What is Erectile Dysfunction(ED)?

Erectile Dysfunction, commonly abbreviated as ED, is the inability to get or keep an erection firm enough for sexual intercourse. ED should not be confused as impotence which stems from a lack of sexual desire or problems with ejaculation or orgasm. Both cause an inability to get or keep an erection firm enough for sexual intercourse, however, ED is medically treatable while impotence is psychologically treatable.

ED covers a wide range of causes which could be the complete inability to achieve erection, only periodic ability to do so, or the ability to obtain only brief erections. ED is difficult to diagnose because of the wide range of causes and erection behaviors and affects 15 to 30 million American men, most of which are over 30. No-one knows if the growing number of men with ED is due to an increase of diagnosis and recognition, or if there are other environmental factors, however, the increasing number of men with ED has brought to attention the need for treatment. If you have difficulty having or keeping an erection more than 25% of the time, it is considered a problem and you should talk to your doctor.

What Causes Erectile Dysfunction(ED)?

Several factors could contribute to the cause of ED. Injury to the nerves or any injury which may impair blood flow in the penis has the potential to cause ED. Initial injuries may not appear to cause any damage; however, the incidence of ED could increase with age.

The disruption of any part of sequences of events required to obtain an erection could also cause ED. Any interruption involving the nerve impulses in the brain, spinal column, and nerves in the penis, as well as response in muscles, veins, fibrous tissues, and arteries involving the corpora cavernosa could all be potential causes of ED. According to Medicine.Net, the corpora cavernosa is the two chambers in the penis which run the length of the organ and are filled with spongy tissue. Blood flows in and fills the open spaces in the spongy tissue to create an erection. These sequences of events are vital in obtaining and maintaining an erection.

Diseases such as diabetes, chronic alcoholism, kidney disease, atherosclerosis, multiple sclerosis, vascular disease, and neurological diseases are a significant contributing factor of ED. These diseases are so significant that they account for about 70 percent of ED cases. Diabetes is the leading cause of ED with between 35 and 50 percent of men diagnosed with both.

Lifestyle choices contribute to ED. Smoking which affects blood flow in veins and arteries, being overweight and little to no exercise are possible causes of ED. Psychological factors also hold weight to a 10 to 20 percent incidence of ED. Stress, low self-esteem, anxiety, depression, guilt, poor relationship communication, and fear of sexual failure all contribute psychologically, causing ED. Having a physical cause could also trigger a psychological reaction, triggering ED.

Increased risk of ED also stem from heart disease, vascular problems, and hormonal abnormalities such as decreased testosterone levels.

Surgery, especially radical prostate and bladder surgery for cancer may injure the nerves and arteries near the penis, causing ED. Harming nerves, smooth muscles, arteries, and fibrous tissues of the corpora cavernosa can cause injury to the penis, spinal cord, prostate, bladder, and pelvis which may lead to ED.

Side effects to some medications may lead to ED. In some instances, once the medication is stopped, the side effects decrease or become non-existent. Common medications creating a side effect of ED are blood pressure drugs, appetite suppressants, antihistamines, tranquilizers, antidepressants, and cimetidine (an ulcer drug).

How is Erectile Dysfunction (ED) Diagnosed?

The first step of diagnosis is identifying the problem. If you have difficulty having or keeping an erection more than 25% of the time, it is considered a problem and you should talk to your doctor.

Once you see your doctor, they may perform several tests and ask many questions such as getting a medical and sexual history, current and past medications, drug history, physical examination, psychological examination, and potentially other laboratory tests.

A medical and sexual history will help the doctor to understand the degree and potentially the nature of ED. Family diseases may be an underlying cause. Sexual history will provide activity which may reveal issues with sexual desire, erection, ejaculation, or orgasm.

Some prescription or other illegal drugs induce a chemical reaction causing a side-effect of ED. Eliminating drug use and adjusting medications often times alleviates the problem.

A thorough physical examination can reveal physical abnormalities contributing to the cause of ED. Sensitivity to touch, abnormal secondary sex characteristics, such as hair pattern or breast enlargement, circulatory problems, and unusual characteristics of the penis itself all can be contributing factors or causes of ED.

Other tests may include the psychological cause of ED. Monitoring erections occurring during sleep will provide information to diagnose ED. Nocturnal erections are normal, however; if they are not present, a psychological cause may be ruled out. This test is not completely reliable and should be used at the discretion of your doctor.

A psychological exam with yourself and your partner could determine expectations and perceptions before and during sexual intercourse. These expectations could play into the fear of sexual failure, causing ED.