View Full Version : Erectile Dysfunction

08-02-2012, 01:25 PM
Slideshow: A Visual Guide to Erectile Dysfunction

What Is Erectile Dysfunction (ED)?
Erectile dysfunction (ED) occurs when a man has consistent and repeated problems sustaining an erection. Without treatment, ED can make sexual intercourse difficult. According to the Massachusetts Male Aging Study on sexual dysfunction, the problem can first emerge in a man as early as 40. Based on the study, an estimated 18-30 million men are affected by ED.

ED vs. Poor Libido
There are several forms of male sexual dysfunction, including poor libido and problems with ejaculation. But ED refers specifically to problems achieving or maintaining an erection. Men with ED often have a healthy libido, yet the body fails to respond. In most cases, there is a physical basis for the problem.

Symptoms of ED
Symptoms of ED include:

Erections that are too soft for sexual intercourse.
Erections that last only briefly.
An inability to achieve erections.

Men who cannot get or maintain an erection (75% of the time that they attempt sex ) are considered to have erectile dysfunction.

Who Gets ED?
Sexual dysfunction and ED become more common as men age. According to the Massachusetts Male Aging Study, about 40% of men experience some degree of ED at age 40 compared with 70% of men at age 70. And the percentage of complete ED increases from 5% to 15% as age increases from 40 to 70 years. But this does not mean growing older is the end of your sex life. ED can be treated at any age.

The Mechanics of ED
An erection occurs when blood fills two chambers known as the corpora cavernosa. This causes the penis to expand and stiffen, much like a balloon as it is filled with water. The process is triggered by impulses from the brain and genital nerves. Anything that blocks these impulses or restricts blood flow to the penis can result in ED.

Causes of ED: Chronic Disease
The link between chronic disease and ED is most striking for diabetes. Nearly one out of every two men with diabetes experiences ED. Yet evidence shows that good blood sugar control can minimize this risk. Other conditions that may cause ED include cardiovascular disease, atherosclerosis (hardening of the arteries), kidney disease, and multiple sclerosis. These illnesses can impair blood flow or nerve impulses throughout the body.

Causes of ED: Lifestyle
Lifestyle choices that impair blood circulation can contribute to ED. Smoking, excessive drinking, and drug abuse may damage the blood vessels and reduce blood flow to the penis. Smoking makes men with atherosclerosis particularly vulnerable to ED. Smokers have almost twice the risks of ED compared with nonsmokers. Being overweight and getting too little exercise also contribute to ED. Studies indicate that men who exercise regularly have a lower risk of ED.

Causes of ED: Surgery
Surgery, including treatments for prostate cancer, bladder cancer, or BPH can sometimes damage nerves and blood vessels near the penis. In some cases, the nerve damage is permanent, and the patient will require treatment to achieve an erection. In others, surgery causes temporary ED that improves on its own after 6 to 18 months.

Causes of ED: Medication
ED may be a side effect of medication, including certain blood pressure drugs, antidepressants, and tranquilizers. Men should talk with their doctor if they suspect a prescription or over-the-counter drug may be causing erectile problems.

Causes of ED: Psychological
ED usually has something physical behind it, particularly in older men. But psychological factors may be to blame in 10% to 20% of men with ED. Experts say stress, depression, poor self-esteem, and performance anxiety can short-circuit the process that leads to an erection. These factors can also make the problem worse in men whose ED stems from something physical.

ED and Bicycling
Research suggests avid cyclists suffer more ED than other athletes. The trouble lies in the shape of some bicycle seats that put pressure on the perineum. This area between the anus and scrotum contains arteries and nerves vital to sexual arousal. Cyclists who ride for many hours each week may benefit from seats designed to protect the perineum.

Diagnosing ED: Physical Exam
To diagnose ED, your doctor will ask you questions about your symptoms and medical history. The doctor will conduct a complete physical exam to uncover signs such as poor circulation or nerve trouble. And your physician will look for abnormalities of the genital area that could cause problems with erections.

Diagnosing ED: Lab Tests
Several lab tests can help diagnose male sexual problems. Measuring testosterone levels can determine whether there is a hormonal imbalance, which is often linked to decreased desire. Blood cell counts, cholesterol levels, and liver function tests can reveal medical conditions that may account for ED.

