Erectile dysfunction is when a man cannot achieve or maintain an erection that is firm enough for sexual intercourse. Having ED once in a while is normal, but if you experience ED for more than three months, talk to your doctor.
The most common cause of erectile dysfunction is a cardiovascular problem. The blood vessels in the penis are among the smallest in the body and are often the first to exhibit symptoms of high blood pressure (hypertension) or arthersclerosis (hardening of the arteries), or diabetes.
Other causes of erectile dysfunction include surgery, such as prostate cancer surgery, that affects the nerves or blood vessels that play a role in getting erections. Side effects from medications such as antidepressants or antihistamines, emotional or mental stress, and lifestyle choices including smoking and alcohol and drug abuse can also cause ED.
Diagnosing erectile dysfunction involves a discussion of your medical history and symptoms; a physical examination to look for signs of problems with your circulatory, nervous, and endocrine system; and routine lab tests to check for underlying conditions such as heart disease, diabetes, and low testosterone.
- Medication Adjustments: Adjusting a medicine that is triggering ED may be all you need to do
- Behavioral Changes: Quitting smoking, exercising, or losing weight can improve ED
- Counseling: This can help if your ED is affected by stress, depression or anxiety
- Medications: Medications such as Viagra increase your response to sexual arousal. They help to relax the muscles in your penis allowing blood to flow in.
- Vacuum Erection Device: Also called a penis pump, this device draws blood into your penis using a plastic tube and pump. A constriction ring at the base of your penis helps you keep the erection.
- Penile injections and Suppositories: Rice-sized pellets inserted into the urethra relax the muscles and blood vessels in your penis to allow blood to flow in to create an erection.
- Surgery/Penile Implant: When other treatments have not worked, the surgical placement of a penile implant or penile prosthesis can allow men to be sexually intimate. Sensation and orgasm do not change with the placement of a penile implant.
Do “male enhancement” pills work?
In a word, no. Over-the-counter pills sold on late night TV and in men’s magazines are herbal supplements that are not regulated by the FDA and have not been shown to be effective for erectile dysfunction or penile enlargement.
How can I bring up my erectile dysfunction with my doctor?
Start the conversation by acknowledging that this is a hard subject for you to talk about. You might also mention that you’re concerned about erectile dysfunction being an early indicator of a more severe problem like cardiovascular disease or diabetes. Your urologist will discuss your concerns with the professionalism you’d expect when discussing any other medical condition and will help put you at ease.