Erectile dysfunction is among the more common health problems men will encounter during their lives. It’s one of those inevitable parts of aging, with some studies suggesting it affects more than half of men over 60. It’s also linked to a host of other factors, some of which are easily solved.
But erectile dysfunction (ED) also can be an early indicator of heart disease. In fact, in some men, it can predate serious cardiac complications by 10 years. This is because the arteries in the penis are smaller than those in the heart. So, the impact of coronary artery disease may be quicker to show up in that region.
One of the first tests to evaluate patients is an ultrasound of the arteries and veins leading into and out of the penis. Restricted blood flow into those arteries could indicate a life-threatening heart condition.
Once diagnosed, not only can your doctor fix the ED problem, but they will immediately send you to a cardiologist for a stress test.
What Causes ED?
- Diabetes: Up to 50 percent of men with the disease get ED.
- Psychological/emotional: Performance can be affected by depression, stress, anxiety, guilt and low self-esteem.
- Medications: In particular, drugs designed to treat depression, anxiety and high blood pressure can play a role. Here’s a list of drugs that can cause it.
- Smoking: The more you smoke, the more likely you are to have issues.
- Drinking: Alcohol impairs circulation and nerve sensitivity.
- Obesity: A man with a 42-inch waist is twice as likely to have ED than a man with a 32-inch waist, according to one study.
- Hormone imbalance: Testosterone and estrogen are potential culprits.
- Age: Some degree of ED is inevitable as we get older, though severity can vary greatly from person to person.
Another factor that often doesn’t get as much attention as a potential cause of ED is the prevalence of internet pornography. Unfortunately, this has put unrealistic expectations on men and their ability to perform.
Porn addiction also plays a role in a different form of ED – an inability to climax during sex, despite being able to achieve an erection. When you require that kind of imagery to have a release, it can create serious problems in terms of being with another person. That’s a whole other subset of ED for which there’s no cure or medication.
Sometimes, the answer can be elusive. There are patients who have no trouble with an erection, but they simply lack the desire for sex. That’s a curious subject for urologists and others studying it. We don’t really have a handle on what controls libido.
Often, the first diagnostic option in your doctor’s toolbox is a little blue pill. This will tell them whether a patient is physically able to get an erection. These medications work by blocking the enzymes that break down the nitric oxide that causes erection.
Other options include blood tests to measure hormone and blood sugar levels; ultrasound (penile doppler) to assess blood flow; a vascular stimulant injected into the penis to create an erection; and pelvic X-rays.
Considering that ED has a wide range of causes, it shouldn’t be surprising that treatment options also are broad. They include:
- Oral drugs: The group includes Viagra, Cialis and Levitra.
- Testosterone therapy: This can be useful in cases where low sex drive and low testosterone levels are to blame.
- Penile injections: This is an option for men who don’t respond to oral medications.
- Vacuum erection devices: Another option when medication doesn’t work.
- Penile implants: An option for older men.
When You Should Ask for Help
ED is defined as anything that goes wrong with your erection when you want to have sex. Severity will vary greatly – from occasional to a complete inability to achieve or maintain an erection.
Fortunately, the success of oral medications has brought the issue of ED into the mainstream. The existence of these options has encouraged a lot of men – often younger and younger – to seek help. In earlier times, many of those men would have remained silent.Erectile dysfunction can play a major role in your quality of life. Talk to your doctor if you are experiencing issues.