What is Erectile Dysfunction?

Erectile Dysfunction (ED) is defined as the inability to achieve and/or maintain an erection sufficient for satisfactory sexual intercourse.  While most often associated with older men, Erectile Dysfunction is a common problem for men of all ages.

The term “impotence” was once loosely used to imply the same condition. Many men consulting the physicians of the Boston Medical Group can achieve an erection, but it is usually not as firm or as lasting as it once was.

What are the Signs of Erectile Dysfunction?

• Difficulty achieving or maintaining an erection occurring at least once in every four times of attempting sexual intercourse, or persisting for more than one month.
• Achieving an erection taking longer than usual or becoming more difficult in certain positions.
• Sexual erection becoming weaker or less rigid.
• Maintaining an erection becoming a conscious effort or becoming more and more difficult.
• Morning erections becoming less frequent or less rigid.
• Climaxing or ejaculating more rapidly or with an incomplete erection.

How Common is Erectile Dysfunction?

Erectile Dysfunction is very common in the United States and around the World. Although ED is more common in men over 40, it can affect men of all ages.  According to the Massachusetts Male Aging Study, which was the largest survey of male erectile dysfunction ever conducted, is even more common that previously thought.  For example: 

• 52% of all men between the ages of 40 and 70 have some degree of erectile dysfunction (classified as mild, moderate or severe).
• At least 1 in 10 men cannot get an erection at all (complete ED).
• The majority of causes of erectile dysfunction are physical in nature.
• There is a strong association between age and ED – that is, the prevalence of ED increases with age.
• While 39% of men at the age of 40 are affected by ED, 67% of men at the age of 70 are affected.

Erectile Dysfunction Causes: Psychological

Psychological factors account for about 10% of erection problems and often result from nervousness, performance anxiety or fear of failure during lovemaking. These factors cause a surge of adrenaline which reduces blood flow to the penile area, often resulting in erectile difficulty. Psychological ED may become self-perpetuating. After several episodes of repeated failure, the body becomes accustomed to releasing adrenaline at the very thought of a sexual encounter. This can become a vicious cycle difficult to break without help.

Other less common causes include stress, low sexual drive, guilt, anxiety, sexual boredom or depression.

The characteristics of psychological erectile dysfunction include:

• The ability to achieve or maintain an erection with one partner but not with another
• The ability to achieve or maintain strong and lasting erections in the mornings and during masturbation but not during lovemaking.
• The tendency to affect younger men with unstable relationships or unsettling past experiences.

Erectile Dysfunction Causes: Physical

About 90% of cases of ED are caused by physical factors, classified as vascular (related to blood flow) and non-vascular diseases. It is estimated that 70% of cases of ED may be attributable to vascular diseases alone.

The penis requires a healthy blood flow to become completely erect, and even a marginal reduction in blood flow can cause problems. This condition is referred to as “vascular insufficiency” and is known to be caused by, or associated with, the following risk factors:

• Diabetes
• Hypertension
• High Blood Cholesterol
• Cardiac diseases
• Smoking
• Poor Overall Circulation

Research indicates that more than 200 prescription medications can cause, contribute to, or aggravate ED. However, it is imperative that you must not discontinue your medications unless otherwise instructed by your physician.

Other associated physical conditions or causes are less common. These include:

• Hormonal deficiencies caused by testicular disease, liver disease or thyroid problems.
• Neurological problems such as Multiple Sclerosis, Stroke or Parkinson’s disease.
• Trauma to the pelvic area as experienced in certain types of surgery, radiation therapy or automobile accidents resulting in damaged pelvic nerves or arteries.
• Chronic illnesses such as chronic liver disease, chronic renal disease etc.
• Peyronie’s plaque or disease, a peculiar condition of excessive fibrosis in the penile tissue

It is however, not uncommon to see ED in an otherwise completely healthy person, both physically and psychologically. It is postulated that the penile circulation is intrinsically precarious, being an end-artery. As men age, partial obstructions to the blood flow of the penis may become more common.  While this may in inconsequential under normal conditions, it may be enough to cause insufficient blood flow to the penis when sexually aroused.

Erectile Dysfunction’s Adverse Effects on Daily Life

Erectile dysfunction may cause or exacerbate psychological problems such as poor motivation, feelings of inadequacy, frustration, denial and low self-esteem, and may ultimately lead to depression. As a result, personal, family and business relationships may be adversely affected if it is left untreated.

The Importance of Proactively Treating Erectile Dysfunction

As with any medical condition, erectile dysfunction is best be treated promptly. The sooner it is diagnosed and treated, the better the outcome, for the following reasons:
First, identifying and correcting the underlying problem will help prevent further deterioration, a natural progression of the condition. There is no long-term benefit of treating only the symptoms of ED.
Second, disuse of an organ can cause progressive loss of function via progressive loss of healthy tissue. This condition is called “disuse atrophy” and is particularly important in the case of penile health.  In other words, the less the penis is used with healthy erections, the less able it will be to produce healthy erections in the future.
Third, ED is more than just a sexual problem. A fulfilling sex life can lead to greater satisfaction in many other aspects of life, including social, family and work environments.
Finally, a healthful sex life can contribute to your overall good health and well-being.

Sources:

1. The National Institute of Diabetes and Digestive Kidney
2. WebMD
3. The US FDA