cause. You may also need to use a combination of treatments, including medication, lifestyle changes, or therapy.
Your doctor may prescribe medication to help manage your symptoms of ED. You may need to try several medications before you find one that works. These medications can have side effects. If you’re experiencing unpleasant side effects, talk to your doctor. They may be able to recommend a different medication.
The following medications stimulate blood flow to your penis to help treat ED:
- alprostadil (Caverject)
- avanafil (Stendra)
- sildenafil (Viagra)
- tadalafil (Cialis)
- testosterone (Androderm)
- vardenafil (Levitra)
Lifestyle changes and diet
Healthy lifestyle habits may prevent ED, and in some situations reverse the condition:
- Exercise regularly.
- Maintain a low blood pressure.
- Eat a balanced, nutritious diet.
- Maintain a healthy weight.
- Avoid alcohol and cigarettes.
- Reduce your stress.
ED is often related to problems with your blood flow, so maintaining your blood vessel health through exercise and a healthy diet may help reduce your risk for ED.