Men's Health: Erectile Dysfunction

In today’s world we are all guilty of getting some of our health news from the television or radio. They may be advertising the newest weight loss drug or commenting on a new procedure or study that helps revitalize your sex life. It’s important to talk to your doctor to help you decide if these new procedures and medications are right for you. Unfortunately, men are notorious for avoiding visits to the doctor’s office. Since June is men’s health month, we want to make sure men are taking the necessary steps to keep themselves healthy and happy.

Some people have trouble speaking with their doctors about sex. One of the common types of male sexual dysfunction is Erectile Dysfunction (ED). ED is the inability to get and keep an erection firm enough for sex. It becomes more common as men get older, but it is not a natural part of aging. Having erection trouble from time to time is not necessarily a cause for concern. If ED is an ongoing issue, however, it can cause stress, affect self-confidence, and contribute to relationship problems. Problems getting or keeping an erection also can be a sign of an underlying health condition that needs treatment and is a risk factor for heart disease.

Erectile Dysfunction Causes

ED may be caused by a combination of physical and psychological issues. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen ED. In most cases, ED is caused by something physical. Common causes include:

· Heart disease

· Clogged blood vessels (atherosclerosis)

· High cholesterol

· High blood pressure

· Diabetes

· Obesity

· Certain prescription medications, including antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate conditions

· Tobacco use, which restricts blood flow to veins and arteries, can cause chronic health conditions that lead to erectile dysfunction

· Alcoholism and other forms of substance abuse

· Sleep disorders

· Treatments for prostate cancer or enlarged prostate

· Prolonged bicycling, which can compress nerves and affect blood flow to the penis, may lead to temporary or permanent erectile dysfunction

The brain plays a key role in sexual arousal and the physical events that cause an erection. A number of things can interfere with sexual feelings and cause or worsen ED like psychological conditions, such as stress, anxiety or depression

Erectile Dysfunction Diagnosis

Your doctor will conduct a physical exam and a medical history to diagnose ED and recommend a treatment. If you have chronic health conditions or your doctor suspects that an underlying condition might be involved, you might need further tests or a consultation with a specialist.

Tests for underlying conditions might include:

  • Physical exam. This might include careful examination of your penis and testicles and checking your nerves for sensation.
  • Blood tests. A sample of your blood might be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health conditions.
  • Urine tests (urinalysis). Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions.
  • Ultrasound. This test is usually performed by a specialist in an office. It involves using a wandlike device 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. This test is sometimes done in combination with an injection of medications into the penis to stimulate blood flow and produce an erection.
  • Overnight 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.This device measures the number and strength of erections that are achieved overnight. It can help to determine if your ED is related to psychological or physical causes.
  • Psychological exam. Your doctor might ask questions to screen for depression and other possible psychological causes of ED.

Living With Erectile Dysfunction

Complications resulting from ED can include:

  • An unsatisfactory sex life
  • Stress or anxiety
  • Embarrassment or low self-esteem
  • Relationship problems
  • The inability to get your partner pregnant

For many men, ED is caused or worsened by lifestyle choices. They can take steps and make choices that might help improve symptoms of ED.

  • If you smoke, quit.
  • Lose excess pounds. Being overweight can cause or worsen ED.
  • Include physical activity in your daily routine. Exercise can help with underlying conditions that play a part in ED by reducing stress, helping you lose weight, and increasing blood flow.
  • Get treatment for alcohol or drug problems. Drinking too much or taking certain illegal drugs can worsen ED directly or by causing long-term health problems.
  • Work through relationship issues. Consider couples or marriage counseling if you are having trouble improving communication with your partner or working through problems on your own.

Erectile Dysfunction Treatments

There are several new treatments for ED. For many men, the answer is as simple as taking a pill. Getting more exercise, losing weight, or stopping smoking may also help.

Oral medications are a successful ED treatment for many men. These medications enhance the effects of nitric oxide — a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation.

Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing men to function normally. Oral ED medications are not aphrodisiacs, will not cause excitement, and are not needed in men who get normal erections.

The medications vary in dosage, how long they work, and the possible side effects. Your doctor will consider your particular situation to determine which medication might work best. These medications might not fix your ED immediately. You might need to work with your doctor to find the right medication and dosage for you.

Before taking any medication for ED, including over-the-counter supplements and herbal remedies, check with your doctor.

Medications for ED might not work or might be dangerous if you:

  • Take nitrate drugs — commonly prescribed for chest pain (angina) — such as nitroglycerin (Minitran, Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket) and isosorbide dinitrate (Dilatrate-SR, Isordil)
  • Have very low blood pressure (hypotension) or uncontrolled high blood pressure (hypertension)
  • Have severe liver disease
  • Have kidney disease that requires dialysis