An in-depth report on the causes, diagnosis, treatment, and prevention of erectile dysfunction.
Erectile dysfunction (ED), formerly called impotence, can affect men of all ages, although it is much more common among older men. It is normal for men to occasionally experience ED. However, if the problem becomes chronic, it can have adverse effects on relationships, emotional health, and self-esteem.
ED can be a symptom of an underlying health condition. If ED becomes an on-going problem, it is important to talk to your doctor.
Causes of Erectile Dysfunction
- Physical causes are the main reasons for ED. They include atherosclerosis (which also causes heart disease and peripheral artery disease), high blood pressure, diabetes, neurological disorders, medication side effects, prostate surgery, radiation treatment to the pelvis, and other health conditions.
- Psychological causes of ED include anxiety, depression, stress, and problems in relationships.
- Lifestyle factors that increase risk for ED include smoking, alcohol use, and other substance abuse.
Phosphodiesterase-5 (PDE5) Inhibitors
ED is usually treated with a PDE5 inhibitor drug such as:
- Sildenafil (Viagra)
- Vardenafil (Levitra, Staxyn)
- Tadalafil (Cialis)
- Avanafil (Stendra)
These drugs are generally safe and effective for most men. They may not be appropriate for men with certain health conditions, such as severe heart disease, heart failure, uncontrolled high blood pressure, diabetes, or a history of stroke or heart attack. Men who take nitrate drugs cannot use PDE5 inhibitors. PDE5 inhibitors can also interact with other medications. Talk to your doctor about whether PDE5 inhibitor drugs are a safe choice for you.
Other treatments for ED include:
- Alprostadil injections or suppositories
- Testosterone replacement therapy (for men with low testosterone levels)
- Vacuum devices
- Penile implants
- Vascular surgical procedures
It is very important to treat any underlying health conditions that may be causing ED. It is also important to engage in healthy lifestyle behaviors by eating right, staying physically active, reducing stress, and stopping smoking and substance abuse.
Testosterone Products: Safety Risks
The FDA has issued a warning that testosterone products may increase the risk for heart attack, stroke, and death from cardiovascular causes. The FDA has also required that all testosterone products' labels include information on increased risk for blood clots in the veins. These products can have other serious health risks as well.
Testosterone products are approved to treat men who have hypogonadism (low testosterone levels). ED can be one of the symptoms of low testosterone. However, it is not clear if these products are helpful for ED in men who have hypogonadism. They should not be prescribed to men who have normal testosterone levels. Doctors are concerned that these products are being overprescribed due to increased advertising, and not medical need.