Erectile Dysfunction (ED) is the inability to achieve or sustain an erection suitable for sexual intercourse. An estimated 10 million to 20 million American men have been diagnosed with ED, with an additional 10 million having partial erectile dysfunction. Cases of ED become more prevalent with age, and the majority of those diagnosed are 65 or older. At least half of men over the age of 50 have some degree of erectile dysfunction.
Erectile dysfunction is typically associated with the aging process but it may also be a consequence of illness or medical treatments. It can occur in men even in their twenties. Physical causes stem from a breakdown in the sequence of events that lead to an erection, usually from low blood flow in the erectile tissue, but also from impaired nerve impulses from the brain to the penis. Diseases that commonly cause ED include diabetes, kidney disease, vascular disease, neurological diseases and prostate cancer.
An occasional inability to achieve an erection is normal and should not cause worry. But failure to reach or sustain an erection more than half of the time, at any age, may indicate a condition that needs treatment.
Your physician will perform a physical examination, including sexual history, and a psychosocial evaluation to determine stress levels. It is essential to provide a detailed history of medication and drug use since about 25 percent of ED cases can be attributed to medications for other conditions. A series of tests are available, including:
- Blood tests: A blood count test can detect abnormal hormone levels, thyroid levels or cholesterol levels. Urinalysis: An analysis of your urine will provide a reading of protein and sugar in your urine. Abnormal measurements of these substances can indicate diabetes or kidney disease, which can cause ED.
- Ultrasound: This imaging test uses high-frequency sound waves to take pictures of the body's tissues and evaluate blood flow.
- Medication: Several drugs can increase the flow of blood into the penis so that when a man is sexually stimulated, he can get an erection.
- Intra-urethral therapy: Medicated pellets about the size of a grain of rice are inserted into the urethra through the tip of the penis, enabling an erection.
- Intracavernosal injection therapy: Medications are injected into the shaft of the penis to increase blood flow.
- Vacuum/constrictive devices: A large cylinder is placed over the penis and a vacuum is created, drawing blood into the penis for an erection. A small rubber ring is then placed around the base of the penis to maintain the erection.
- Penile prosthesis: In this surgery, the physician implants a bendable or inflatable device into the penis, which will create an erection.
- Psychotherapy and behavioral therapy: If ED is the result of psychosocial issues, such as performance anxiety or depression, the physician can refer a specialist.
For more information on ED visit WebMD's Erectile Dysfunction Health Center.