This article is more than 5 years old. Information may no longer be current.
What is erectile dysfunction?
Click Here to Manage Email Alerts
Erectile dysfunction, or impotence, is when a man can longer achieve or maintain an erection firm enough for sexual intercourse. Erectile dysfunction is a persistent problem, and can be causes by medications, psychological or physical factors and various disorders. It is estimated that as many as 30 million men suffer from erectile dysfunction in the United States.
The penis has two chambers, called the corpora cavernosa, that run the length of it on either side. Between those is the corpus spongiosum, which contains the urethra. When a man experiences sexual stimulation, whether it be physical or mental, the brain, nerves, blood vessels and hormones send signals for the muscles around the corpora cavernosa to relax. As the muscles relax, the corpora cavernosa begin to fill up with blood, where it is then trapped. This causes the penis to become firm and lengthened, which results in an erection. Once an orgasm has occurred, the blood releases and the penis becomes flaccid. The sequence of events that cause an erection are precise, and they include nerve impulses in the brain, spinal column and area around the penis, and response in muscles, fibrous tissues, veins and arteries in and around the corpora cavernosa. If even one of the events is disrupted, it could result in erectile dysfunction (ED).
Risk factors for ED include tobacco use, being overweight, certain medications such as antidepressants, antihistamines and high blood pressure medications, and prolonged bicycling.
Conditions such as diabetes, high blood pressure, nerve diseases or damage, multiple sclerosis, atherosclerosis and heart disease can all cause damage to the nerves, arteries, smooth muscles and fibrous tissues, and are the cause of most ED cases. Other physical causes ED include:
- Alcohol and other substance abuse;
- High cholesterol;
- Injuries or surgeries that affect the spinal cord or pelvic area;
- Low testosterone;
- Metabolic syndrome;
- Parkinson’s disease;
- Peyronie’s disease; and
- Treatment for prostate cancer or enlarged prostate.
In addition to physical causes, psychological factors could also be cause for ED. These can include depression, anxiety, stress, fear of sexual failure and problems within a relationship.
Complications that can result from ED include an unsatisfactory sex life, stress, anxiety, embarrassment, low self-esteem, marital or relationship problems and the inability to get a partner pregnant.
Treatment options for ED vary, depending on the cause of a man’s ED. Options for treatment include:
- Blood vessel surgery;
- Injectable alprostadil medications, such as Caverject Impulse (Pfizer Inc.);
- Oral medications, such as Viagra (sildenafil citrate, Pfizer Ireland), Cialis (tadalafil, Lilly), Levitra (vardenafil hydrochloride, Bayer Healthcare) and Staxyn (vardenafil hydrochloride, Bayer Healthcare);
- Penile implants;
- Penis pumps or other vacuum devices; and
- Testosterone replacement therapy.
Additional information may be found at these websites:
http://kidney.niddk.nih.gov/KUDiseases/pubs/ED/index.aspx
http://www.nlm.nih.gov/medlineplus/tutorials/erectiledysfunctionyourchoices/ur029206.pdf