Erectile dysfunction (impotence) occurs when a man can no longer get or keep an erection firm enough for sexual intercourse. Having erection trouble from time to time isn’t necessarily a cause for concern. But if erectile dysfunction is an ongoing problem, it may cause stress, cause relationship problems or affect your self-confidence.
Even though it may seem awkward to talk with your doctor about erectile dysfunction, go in for an evaluation. Problems getting or keeping an erection can be a sign of a health condition that needs treatment, such as heart disease or poorly controlled diabetes. Treating an underlying problem may be enough to reverse your erectile dysfunction.
If treating an underlying condition doesn’t help your erectile dysfunction, medications or other direct treatments may work.
Physical Causes of Erectile Dysfunction
In most cases, erectile dysfunction is caused by something physical.
Common causes include:
- Heart disease
- Clogged blood vessels (atherosclerosis)
- High cholesterol
- High blood pressure
- Metabolic syndrome
- Parkinson’s disease
- Multiple sclerosis
- Low testosterone
- Peyronie’s disease, development of scar tissue inside the penis
- Certain prescription medications
- Tobacco use
- Alcoholism and other forms of substance abuse
- Treatments for prostate cancer or enlarged prostate
- Surgeries or injuries that affect the pelvic area or spinal cord
Psychological causes of erectile dysfunction
The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:
- Depression, anxiety or other mental health conditions
- Relationship problems due to stress, poor communication or other concerns
Other Risk Factors
A variety of risk factors can contribute to erectile dysfunction. They include:
- Medical conditions, particularly diabetes or heart problems.
- Using tobacco, which restricts blood flow to veins and arteries. Over time tobacco use can cause chronic health problems that lead to erectile dysfunction.
- Being overweight, especially if you’re very overweight (obese).
- Certain medical treatments, such as prostate surgery or radiation treatment for cancer.
- Injuries, particularly if they damage the nerves that control erections.
- Medications, including antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate cancer.
- Psychological conditions, such as stress, anxiety or depression.
- Drug and alcohol use, especially if you’re a long-term drug user or heavy drinker.
- Prolonged bicycling, which may compress nerves and affect blood flow to the penis, can lead to temporary erectile dysfunction.
Nonsurgical Treatment at CORE
Oral medications are a successful erectile dysfunction treatment for many men. They include:
- Sildenafil (Viagra)
- Tadalafil (Cialis)
- Vardenafil (Levitra, Staxyn)
All three medications work in much the same way. These drugs enhance the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation. These medications vary in dosage, how long they work and their side effects. Your doctor will take into account your particular situation to determine which medication may work best.
Possible side effects include flushing, nasal congestion, headache, visual changes and stomach upset.
These medications may not fix your erectile dysfunction immediately. You may need to work with your doctor to find the right medication and dose for you.
Before taking any prescription erectile dysfunction medication (including over-the-counter supplements or herbal remedies), get your doctor’s OK. Although these medications can help many people, not all men should take them to treat erectile dysfunction.
Other medications for erectile dysfunction include:
- Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Caverject Impulse, Edex) into the base or side of your penis. Each injection generally produces an erection that lasts about an hour. Because the needle used is very fine, pain from the injection site is usually minor. Side effects can include bleeding from the injection, prolonged erection and formation of fibrous tissue at the injection site.
- Alprostadil penis suppository. Alprostadil intraurethral (Muse) therapy involves placing a tiny alprostadil suppository inside your penis in the penile urethra. You use a special applicator to insert the suppository into your penile urethra. The erection usually starts within 10 minutes and lasts between 30 and 60 minutes. Side effects can include pain, minor bleeding in the urethra, and formation of fibrous tissue inside your penis.
- Testosterone replacement. Some men have erectile dysfunction caused by low levels of the hormone testosterone, and may need testosterone replacement therapy.
There is always help. Make an appointment today.