From Taboo to Awareness: Erectile Dysfunction in Men from ginnymiller's blog

Erectile dysfunction (ED) is trouble getting and keeping an erection firm enough for sexual intercourse. It can be a sign of underlying health conditions like heart disease, diabetes or neurological issues such as a stroke.

Having a hard time getting an erection from time to time isn’t uncommon, but it is important to find out what causes it.

Age

Men of all ages can experience erectile dysfunction, and rates are rising. Increased reporting and diagnosis are due to more effective treatments, direct-to-consumer advertising, and screening by doctors. But age is also a factor: ED becomes more common as people get older. Often, the first sign is that it takes longer to achieve an erection. It may be less turgid, or it might take more pressure to maintain an erection. Sometimes, the erection lasts shorter time after orgasm, and it is harder to get an erection at all. Some Other ED Medicine like:

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It’s important to note that most cases of ED are secondary, meaning that a person’s normal erectile function became a problem for some reason. Some of these reasons include problems with blood flow, nervous system, or hormone levels. They can also include psychological issues that cause anxiety about sexual performance.

In addition, a number of medications can also cause ED or make it worse. Taking certain drugs, such as antidepressants, diuretics, nitrates, and some types of cholesterol medication, can negatively impact sexual function. It is important to talk with a doctor before starting a new medicine or making any changes to your diet and exercise routine. The most common treatment for ED is a drug called sildenafil (sold as Viagra). This works in two-thirds of the cases. Other physical and psychological treatments have also been shown to be effective.

Genetics

Erectile dysfunction affects a fifth of men over the age of 20 in the United States. It becomes more common as a man gets older, and it is a risk factor for health problems like cardiovascular disease and diabetes. Despite the stigma and embarrassment associated with discussing sex issues with doctors, a man who has ED should talk to his doctor because it may be a sign of health problems that are easy to treat.

A team of researchers has discovered a part of the human genome that may make some men more susceptible to impotence. Their findings, published in this week’s Proceedings of the National Academy of Sciences, suggest a single area on chromosome 6 called SIM1 might determine whether a person has trouble getting an erection or not. The scientists believe something in this area influences how the SIM1 gene is expressed, either causing it to turn on or off more often and potentially increasing a man’s chances of developing erectile dysfunction.

The team used detailed questionnaires, electronic health records and genetic data from participants in two large, diverse research cohorts. They found that people with a mutation in the SIM1 gene had a 26 percent greater chance of suffering from erectile dysfunction than those without it. The researchers hope that identifying this first genetic risk factor for ED will open up investigations into new, genetic-based therapies for the condition.

Mental Health

For many people, a satisfying sex life is an important component of both their mental and physical health. But if the problems with sexual function are psychological in origin, they can have devastating effects on a person’s emotional and relationship well-being.

Erectile dysfunction can cause feelings of anxiety, guilt and low self-esteem. It can also lead to a lack of interest in the bedroom, which in turn affects intimacy in a romantic relationship. In addition, some medications can contribute to ED by affecting hormones, blood flow and nerves. For example, some antidepressants can cause ED in men, as can drugs used to treat high blood pressure and heart conditions.

Intimate relationship conflicts and a lack of physical stimulation can also zap male libido, as can recreational drug use, excessive masturbation and depression. Psychotherapy and medication are often recommended, but lifestyle changes and enhancing the health of a couple’s romance can help with these issues as well. (Note that some types of psychotherapy, such as cognitive-behavioral therapy, can make erectile dysfunction worse in some people.) Intimacy With Imperfection: Getting through to the Heart of Sex after Prostate Cancer, by Ralph Alterowitz and Barbara Alterowitz, De Capo Lifelong Books, 2004. Also available as ebook.). This book provides honest, compassionate and practical advice on how to deal with sex after prostate cancer surgery or radiation treatment.

Lifestyle

Several treatments for erectile dysfunction have been successful, including medication such as sildenafil (Viagra), vacuum devices that encourage blood flow to the penis, and psychological treatment. Your doctor can recommend the best treatment option for you based on your age, health and personal preferences.

Men with erectile dysfunction may be embarrassed to discuss it with their doctors, but it’s important to get a diagnosis because it can be the first sign of serious health problems such as heart disease and high blood pressure. It also may be a side effect of some medications.

Some medications can decrease sexual desire, including nitrates used to treat angina, and other antidepressants and some antipsychotics. Stress, depression and anxiety can also contribute to ED. Psychological treatment with a trained counselor may help.

Modifiable risk factors for erectile dysfunction include smoking, lack of physical activity and an unhealthy diet. All of these can affect vascular endothelial function, decreasing the availability of nitric oxide, which plays a key role in erections. Lifestyle changes that increase nitric oxide and reduce low-grade clinical inflammation may improve erectile dysfunction. Many supplements and alternative therapies are marketed with claims of helping with ED, but the U.S. Food and Drug Administration warns that they may contain unsafe ingredients or undetermined dosages of pharmacologically active drugs. Talk to your doctor before trying any supplements.