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Erectile dysfunction (ED) is the inability to get or keep an
erection firm enough for sex, and it can be caused by physical, psychological,
or lifestyle factors. Physical causes include heart and blood vessel
diseases, diabetes, hormonal issues, and nerve damage, while psychological
factors can involve stress, anxiety, depression, and relationship problems.
Lifestyle factors like excessive alcohol use, smoking, and a lack of exercise
can also contribute. ED is often treatable through lifestyle changes, medications,
therapy, or other medical devices and procedures.
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Causes of erectile dysfunction
- Physical:
- Cardiovascular
diseases like atherosclerosis, high blood pressure, and heart conditions.
- Diabetes,
which can damage nerves and blood vessels.
- Hormonal
imbalances, such as low testosterone levels.
- Nerve
damage from conditions like multiple sclerosis or spinal cord injuries,
or from surgery.
- Chronic
kidney disease, obesity, and sleep apnea.
- Psychological:
- Stress,
anxiety, and depression.
- Relationship
problems or fear of intimacy.
- Sexual
performance anxiety.
- Lifestyle:
- Excessive
alcohol intake.
- Smoking
and using illegal drugs.
- Lack
of physical activity.
- Certain
medications, including some for depression, heart conditions, and cancer.
Diagnosis and treatment
- A
doctor can diagnose ED by discussing your symptoms and overall health and
may perform a physical exam.
- Lifestyle
changes:
- Losing
weight if overweight.
- Eating
a healthy diet.
- Exercising
regularly.
- Reducing
stress.
- Limiting
alcohol and quitting smoking.
- Medical
treatments:
- Oral
medications: Phosphodiesterase inhibitors like
sildenafil, vardenafil, avanafil, or tadalafil are often the first line
of treatment.
- Injections: If
oral medications don't work, a doctor may recommend injecting a drug like
alprostadil.
- Other
devices: Vacuum erection devices can be
effective for some men.
- Surgery: Penile
prosthesis surgery is an option for severe cases.
- Psychological
treatments:
- If
psychological factors are the cause, a doctor may recommend therapy, such
as cognitive behavioral therapy or sex therapy, which may also involve
your partner.
Important considerations
- ED
can be a sign of an underlying health condition, such as heart disease,
that needs treatment.
- Almost
all cases of ED are treatable, but reluctance to seek treatment is a major
barrier.
- While
more common with age, ED is not a natural part of aging and is treatable
at any age.
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