Erectile dysfunction is the inability to obtain or maintain an erection satisfactory for sexual activity. As many as half the men over age 40 may have some degree of erectile dysfunction, also called ED.
A penis is usually soft and limp. Sexual excitement relaxes muscles in the organ and reduces the flow of blood from it. As a result, bodies in the penis called corpora cavernosa fill with blood, making the organ rigid and erect. Any condition that reduces muscle relaxation, blocks blood flow into the penis, or increases the outward flow of blood may result in erectile dysfunction.
Erectile dysfunction may be caused by tobacco use, diabetes, diseases of the arteries or other blood vessels, excess fat in the blood, surgery, or injury to the pelvis. It may result from use of certain medications, such as drugs to lower blood pressure, antidepressants, and hormone drugs. Low levels of the male hormone testosterone in the blood may also cause erectile dysfunction. In addition, erectile dysfunction may have psychological causes.
To help a patient with erectile dysfunction, a doctor begins by analyzing the patient’s medical and sexual history. The doctor may order laboratory testing of blood sugar, cholesterol, and testosterone levels. Some patients may undergo arteriography, a technique that makes arteries visible on an X-ray image; ultrasound examination to measure blood flow to the penis; or studies to monitor erections during sleep.
Treatment may involve lifestyle changes, such as reducing cholesterol levels, quitting smoking, or, for diabetics, treating high blood sugar. Physicians may prescribe testosterone for patients with low hormone levels. Other patients may use oral medications, such as sildenafil (sold under the trade name Viagra) and apomorphine, to stimulate erection. If other treatments fail, certain patients may be treated with injections to increase blood flow to the penis, or by surgically implanting a device to produce erections.
