Understanding Erectile Dysfunction: A Guide to Men’s Sexual Health

If you have trouble getting or keeping an erection, you might feel embarrassment and avoid intimacy with your partner. It’s important to understand that erectile dysfunction is a medical issue that can affect men at any age – although it’s more common in older men. And there are treatments that can help.

What Causes ED?

ED can be caused by many different things, including physical health problems, mental health issues and lifestyle choices.

• Health Conditions. Long-lasting health problems like high blood pressure, diabetes and high cholesterol can interrupt blood flow to the penis, making it difficult to have an erection. Being overweight can make these problems worse.
• Hormonal imbalances. If a man has low levels of testosterone, it can affect his sex drive and his ability to have an erection. Testing for hormone levels is important if symptoms suggest a hormone problem.
• Psychological factors. Stress, anxiety and depression can lead to ED. These mental health issues can affect a man's desire and performance in sexual activities. Sometimes, the medicines used to treat these conditions can cause ED.
• Lifestyle influences. Unhealthy habits like smoking, drinking too much alcohol and eating poorly can lead to ED. Not exercising enough also can lower heart health, which is important for erections.

How Doctors Diagnose ED

Doctors usually start diagnosing ED with a questionnaire called the Sexual Health Inventory for Men (SHIM). This survey helps measure how severe the ED is and how much it affects a man's life. It also helps doctors figure out the best way to treat ED.

Treatments for ED depend on what's causing it. Lifestyle changes are usually the first step and involve eating healthier and exercising regularly to improve heart health and help with erections.

Medications also are an option and can be prescribed to help increase blood flow to the penis to help with erections. If ED is caused by psychological issues, talking to a counselor or therapist can help.

Advanced Treatments for Erectile Dysfunction

When simpler steps like changing your lifestyle or taking medication don't help with ED, doctors might suggest other options, such as penile injections, vacuum erection devices and surgery.

Penile injections. This method involves using a small needle to inject medicine directly into the side of the penis. The medicine helps blood flow better and helps with erections in just minutes. Although this treatment can be highly effective, the idea of injecting oneself can seem scary. If you decide on injections, your doctor can discuss your concerns and provide injection training in the office.

Vacuum erection devices. Also known as penis pumps, these are devices that help create an erection without surgery. A plastic tube is placed over the penis while a pump creates a vacuum that draws blood into the penis, making it erect. A band is placed at the base of the penis to maintain the erection. This device can help with many different causes of ED, whether they are mental or physical.

Surgical treatments. Surgery is usually considered when other treatment methods haven't provided relief. There are two main types of surgery. They include:

• Penile implants, where doctors put devices inside the penis on both sides. These can be inflated or contain firm rods that can bend. These implants look and feel natural and cannot be seen from the outside.
• Vascular surgery is less common and used for men with specific blood flow problems in their penis. Surgeons may fix damaged vessels or create a new path for blood to flow to help get an erection.

What Should You Do If You Think You Have ED?

If you think you might have ED, fill out the SHIM questionnaire. After that, talking to your primary care doctor or a urologist can help you find the right treatment. ED can affect relationships and how a man feels about himself. It’s important to talk openly with spouses and partners, and understand that ED is a widespread problem that doesn't reflect on one's masculinity.

Erectile dysfunction is a condition that many men can manage with the right treatment. If you have symptoms of ED, help is out there. Talk to your doctor about your treatment options to regain control of your sexual health and maintain your quality of life.