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Posted on 02-07-2012
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When a man can’t get an erection to have sex or can’t keep an erection long enough to finish having sex, it’s called erectile dysfunction or impotence. Erectile dysfunction can occur at any age, but it is more common in men older than 65.

Erectile Dysfunction: Causes

Reduced blood flow to the penis. Like in other parts of the body, the arteries which take blood to the penis can become narrowed. The blood flow may then not be enough to cause an erection. ‘Risk factors’ can increase your chance of ‘narrowing of the arteries’. These include: getting older; high blood pressure; high cholesterol; smoking; diabetes.

Illnesses including kidney or heart disease, or diabetes, can cause erectile dysfunction

A reduction in blood flow to the penis, common in men who have hardening of the arteries

Diseases such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, and vascular disease account for a large percentage of cases of erectile dysfunction.

Symptoms of Erectile Dysfunction

Sometimes, erectile dysfunction (ED) only occurs in certain situations.

For example, you may be able to obtain an erection during masturbation, or you may find that you sometimes wake up with an erection. However, you may be unable to obtain an erection when you are with your sexual partner.

Erections depend on healthy blood flow to the penis. During an erection, vessels in the penis become engorged with blood to produce an erection. Many diseases that affect the blood vessels can interfere with blood flow to the penis. Atherosclerosis (hardening of the arteries) and high blood pressure (hypertension) can cause abnormal blood flow to the penis and can affect a man’s ability to have an erection.

How is the condition diagnosed?

A medical evaluation is done when a man expresses concerns about erectile dysfunction to his healthcare provider. The evaluation may include a physical and psychological exam, and a written questionnaire on past sexual experiences. Lab tests are done to rule out certain diseases.

How is erectile dysfunction treated?

Drugs for treating ED can be taken orally, injected directly into the penis, or inserted into the urethra at the tip of the penis. In March 1998, the Food and Drug Administration (FDA) approved Viagra, the first pill to treat ED. Since that time, vardenafil hydrochloride (Levitra) and tadalafil (Cialis) have also been approved. Additional oral medicines are being tested for safety and effectiveness

Oral therapy using one of the three ED drugs now on the market is the ‘first line’ treatment for erectile dysfunction, Dr. Langenstroer said, adding that primary care physicians most often prescribe these drugs. “Viagra, Levitra, and Cialis are all in the same class of drugs called phosphodiesterase inhibitors,” he said. “What they do in simple terms is block an enzyme and prolong erections by a process that is driven by nitric oxide.”

Many reasonable nonsurgical treatment options exist for erectile dysfunction (also called male impotence), including external vacuum devices, medications (oral and topical), hormonal therapy, penile injection therapy, and intraurethral pellet therapy. Sex counseling is another option and is discussed in Living With Erectile Dysfunction.

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