Erectile dysfunction (ED) is the inability to achieve or maintain an erection firm enough for sexual intercourse. Signs of ED vary from a total inability to get an erection, an inconsistent ability to do so, or a tendency to sustain only brief erections.

Symptoms

• Inability to achieve or maintain an erection
• Inconsistent ability to achieve/maintain erection
• Tendency to sustain only brief erections

Causes

Causes of ED are usually a side effect of physical disease, injury, or drugs. While there are many causes, the most common physical causes include:

• Diabetes
• High Blood Pressure
• Heart Disease
• Obesity
• Atherosclerosis
• Prescription Medications
• Smoking
• Alcoholism or Substance Abuse

The most common psychological causes include:

• Relationship Issues
• Stress
• Depression or Anxiety

Diagnosis

Your doctor will perform a detailed history exam, asking if you have difficulty achieving an erection, if the erection is suitable for intercourse, if the erection can be maintained, and if ejaculation occurs. During the tests for ED, you will also be asked about any medications you are currently taking, any surgeries in the past, and other disorders (i.e. prostate surgery, history of trauma, radiation exposure, etc.) Other questions may be asked about risk factors such as drug, alcohol, and tobacco usage, indications of depression, relationship with your sexual partner, and other similar inquiries. A physical exam will also be necessary, paying close attention to the genitals and nervous, vascular, and urinary systems. The physical examination will help determine the cause of the erectile dysfunction.

Treatment

Based on the severity of the ED issue, your doctor will suggest treatments from least to most invasive. Something as simple as making healthy lifestyle changes (such as quitting smoking, reducing alcohol consumption, and losing weight) may help to solve the issue.

Surgery is an option in some cases of erectile dysfunction. Most surgery cases are performed for one of three reasons: to implant a device to initiate erections; to reconstruct arteries and increase penis blood flow; to block off veins that allow blood to leak from the penile tissues.

Other treatment options include:

Psychotherapy

The stress of erectile dysfunction and its toll on self-confidence and/or a relationship can be hard to deal with. Speaking to a psychologist or counselor about how to cope emotionally can be of great benefit to some people.

Oral Medications

Certain oral medications can be used to relax the penis and allow for proper blood flow when sexually aroused.

Drug Therapy

Other drugs may be used to treat erectile dysfunctions such as self-injections of medication at the base of the penis, hormone replacement for low testosterone, or suppositories.

Vacuum devices

A hollow tube is placed over the penis and the air inside the tube is vacuumed out (manually or battery operated) using a pump. The vacuum pulls blood into the penis, leading to an erection. Once the erection is achieved, a tension ring is placed at the base of the penis to keep the blood in the penis to maintain and erection.

Prognosis

To achieve erection, a complex process has to take place within the man’s body. Because this process is so in-depth and complex, sexual dysfunction and ED are extremely common in men. It is estimated that as many as 30 million men in the United States are affected by ED (The National Institutes of Health).

Erectile dysfunction is usually a side effect of physical disease, injury, or drugs. Treatment is an option for virtually any man needing to improve the quality of his sex life.