With ever-present advertisements touting the benefits of erectile dysfunction (ED) drugs, the condition has become highly visible in recent years. But that doesn’t make it any more welcome for the 5 to 15 percent of American men whose sex lives are affected.
Sometimes called impotence, ED is the inability to get or keep an erection firm enough for sexual intercourse. The disorder can occur at any age, but is more common in men over age 75, according to the American Academy of Family Physicians (AAFP).
Since sexual arousal is a complex process involving hormones, emotions, nerves, muscles, blood vessels and the brain, a malfunction in any of these can lead to ED. Stress, exhaustion and psychological issues can also contribute, and anxiety over maintaining an erection can actually make it harder to attain. In short, any condition that inhibits blood flow to the penis can lead to ED.
According to the AAFP and the Mayo Clinic, ED can be caused by:
The vast majority of ED cases are caused by disease, according to the National Institutes of Health (NIH), while drug side effects account for 25 percent.
Diagnosis & Tests
Doctors can rule out various systemic causes of ED with a physical exam. Breast enlargement in men, for instance, can indicate hormonal issues, while decreased pulses in the wrists or ankles can suggest blood flow problems, according to the NIH.
Beyond that, several tests can lead to an ED diagnosis. According to the Mayo Clinic, these include:
Medications & Treatment
A wide variety of drugs and treatments are available for ED, from simple pills to complex surgeries. The cause and severity of ED will determine which treatment is recommended, according to the AAFP. Some treatments can have significant side effects.
Psychotherapy is an option to treat anxiety-related ED, according to the NIH. The patient's partner can help in the process of developing intimacy and stimulation.
Oral medications successfully treat ED in many men, according to the Mayo Clinic. These include sildenafil (commonly known by the brand name Viagra), tadalafil (Cialis) and vardenafil (Levitra). Each works by enhancing naturally-occurring nitric oxide, which relaxes muscles in the penis and increases blood flow.
However, these medications should not be taken by men who take blood thinners, high blood pressure medicines, nitrate drugs for angina, or alpha blockers for an enlarged prostate. According to the NIH, the combination of ED pills with these other prescription medications can cause a sudden, dangerous drop in blood pressure.
Other ED medications include:
If medications don't work, more aggressive treatments may be recommended, including:
A variety of lifestyle choices can affect the ability to achieve and maintain an erection, so preventing ED is possible in some cases. Men are encouraged to manage chronic health problems with their doctors and to exercise regularly. They also should avoid smoking and excess alcohol and get help for anxiety or depression, according to the Mayo Clinic.