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Overcoming erectile dysfunction

You've probably seen enough advertisements to know that there is a variety of treatments for erectile dysfunction (ED).

To be sure, treatment for ED can help get your love life back on track. But there's another important reason to see a doctor if you have ED: The condition could be the result of a more serious underlying medical problem.

What is ED?

According to the American Urological Association (AUA), ED is the repeated inability to achieve or maintain an erection suitable for sexual intercourse. Some men are completely unable to achieve an erection. Others have inconsistent or brief erections.

Having ED can be frustrating, but the condition is almost always treatable.

Causes of ED

Conditions that might cause ED can involve blood vessels, nerves, hormones, lifestyle choices or psychological factors. For example, according to the AUA, ED may be caused by:

  • Poor blood flow. Atherosclerosis—the hardening and narrowing of arteries often linked to long-term effects of high blood pressure and high cholesterol—can get in the way of the proper blood flow needed for an erection.
  • Nerve disorders. Multiple sclerosis, Parkinson's disease and other similar disorders can interrupt vital nerve impulses to and from the brain.
  • Diabetes. This common condition can damage small blood vessels that bring blood to the penis. It can also damage the nerves needed for an erection.
  • Lifestyle choices. Habits that contribute to heart disease and blood vessel problems also increase ED risk. Smoking, weighing too much and not exercising enough are all possible ED causes.
  • Psychological factors. Experts estimate that 10 to 20 percent of ED cases are the result of emotional or psychological issues, such as stress, anxiety, guilt, depression and low self-esteem.
  • Medication side effects. More than a hundred medications have ED as a side effect. For example, some medicines that treat high blood pressure, ulcers, infections, anxiety, depression and other ailments can also cause ED. 
  • Hormone problems. Less commonly ED may be linked to low levels of testosterone in the blood.

Treatment

Depending on what's causing ED, there are likely to be a number of treatment options available.

For some men, simply losing weight, exercising and quitting smoking helps overcome ED. Others see improvement by switching medications to drugs less likely to have ED as a side effect. Men with low testosterone can boost hormone levels with gels, shots or other methods. Therapy and behavior modification can help men dealing with psychological issues.

But for millions of men, the most effective treatment involves an oral medication, such as avanafil (Stendra), sildenafil citrate (Viagra), tadalafil (Cialis) or vardenafil hydrochloride (Levitra, Staxyn).

These drugs all work the same way. During sexual stimulation, they relax smooth muscles in the penis, allowing increased blood flow.

According to the AUA, nearly 80 percent of men with ED have success with oral medications. Those who don't may see results with drugs injected directly into the penis. Unlike oral medications, injections trigger an automatic erection as blood vessels expand.

For men who can't—or don't want to—take medications, a vacuum pump device can be used to draw blood into the penis. Once the penis is engorged, an elastic band goes around the base to maintain the erection.

For men with severe ED, surgery—including an implanted penile prosthesis—may be an option.

If you're experiencing ED, ask your doctor about a treatment that’s right for you.

reviewed 7/10/2019

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