ED: A Sign of Heart Disease?
In some cases, ED can be a warning sign of more serious disease. A 2010 study suggests ED is a strong predictor of heart attack, stroke, and death from cardiovascular disease. The researchers say all men diagnosed with ED should be evaluated for cardiovascular disease. This does not mean every man with ED will develop heart disease, or that every man with heart disease has ED, but patients should be aware of the link.

Treating ED: Lifestyle Changes
Many men with ED are able to improve sexual function by making a few lifestyle changes. Giving up smoking, losing weight, and exercising more often can help by improving blood flow. If you suspect a medication could be contributing to ED, talk to your doctor about adjusting your dosage or switching to another option.

Treating ED: Oral Medications
You've probably heard of Viagra, but it's not the only pill for ED. This class of drugs also includes Cialis, Levitra, and Staxyn. All work by improving blood flow to the penis during arousal. They're generally taken an hour before sexual activity and should not be used more than once a day. Cialis can be taken up to 36 hours before sexual activity and also comes in a lower, daily dose. Staxyn dissolves in the mouth. All require an OK from your doctor first for safety.

Treating ED: Injections
While pills for ED are convenient, some men sustain stronger erections by injecting medication directly into the penis. Drugs approved for this purpose work by widening the blood vessels, causing the penis to become engorged with blood. Another option is inserting a medicated pellet into the urethra. The pellet can trigger an erection within 10 minutes.

Treating ED: Vacuum Devices (Pumps)
Vacuum devices for ED, also called pumps, offer an alternative to medication. The penis is placed inside a cylinder. A pump draws air out of the cylinder, creating a partial vacuum around the penis. This causes it to fill with blood, leading to an erection. An elastic band worn around the base of the penis maintains the erection during intercourse.

Treating ED: Surgery
If ED is caused by a blockage in an artery leading to the penis, surgery can often restore blood flow. Good candidates are typically younger men whose blockage stems from an injury to the crotch or pelvis. The procedure is not recommended for older men with widespread narrowing of the arteries.

Treating ED: Implants
In men with persistent ED, a penile implant can restore sexual function. An inflatable implant uses two cylinders that are surgically placed inside the penis. When an erection is desired, the man uses a pump to fill the cylinders with pressurized fluid. Another option is a malleable implant, which bolsters erections with surgically implanted rods.

Treating ED: Psychotherapy
Even when ED has a known physical cause, psychotherapy can be beneficial. A therapist can teach the man and his partner techniques to reduce performance anxiety and improve intimacy. Therapy can also help couples adjust to the use of vacuum devices and implants.

Treating ED: Alternative Therapies
Talk with your doctor before trying supplements for ED. They can contain 10 or more ingredients and may complicate other health conditions. Asian ginseng and ginkgo biloba (seen here) are popular, but there isn't a lot of good research on their effectiveness. Some men find that taking a DHEA supplement improves their ability to have an erection. Unfortunately, the long-term safety of DHEA supplements is unknown. Most doctors do not recommend using it.

Treating ED: Buyer Beware
A quick web search will reveal dozens of "dietary supplements" that claim to treat ED. But the FDA warns that many of these are not what they seem. An investigation discovered the pills often contain prescription drugs not listed on the label, including the active ingredient in Viagra. This puts the man at risk for dangerous drug interactions.

ED: Reducing Your Risk
Some tips to reduce your risk of ED include:

Exercise and maintain a healthy weight.
Stop smoking.
Avoid alcohol and substance abuse.
Keep your diabetes under control.

Discussing ED With Your Partner
It's natural to feel angry or embarrassed when dealing with ED. But don't forget that your partner is also affected. Talking openly about ED will help your partner understand the diagnosis and treatment options. This will reassure your partner that you haven't lost interest.


23-02-2012, 02:41 PM
Erectile Dysfunction

Erectile dysfunction or ED is the inability to achieve or sustain an erection suitable for sexual intercourse. Problems with erections may stem from medications, chronic illnesses, poor blood flow to the penis, drinking too much alcohol, or being too tired. Lifestyle changes, medications, and other treatments are often used to treat ED.

Men have a lot of fears about erectile dysfunction. Fight those fears with facts. Stop worrying and start learning about why men sometimes don't get erections.

What Is Erectile Dysfunction?

What Is Impotence? (http://www.webmd.com/erectile-dysfunction/guide/erectile-dysfunction-basics)
How common is it? What can I do about it? Get an overview here.
Erection Anatomy (http://www.webmd.com/erectile-dysfunction/guide/how-an-erection-occurs)
Did you know that erections start in the brain? Find out how the penis enlarges and how ejaculation occurs in this illustrated guide.


