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:
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.