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Erectile Dysfunction

Erectile Dysfunction

Definition

Erectile dysfunction (ED) is the inability to attain or maintain an erection of the penis that is firm enough for sexual intercourse.

To initiate and maintain an erection, the penis must fill with blood. One type of blood vessel opens wide to allow blood into the penis. Meanwhile, a second type of blood vessel squeezes down to keep the blood from leaving the penis. Nerve signals cause the proper changes in the blood vessels.

Causes

The following factors can cause erectile dysfunction:

Risk Factors

ED is more common in men who are 65 and older. It is also more common in men of Hispanic descent.

Factors that increase your chance of developing ED include:

  • Obesity
  • Certain medical conditions:
    • Diabetes
    • Arteriosclerosis—hardening of the arteries
    • Chronic kidney disease
    • Liver failure
    • Endocrine disorders
    • Prostatitis
    • Peyronie’s disease—bending of the penis caused by scar tissue
    • Neurological disorders such as multiple sclerosis , peripheral neuropathy, and stroke
    • High blood pressure
    • Psychiatric disorders, such as anxiety and depression
  • Traumatic conditions:
    • Vascular surgery
    • Pelvic surgeries, particularly for prostate cancer
    • Spinal cord injury
  • Behaviors:
    • Alcohol use
    • Illegal drug use
    • Anabolic steroid use
    • Heavy smoking
    • Interpersonal conflicts with a sexual partner
  • Medications:
    • Antihypertensives—for high blood pressure
    • Antihistamines—common as allergy medication
    • Antidepressants
    • Tranquilizers
    • Antipsychotics

Symptoms

Symptoms include:

  • A less firm penis
  • Fewer erections

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Expect questions about the frequency, quality, and duration of your erections. Your answers may help the diagnosis.

Your bodily fluids may be tested. This can be done with blood tests.

Treatment

Treatment options include:

Prevention

To reduce your chance of becoming impotent:

  • Follow treatment plans to manage blood pressure , diabetes, or depression.
  • Maintain a healthy weight .
  • Eat a healthful diet .
  • If you smoke, talk to your doctor about ways to quit . Smoking is significantly associated with ED in older men.
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