If you suffer from erectile dysfunction (ED), you are not alone. An estimated 30 million men in the United States share this condition. The number of men with ED and the severity of ED increase with age and 40 percent of men between 50 and 59 years of age will have some degree of ED.
Fortunately, you do not have to live with ED. Treatment options are available for a wide range of situations. While it may be embarrassing to discuss ED with your doctor, 90 percent of cases have underpinning physical causes that could have important implications for your overall health.
What is ED?
The technical definition of erectile dysfunction is the inability to maintain an erection firm enough for sexual intercourse, but this may mean very different things to different men.
What causes ED?
Most causes are physical, though psychological factors including stress, anxiety, depression or fear of sexual failure, may exacerbate the situation. An erection is normally the result of a complex interplay of nerves, blood vessels, smooth muscle and connective tissue, all of which are susceptible to interference. Certain medications, smoking or excessive alcohol or other recreational drug use could contribute to ED. Many neurologic conditions such as Multiple Sclerosis may contribute. Sometimes injury, surgery or radiation treatments can affect involved nerves or blood vessels. Many cases are the result of clogged blood vessels caused by the same factors that contribute to heart disease, such as diabetes, high blood pressure and obesity.
How can I prevent ED?
Dr. Cushman’s post on reducing stroke and cardiovascular disease risk highlights seven key measures for good health. These same measures play an important role in combating ED. In fact, a 2010 Italian study randomized 60 men with ED to receive either medication alone or medication plus 3 hours per week of aerobic physical activity. After 3 months, 39 percent of the medication alone group reported completely normal erections versus 78 percent of the medication plus exercise group [i].
How else is ED treated?
The first pill approved to treat ED in the late 1990s was actually developed to treat high blood pressure but was found to have the interesting side effect of producing an erection. Oral medications are effective in about 70 percent of cases. There are many other options for treatment including suppositories, injections, vacuum devices and even surgery, all of which can be highly effective. Gene therapy for ED is currently under investigation at several centers.
Is ED a serious condition?
ED is often a warning sign of clogged arteries all over the body, including the heart. ED is now recognized as a stronger predictor for cardiovascular disease than family history, smoking or high cholesterol! There is generally a 2 to 5 year period between the onset of ED and a heart attack or stroke. Your doctor can help determine whether you might benefit from further testing.
Peter Holoch, MD, is a Urologist at the University of Vermont Medical Center and Associate Professor at the Larner College of Medicine at UVM.
[i] Maio, G., Saraeb, S. and Marchiori, A. (2010), Physical Activity and PDE5 Inhibitors in the Treatment of Erectile Dysfunction: Results of a Randomized Controlled Study. Journal of Sexual Medicine, 7: 2201–2208