Erectile Dysfunction (ED)
What is erectile dysfunction?
When a man can't get an erection to have sex or can't keep an erection long enough to finish having sex, it's called erectile dysfunction. (It used to be called impotence). Erectile dysfunction can occur at any age, but it is more common in men older than 75.
Is erectile dysfunction just a part of old age?
Erectile dysfunction doesn't have to be a part of getting older. It's true that as you get older, you may need more stimulation (such as stroking and touching) to get an erection. You might also need more time between erections. But older men should still be able to get an erection and enjoy sex.
What causes erectile dysfunction?
Erectile dysfunction can be caused by:
- Diabetes (high blood sugar)
- Hypertension (high blood pressure)
- Atherosclerosis (hardening of the arteries)
- Stress, anxiety or depression
- Alcohol and tobacco use
- Some prescription medications, such as antidepressants, pain medicine and medicine for high blood pressure
- Fatigue
- Brain or spinal-cord injuries
- Hypogonadism (which leads to lower testosterone levels)
- Multiple sclerosis
- Parkinson's disease
- Radiation therapy to the testicles
- Stroke
- Some types of prostate or bladder surgery
If you can't keep your blood sugar or your blood pressure under control, you can get erectile dysfunction. It's important that you take your medicines for these problems just the way your doctor tells you.
Sometimes your hormones get out of balance and this causes erectile dysfunction. Your doctor will decide if you need blood tests to check your hormones.
Some medicines can cause erectile dysfunction. If this is true for you, your doctor may take you off that medicine or give you a different one.
Drinking too much alcohol, smoking too much and abusing drugs can also cause erectile dysfunction.
Problems in your relationship with your sexual partner can also cause erectile dysfunction. Improving your relationship may help your sex life. If you decide to seek therapy, it will probably be most effective if your sex partner is included. Couples can learn new ways to please one another and to show affection. This can reduce anxiety about having erections.
Feelings that can lead to erectile dysfunction
- Feeling nervous about sex, perhaps because of a bad experience or because of a previous episode of impotence
- Feeling stressed, including stress from work or family situations
- Being troubled by problems in your relationship with your sex partner
- Feeling depressed
- Feeling so self-conscious that you can't enjoy sex
- Thinking that your partner is reacting negatively to you
How is erectile dysfunction diagnosed?
Your doctor will probably start by asking you some questions and doing a physical exam. Samples of your blood and urine may be tested for diseases and disorders. Other tests may also be needed. Your doctor will determine which tests are right for you.
How is erectile dysfunction treated?
How erectile dysfunction is treated depends on what is causing it. After your doctor checks you for medical problems and medicines that might cause erectile dysfunction, he or she may have you try a medicine to help with erectile dysfunction. Sildenafil, tadalfil and vardenafil are medicines that are taken by mouth. Not everyone can use these medicines. Your doctor may talk to you about alprostadil if oral medicines aren't an option for you. Alprostadil is a synthetic version of prostaglandin E. It can be injected into the penis or inserted as a tiny suppository into the urethra. Your doctor will help you decide which treatment is best for you.
What other options do I have?
If the medicines aren't right for you, you could also try using a penile implant, vacuum pump devices, or you could have surgery. Your doctor may send you to an urologist to talk about these options.