Conditions That Cause Impotence (http://www.webmd.com/erectile-dysfunction/guide/physical-causes-erectile-dysfunction)
It's not always a case of mind over matter.
Erectile Dysfunction and Drugs (http://www.webmd.com/erectile-dysfunction/guide/drugs-linked-erectile-dysfunction)
A side effect of some medications can be erectile dysfunction. Read on, you may need to check your medicine cabinet.

Are You at Risk?

Diabetes and Erectile Dysfunction (http://www.webmd.com/erectile-dysfunction/guide/ed-diabetes)
Are you aware that diabetes and erectile dysfunction are linked? In men with diabetes, impotence may occur as an early complication.
Impotence and Blood Vessel Problems (http://www.webmd.com/erectile-dysfunction/guide/vascular-disease-ed)
Erections are all about blood flow to the penis. Learn more about conditions that affect blood flow – and cause male impotence.
Erectile Dysfunction and Bicycling (http://www.webmd.com/erectile-dysfunction/guide/is-biking-bad-for-bedroom)
Is biking bad for the bedroom? Certain bicycle seats may cause erectile dysfunction.


Preventing Erectile Dysfunction (http://www.webmd.com/erectile-dysfunction/guide/preventing-ed)
A healthy lifestyle can mean a healthy love life.

For people who are at risk of developing erectile dysfunction, taking active steps to prevent its occurrence will not only help you maintain erectile function, but also help you lead a healthier life overall. Some steps you can take to prevent ED include:

Stop smoking.
Exercise (http://www.webmd.com/fitness-exercise/default.htm) regularly.
Maintain a healthy weight (http://www.webmd.com/diet/tc/healthy-weight-what-is-a-healthy-weight).
Review your medications (http://www.webmd.com/drugs/index-drugs.aspx) with your doctor and ask about possible substitutions for those that may cause ED (http://www.webmd.com/erectile-dysfunction/guide/erectile-dysfunction-overview-facts) (never stop or change a medication without first talking to your doctor).
Take prescribed medications as directed.
Avoid excessive use of alcohol (more than two drinks a day).
Avoid the use of illegal drugs.
If you have a chronic illness such as diabetes (http://diabetes.webmd.com/default.htm) or kidney disease, follow your doctor's guidelines to keep these conditions in control.

Further Reading:

Crestor Halts Artery Thickening (http://www.webmd.com/cholesterol-management/news/20070326/crestor-halts-artery-thickening)
Diabetes Drug Actos Slows Artery Plaque (http://diabetes.webmd.com/news/20070101/diabetes-drug-actos-slows-artery-plaque)
Hardened Arteries: It's About More Than Heart Disease (http://www.webmd.com/heart-disease/features/hardened-arteries-its-about-more-than-heart-disease)
Alert: Bypass Over Angioplasty for Patients with Diabetes (http://diabetes.webmd.com/clinical-alert-bypass-over-angioplasty-patients-diabetes)
Atherosclerosis and Erectile Dysfunction (http://www.webmd.com/erectile-dysfunction/atherosclerosis-and-erectile-dysfunction)
High Blood Pressure and Atherosclerosis (http://www.webmd.com/hypertension-high-blood-pressure/guide/atherosclerosis)
Atherosclerosis and High Blood Pressure (http://www.webmd.com/hypertension-high-blood-pressure/atherosclerosis-and-high-blood-pressure)
See All Sex Problems in Men Topics (http://www.webmd.com/sex-relationships/sex-problems-in-men-directory)

Symptoms & Types

Erectile dysfunction is different from other conditions that affect sexual intercourse. Here's information on the symptoms of ED, and whether treatment is needed.

Erection Problem Checklist (http://www.webmd.com/erectile-dysfunction/guide/erection-problem-checklist)
Failure to achieve an erection occasionally is not unusual; many men report having erection problems sometimes.

Warning Signs

Erectile Dysfunction as Warning Sign (http://www.webmd.com/erectile-dysfunction/guide/erectile-dysfunction-as-warning-sign)
Your sexual dysfunction may be trying to tell you that something else is wrong. Impotence may be a warning sign for another problem.


Psychological Erectile Dysfunction (http://www.webmd.com/erectile-dysfunction/guide/ed-psychological-causes)
After all, erections do start in the brain.

Diagnosis & Tests

Is it just a bad day -- or erectile dysfunction? These articles help you separate erectile dysfunction from the many other things that can cause erection failure.

