Robert Wood Johnson University Hospital

Erectile Dysfunction (ED) / Impotence

Erectile Dysfunction (ED) / Impotence

What is ED?

Impotence, or erectile dysfunction, may result from the total inability to achieve erection, an inconsistent ability to achieve an erection, or the ability to only sustain a brief erection. According to the National Institutes of Health (NIH), up to 30 million men are affected by ED, depending on the definition used.

Although in the past it was commonly believed to be due to psychological problems, it is now known that for most men erectile dysfunction is caused by physical problems, usually related to the blood supply of the penis. Many advances have occurred in both diagnosis and treatment of ED.

What are the risk factors for ED?

One risk factor is advancing age. According to the American Urological Association (AUA), as men age, the level of circulating testosterone decreases, which may interfere with normal erection. While a low testosterone level itself is rarely the cause of ED, low testosterone can be an additional contributing factor in many men who have other risk factors for ED. Other risk factors for ED include various medical problems such as hypertension (abnormally high blood pressure), diabetes, vascular disease, and high levels of blood cholesterol. Smoking and drug and alcohol abuse also are risk factors for ED.

What are the causes of ED?

According to the NIH, ED also is a symptom in many disorders and diseases. Causes of ED include the following:

How is ED diagnosed?

The AUA states that for most men, a diagnosis will require a simple medical history, physical examination, and a few routine blood tests. Most patients do not require extensive testing before beginning treatment.

Diagnostic procedures for ED may include the following:

What is the treatment for ED?

Specific treatment for erectile dysfunction will be determined by your doctor based on:

Some of the treatments available for ED include the following:

How do couples cope with ED?

Erectile dysfunction can cause strain on a couple. Many times, men will avoid sexual situations due to their emotional pain associated with ED, causing their partner to feel rejected or inadequate. It is important to communicate openly with your partner. Some couples consider seeking treatment for ED together, while other men prefer to seek treatment without their partner's knowledge. A lack of communication is the primary barrier for seeking treatment, and can prolong the suffering. The loss of erectile capacity can have a profound effect on a man. The good news is that ED can usually be treated safely and effectively.

Feeling embarrassed about being impotent may prevent many men from seeking the medical attention they need, which can delay diagnosis and treatment for more serious underlying conditions. Impotence itself is often related to an underlying problem, such as heart disease, diabetes, liver disease, or other medical conditions.

Since impotence can be a forewarning symptom of progressive coronary disease, men should tell their physicians about their symptoms of ED. Physicians may ask directly about sexual function, through conversation or a questionnaire during a check-up, in order to detect more serious health conditions sooner.

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