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Erectile dysfunction

Erectile dysfunction (ED) is a common condition, especially in older men. It is estimated that half of all men between the age of 40 and 70 will suffer from it at some point in their lives.

A sad-looking couple sitting on a bed

Causes can be physical and/or psychological. Physical causes include:

Psychological causes include:

ED can also be a side effect of certain medicines.

Risk factors include:

  • Smoking
  • Obesity
  • Some medical treatments, such as those for prostate surgery or radiation treatment for cancer
  • Some medications
  • Psychological conditions, such as stress, anxiety or depression
  • Drug and alcohol use
  • Frequent cycling (compressed nerves and affected blood flow)

What are its symptoms?

Symptoms of erectile dysfunction may include the following:

  • Inability to get an erection
  • An erection that is not firm enough to penetrate the vagina
  • An erection occurs but cannot be maintained long enough to satisfy sexual activity
  • Reduced sexual desire

How is it diagnosed?

Consult your doctor if you experience ED for longer than two weeks. He/she will assess your general health as ED can be the first sign of more serious health conditions, such as heart disease or diabetes. Diagnostic tools include:

  • Blood tests: A sample of your blood will be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health conditions.
  • Urine tests: Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions.
  • Ultrasound: A wand-like device is held over the blood vessels that supply the penis. It creates a video image to let your doctor see if you have blood flow problems.
  • Erection test: Most men have erections during sleep without remembering them. This simple test involves wrapping a special device around your penis before you go to bed.
  • Psychological exam: Your doctor might ask questions to screen for depression and other possible causes of ED.

What are your treatment options?

Treatment options for ED include:

  • Counselling
  • Drug therapy: Prescription medicines can be taken orally such as sildenafil (Viagra) or tadalafil (Cialis), amongst others. Some medication needs to be inserted into the urethra or penis. These medicines boost blood flow to the penis to make erections more attainable. You will need a prescription for these so you will need to consult your doctor about usage. 
  • Vacuum pump: A vacuum device improves firmness by increasing blood flow to the penis.
  • Surgery: In extreme cases, your doctor may recommend surgery. There are two options: Placement of an implant (prosthesis) in the penis or vascular reconstruction surgery to improve blood flow to or reduce blood leakage from the penis and surrounding structures.

In some cases, simple lifestyle changes, such as losing weight, drinking less alcohol, or quitting smoking, may improve erectile dysfunction.

If the erectile dysfunction is caused by a certain medication, your doctor may suggest reducing the dose or trying an alternative drug.

Can it be prevented?

The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health conditions.
For example:

  • Work with your doctor to manage diabetes, heart disease or other chronic health conditions
  • Have regular check-ups and medical screening tests
  • Stop smoking, limit or avoid alcohol, and don't use illegal drugs
  • Exercise regularly
  • Take steps to reduce stress
  • Get help for anxiety, depression or other mental health concerns

IMAGE CREDIT: 123rf.com

The accuracy of this information was checked and approved by physician Dr Thomas Blake in June 2015