Erectile dysfunction is the inability to have or maintain an erection (aka. impotence). Being diagnosed with ED is enough to strike fear in the heart of any man (or his wife), but it doesn't have to be. ED is characterized by the repeated or inconsistent inability to keep firm enough for sexual intercourse or get an erection. Impotence has been used to describe lack of sexual desire, and ejaculation or orgasm problems.
Incidence
ED incidence can be difficult to determine because of the varying degrees of problems. It is estimated that between 15 and 30 million men experience ED. In the U.S. about 22.3 out of every 1,000 men experience ED, which means that more men reported ED due to more and better treatments, like Viagra. The incidence of ED increases with age. By age 40, up to 5% of men will have some form of erectile dysfunction while 15 to 25% of 65 year olds will experience ED.
Causes
ED usually has a physical cause in older men, such as injury, disease, or side effects of drugs. Any disorder or disease that impairs blood flow in the penis or causes injury to the nerves has the potential to cause ED. Biological causes of ED include damaged nerves, arteries, smooth muscles, fibrous tissue, and kidney disease. About 70 % of ED cases are caused by neurologic disease and 30 to 35 % are caused by diabetes. Some medications for blood pressure, antihistamines, antidepressants, appetitie suppressants, tranquilizers, and ulcer drugs have been known to cause ED. Environmental causes include smoking, overweight, and lack of exercise. Prostate or bladder cancer surgery has been known to cause some cases of ED. Psychologists believe stress, guilt, anxiety, low self-esteem, depression, and fear of sexual failure may cause up to 20% of ED cases.
Treatment
ED is not inevitable and is treatable at any age. Urologists treat about 25% of men with ED with Viagra. The remaining 75% seek alternative treatment.
Diagnosis
1) Patient History 2) Physical Examination 3) Laboratory Tests 4) Other Tests including sleep study 5) Psychosocial Examination
Treatment
1) Lifestyle changes may resolve the problem. Quitting smoking, losing excess weight, and increasing physical activity. 2) Reduction in drugs that may cause ED. 3) Psychotherapy and behavior modifications. 4) Oral or injected drugs (drug therapy) such as Viagra, Levitra, or Cialis 5) Vacuum devices 6) Surgical implants 7) Psychotherapy 8) Surgery