Erectile dysfunction (ED), or impotence, is the inability to consistently initiate or keep an erection long enough to have satisfactory sex. To maintain an erection, blood must be able to flow into and stay in the penis until orgasm.
Men have problems with their erections once in a while. If ED occurs often, medical treatment may help.
ED can happen at any age, but is more common in men older than 65.
The most common causes of ED are health problems that affect blood vessels and blood flow in the penis. These include hardening of the arteries (atherosclerosis), which is linked to diabetes, obesity, smoking, high blood pressure, and high cholesterol. Therefore, ED may be a sign of heart disease or other serious health problems.
Examples are medications (antidepressants and drugs to treat high blood pressure, pain, or prostate cancer), alcohol, tobacco, and illegal drugs.
This can result from depression, anxiety, brain diseases such as stroke, and low testosterone (the male sex hormone).
Damage to the nerves that deliver signals from the brain to the penis can occur due to diabetes, multiple sclerosis (MS) spinal cord injuries, pelvic or prostate surgery, radiation therapy, or pelvic trauma.
These diseases affect blood vessels, nerves, and hormone levels
If you have been having ED for more than two months, you should see a doctor to find the cause. To detect the cause of ED, your doctor will take a history of when you started to have problems with erections and sex drive, illnesses or injuries that could cause ED, and any recent physical or emotional changes in your life. You also will need to review all the medications you take. The evaluation most often includes a physical exam.
Depending on the results, your doctor may also order blood tests for hormones, fasting blood glucose (sugar), and cholesterol. Your doctor may also test for liver and kidney. Rarely, some men need special tests to check nerve function, blood vessels, and blood flow.
Treatment for ED will depend on the cause and how serious your condition is. Treatment options can include the following:
Three effective drugs – sildenafil, vardenafil, and talafadil – work by increasing blood flow to the penis during sexual stimulation
Medications injected into the penis or inserted into the urethra to increase blood flow may work when oral medications do not.
All treatment options have risks. Finding the right treatment for you may take several tries. Your doctor will work with you to find the best treatment option for you. If the cause of your ED is a hormone imbalance, your doctor might refer you to an endocrinologist (an expert in hormone-related conditions).
The Hormone Health Network is the public education affiliate of the Endocrine Society dedicated to helping both patients and doctors find information on the prevention, treatment and cure of hormone-related conditions.
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