ERECTILE DYSFUNCTION

(Impotence)

 Basic information

description

Erectile dysfunction (ED) is the consistent inability to get or keep an erection as needed for sexual intercourse. Sexual drive and the ability to have an orgasm may not be affected. ED affects millions of men and can occur at any age. It is not a normal part of aging (though arousal may take longer).

FREQUENT SIGNS & SYMPTOMS

Repeated inability or inconsistent ability to achieve an erection or inability to sustain an erection.

causes

An erection requires a sequence of events. It starts with sexual stimulation in the brain, which sends nerve signals to the arteries and muscles of the penis. The penis fills with blood and grows firm and erect. After the stimulation ends, or ejaculation occurs, the blood leaves the penis, and it softens again. With erectile dysfunction, this sequence of events is disrupted. This can be due to physical (most often) or psychological (mental or emotional) factors.

risk increases with

• Physical factors may include:
  • Diabetes, liver, kidney, or endocrine disorders.
  • Atherosclerosis (hardening of the arteries), heart or blood vessel disease, or high blood pressure.
  • Use of some drugs, such as for high blood pressure.
  • Disorders or injuries of the central nervous system.
  • Alcoholism, smoking, or drugs of abuse.
  • Decreased blood flow to the penis from any cause.
  • Surgery (such as for heart or blood vessels).
  • Prostate cancer treatment.
  • Hormone imbalance or deficiency.
• Psychological factors may include:
  • Fear of sexual failure or performance anxiety, low self-esteem, or lack of interest in sex.
  • Relationship problems with sexual partner.
  • Depression, anxiety, stress, anger, and guilt.
  • Fear of disease (such as sexual) or heart attack.
  • Other people are around (such as mother-in-law).

PREVENTIVE MEASURES

• No specific measures. Some general advice is listed.
• Maintain good health and proper weight.
• Avoid the risk factors where possible.
• Control any medical conditions such as diabetes.
• Ask about side effects before taking any new drug.
• Have open communication with your sexual partner.
• Try to avoid worrying about sexual performance.

expected outcomes

Impotence is treatable in all age groups. Near normal sexual activity can often be achieved with treatment.

possible complications

• Reduced quality of life for the man and his partner.
• Depression, anxiety, and low self-esteem.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your sexual history. Medical tests may be done to diagnose any underlying disorder.
• Treatment steps may involve lifestyle changes, therapy for any illness diagnosed, erectile dysfunction drugs or devices, counseling, and surgery. A treatment plan will be based on your individual case.
• Lifestyle changes may include cutting back on alcohol, smoking, or drug abuse. Reducing stress, diet changes, and increased exercise may be recommended.
• Counseling can help. It may be for emotional problems (such as stress, anxiety, or guilt). Counseling may involve a sex therapist for you and your partner.
• Use of a vacuum inflation device is an option.
• Surgery for an inflatable or non-inflatable penile implant may be helpful if other methods fail.
• Surgery to improve blood flow to the penis may be recommended if there are blood vessel problems.
• To learn more: Erectile Dysfunction Institute, 10949 Bren Road East, Minnetonka, MN 55343; (866) 563-2432; website: www.erectile-dysfunction-impotence.org.

medications

• Drugs for erectile dysfunction (taken by mouth, self-injected, or by suppository) are often prescribed. For proper and safe use, follow all instructions provided.
• If a drug you take is the cause of impotence, a change in drugs or a change in dosage amounts may be made.
• Drugs may be prescribed for an underlying disorder.

activity

No limits. Exercise on a regular basis.

diet

Eat a well-balanced diet.

 notify our office if

• You or a family member has erectile dysfunction.
• Erectile dysfunction continues despite treatment.

Special Notes: