Erectile dysfunction is when a man continues to be unable to achieve and/or maintain an erection that allows sexual activity with penetration.
Erectile dysfunction is often referred to as 'impotence' although this term is no longer favoured because it is not specific and has derogatory overtones.
The cause of erectile dysfunction may be physical or psychological. For most men, the cause is both physical and psychological. In 75% of cases, there will be a physical cause.
Physical causes of erectile dysfunction include:
- high cholesterol
- heart disease
- post prostate cancer
- high blood pressure
- alcohol or other drug use
- some prescribed drugs
- disease of the liver and kidney
- surgery to the bladder, prostate gland, lower bowel and spine
- poor blood flow to the penis resulting from blocked arteries.
Occasionally when a specific cause is identified, direct treatment will completely resolve the problem. This might happen where there has been a sudden psychological problem that is short lived and can be overcome.
Sometimes if erectile dysfunction occurs immediately after starting a new drug, then withdrawing that drug may improve the situation. Importantly and particularly in younger men, pelvic injuries may be associated with erectile dysfunction that can be treated with surgery. Testosterone deficiency may be treated and erectile dysfunction improved.
At the present time, there are no known specific preventative strategies for erectile dysfunction. The early detection of medical problems which may underlie erectile dysfunction is important. By accepting and controlling these health problems, the damage done to tissues of the body, including the penis, may be reduced.
Diabetes which is the most common association with erectile dysfunction may be present for years before a diagnosis is made. During this time considerable damage may be done to tissues of the body including the penis.
Furthermore following diagnosis it is now known that good treatment reduces complications in general and although this hasn't been proven to reduce erectile dysfunction it is likely that this would be the case. Basically this view strengthens the idea that men, particularly as they move into middle age, should have regular health checks.
It is important to distinguish erectile dysfunction from other forms of sexual problems. Some men have little interest in sex (low libido) but can achieve an erection. Other men can achieve an erection but cannot reach an orgasm or ejaculate. Ejaculation may come too early (premature ejaculation) or may sometimes go into the bladder with nothing coming out of the penis (retrograde ejaculation). These different problems will require a different approach to diagnosis and treatment.