Where To Start (http://www.webmd.com/erectile-dysfunction/guide/ed-where-to-start)
Here's what to do if your doctor says, "I think it's erectile dysfunction."


Erectile Dysfunction Tests (http://www.webmd.com/erectile-dysfunction/guide/diagnosing-erectile-dysfunction)
It's not as simple as it sounds. Finding the exact cause of impotence may take a complete physical exam. Get the details here.

Treatment & Care

You may be surprised at all the options for treating erectile dysfunction. These articles are about treating the condition -- and caring for the people who have it.

Discussing Erectile Dysfunction With Your Doctor (http://www.webmd.com/erectile-dysfunction/guide/discussing-erectile-dysfunction-with-your-doctor)
Unfortunately, some men are reluctant or embarrassed to discuss sexual matters with their doctor. As a result, they don't get the help that could resolve their problem with ED.
Treatment for Erectile Dysfunction: Lifestyle Change (http://www.webmd.com/erectile-dysfunction/guide/lifestyle-changes-improve-ed)
A better lifestyle may be all you need for stronger erections.
Sexual Pleasure with Impotence (http://www.webmd.com/erectile-dysfunction/guide/sex-therapy-erectile-dysfunction)
Good things usually happen when an intimate couple sees a sex therapist.
Impotence Drugs (http://www.webmd.com/erectile-dysfunction/guide/erectile-dysfunction-drug-treatment)
What you need to know about drugs used to treat ED.
Erectile Dysfunction Vacuums (http://www.webmd.com/erectile-dysfunction/guide/vacuum-constriction-devices)
Yes, it's the penis pump. Despite its drawbacks, the erectile dysfunction vacuum works very well for many men. Learn more about the pluses and minuses of this tried-and-true device.
Penile Implants (http://www.webmd.com/erectile-dysfunction/guide/penile-prosthesis)
Penile prostheses -- penis implants -- offer a permanent solution to erectile dysfunction. There are more types than you may think.
Erectile Dysfunction Surgery (http://www.webmd.com/erectile-dysfunction/guide/vascular-reconstructive-surgery)
Surgery can improve the blood flow to the penis, thus improving erections.
Natural Remedies for Erectile Dysfunction (http://www.webmd.com/erectile-dysfunction/guide/alternative-treatments-ed)
You may want to try these natural remedies as alternative treatments for erectile dysfunction.
New Impotence Treatments (http://www.webmd.com/erectile-dysfunction/guide/future-treatments-ed)
See what's in the development pipeline as researchers race to bring new erectile dysfunction drugs to market.
Erectile Dysfunction Treatment (http://www.webmd.com/erectile-dysfunction/guide/erectile-dysfunction-treatment)
Erectile dysfunction can be treated at any age. Treatment depends on your overall health and the underlying cause of the problem.
Yohimbe Bark Supplements for ED (http://www.webmd.com/erectile-dysfunction/guide/yohimbe-bark-supplements-for-ed)
For generations, the bark of the yohimbe tree, an evergreen native to western Africa, has been used as a remedy for ED.


Talking with Your Partner (http://www.webmd.com/erectile-dysfunction/guide/ed-talking-your-partner)
It's called communication. Erectile dysfunction affects both partners in a relationship. Here's how to talk about it.
If Your Partner Has Erectile Dysfunction (http://www.webmd.com/erectile-dysfunction/guide/ed-supporting-your-partner)
Here's what you need to know if your partner suffers from erectile dysfunction.
A Woman's Point of View
Here's help for women whose partners suffer from erectile dysfunction.

Living & Managing

WebMD's experts share their knowledge on how to control symptoms, how to manage relationship problems, and how to have a full sex life despite erectile dysfunction.
Living and Coping

Coping with Erectile Dysfunction (http://www.webmd.com/erectile-dysfunction/guide/erectile-dysfunction-coping)
The emotional impact of erectile dysfunction takes a toll. Here's how to deal with it.
Erectile Dysfunction During Sex (http://www.webmd.com/erectile-dysfunction/guide/erectile-dysfunction-during-sex)
There's more to sex than erections. Learn what a leading sexologist has to say.
Erectile Dysfunction and Depression
Depression can accompany erectile dysfunction. Learn to recognize it.
Staying Intimate (http://www.webmd.com/erectile-dysfunction/guide/erectile-dysfunction-maintaining-intimacy)
Erectile dysfunction can create barriers to intimacy. Here's how to overcome them.