Erectile Dysfunction (Impotence)

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Erectile dysfunction (ED), also known as impotence, is the inability to get and maintain an erection that is sufficient for satisfactory sexual intercourse.

ED is a very common condition, particularly in older men. It is estimated that half of all men between the ages of 40 and 70 will have it to some degree.

Why does erectile dysfunction happen?

ED can have a range of causes that can be both physical and mental (psychological). Physical causes include:

  • narrowing of the blood vessels going to the penis – commonly associated with high blood pressure (hypertension), high cholesterol or diabetes
  • hormonal problems
  • surgery or injury

Psychological causes of ED include:

  • anxiety
  • depression
  • relationship problems

 

Symptoms of erectile dysfunction

The main symptom of erectile dysfunction (ED) is the inability to get and maintain an erection for satisfactory intercourse.

ED should not be confused with ejaculation problems such as premature ejaculation, which is a condition where the process of arousal, orgasm and ejaculation occurs very rapidly.

Inability to get an erection

Sometimes ED only occurs in certain situations. For example, you may be able to get an erection during masturbation, or you may find that you sometimes wake up with an erection but you are unable to get an erection with your sexual partner.

In these circumstances, it is likely that the underlying cause of ED is primarily psychological (stress related). However, if you are unable to get an erection under any circumstances, it is likely that the underlying cause is primarily physical.

Seek medical advice

See your GP if ED persists for more than a few weeks. They will assess your general state of health because the condition can be the first sign of more serious health conditions, such as heart disease (when the heart’s blood supply is blocked or interrupted).

Many websites offer treatments for ED but their use is not recommended. The medications that are offered by these sites could be fake and may be dangerous. Even if the medications are genuine, they may not be suitable for you.

It is important that you only take medication for ED that your GP has prescribed for you.

Diagnosis

Although you may be embarrassed, it is important that a healthcare professional diagnoses ED so that the cause can be identified.

ED can usually be diagnosed after a consultation with your GP. This will involve answering questions about your symptoms, as well as a physical examination and some simple tests.

How is erectile dysfunction treated?

ED is primarily treated by tackling the cause of the problem, whether this is physical or psychological.

The narrowing of the arteries (called atherosclerosis) is one of the most common causes of ED. In these cases your GP may suggest lifestyle changes, such as losing weight, to try to reduce your risk of cardiovascular disease. This may help to relieve your symptoms as well as improving your general health. You may also be given medication to treat atherosclerosis, such as cholesterol-lowering statins and drugs to reduce your blood pressure.

There are several treatment options that have proved very successful for ED. Medication, such as sildenafil (sold as Viagra), can be used to successfully manage it in at least two-thirds of men. Vacuum pumps that encourage blood to flow to the penis and cause an erection are also successful in 90% of cases.

Psychological treatments include cognitive behavioural therapy (CBT) and sex therapy.

Overall, treatments for ED have improved significantly in recent years. These days most people are eventually able to return to successful intercourse.

source: nhs.uk
Reproduced by kind permission of the Department of Health, © 2014