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Frequently Asked Questions - About Erectile Dysfunction

What is erectile dysfunction?

Erectile dysfunction (ED) is the inability to achieve or sustain an erection satisfactory for intercourse.  It is perhaps one of the most troubling medical conditions a man can face.  Impotence can be devastating from an emotional standpoint, not only to the man affected, but also to his intimate partner.  For many men, life without sex can be like a water color painting that should possess all of the vibrant colors of life, but instead has been reduced to the dullness of black and white.

Is erectile dysfunction a physical or a psychological problem?

Although erectile dysfunction can actually cause or aggravate psychological problems, we now know that in about 75 percent of cases, erectile dysfunction results from a physical problem as opposed to an emotional one. While it is true that sexual interest may wane over time or that decreased interest in sex may occur in couples experiencing marital strife, a passing lack of desire is not to be confused with erectile dysfunction.

Is erectile dysfunction related to infertility?

No.  Impotence is not an indicator of male fertility or infertility and the two should not be confused.  A man can achieve an erection, ejaculate, and still be infertile; also, a man who has trouble achieving or sustaining an erection may still be able to father a child.

Is erectile dysfunction very common?

Estimates vary; however, it is believed that more than 35 million men in the United States suffer from some degree of erectile dysfunction.  This may be a conservative estimate when you consider that only a small percentage of men with this problem seek help.  As our population ages, these numbers are expected to increase.  And while erectile dysfunction is not a normal condition of aging, the disease tends to affect older men at higher rate than younger men.  One third of men over the age 60 will experience erectile dysfunction at least some of the time.  Severity of the condition in all men can be mild, moderate or severe. 

What are the major physical causes of erectile dysfunction?

Impotence can result from a wide variety of factors.  Some forms of the problem are temporary, such as erectile dysfunction resulting from stress, fatigue, depression or excessive use of drugs and alcohol.  Other forms are more chronic and persistent in nature.  Common causes include diabetes, male hormone deficiencies, side effects of certain prescription medicines, interference with blood flow to the penis (due to high cholesterol or high blood pressure), and prostate surgery or surgery on other nearby organs in the pelvis which can affect sexual performance.

Which medications may cause erectile dysfunction?

Drugs which can cause erectile dysfunction include certain medications for treatment of heart disease, high blood pressure, and depression as well as muscle relaxants. Alcohol, used to excess, can have an adverse effect on a man's ability to have an erection, as can some (illicit) so-called 'recreational' drugs. Some legal over-the-counter drugs can also cause temporary erectile dysfunction.

What interferes with blood flow to the penis?

Atherosclerosis (or hardening of the arteries) and/or high blood pressure are often to blame in many cases of erectile dysfunction.  Hardening of the arteries happens as people age and certain forms of it can be hereditary.  It is also often related to high blood pressure, unhealthy diet, lack of exercise, and lifestyle choices.  Diets high in fatty foods, a sedentary lifestyle, and obesity can all contribute to this condition.  A leading cause of erectile dysfunction is penile arterial insufficiency – meaning not enough blood flows to the inner areas of the penis, which is necessary to produce and sustain an erection.  Excessive cigarette smoking, especially over a long period of time, can cause arterial blockage and wreak havoc with the small blood vessels running through the penis.  There also can be a “leakage” problem, in which the penis cannot trap the blood required to cause an erection.  Impotence can be an early sign of underlying heart and/or blood vessel disease. 

What about diabetes?

Diabetes, a disease affecting an estimated 13 to 14 million individuals in the U.S., is another major cause of erectile dysfunction.  Diabetes – especially undiagnosed, untreated, or uncontrolled diabetes – can set the stage for erectile dysfunction by damaging small blood vessels and nerves essential to the physiological function of achieving an erection.

How is erectile dysfunction evaluated?

Rather than simply choosing a pill or penis injection for treatment, our philosophy is to attempt to define the cause of erectile dysfunction.  Each patient’s need is unique and therapy is individualized based on cause, severity, partner, and budget. 

We begin with a thorough medical history looking for any underlying conditions that might contribute or cause erectile dysfunction.  The initial visit will include a focused physical examination, and when indicated, appropriate blood testing.  Specialized testing may include an ultrasound study of penile blood flow, or at-home monitoring of expected nighttime erections.

What are the most common treatment options for erectile dysfunction?

The first level of therapy involves optimizing general health, elimination (if possible) of offending medicines, and a proper trial of oral therapies such as Viagra, Levitra, or Cialis.  The next step would include adding testosterone, if needed, and tailored penile-injection treatments.  The final option is a minimally invasive, small incision penile-prosthesis implant, which has the highest satisfaction rate of all forms of erectile dysfunction therapy.  Various combinations of these options may be used as well.  Choosing a treatment for erectile dysfunction is often a decision that must take the patient's needs, preferences, and sexual activity patterns into account.  In fact, the range of available treatment options gives most men a choice, and lets them remain in control of the treatment, based on their individual needs.  The best thing a patient can do for an erectile dysfunction problem is to find a good physician that they have confidence in, and work with this individual in resolving the problem.  A urologist is a medical sub-specialist, who is specially trained to diagnose and treat this and many other problems of the genital and urinary tract.

Long gone are the days when a man had to suffer with an erectile dysfunction problem in silence, and cause his sexual partner to suffer.  Sexual intimacy is one of the joys of living, and its absence can have a devastating effect on a man's self-esteem.  It doesn't have to be this way.  Remember: erectile dysfunction is not a personal failing; it is a medical condition that is highly treatable.

Male Care Center - (303) 571-1355
David Sobel, MD.
David Sobel, MD.
David Sobel, MD.
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