What causes erectile dysfunction (ED)?

• Damage to nerves, arteries, smooth muscles, and fibrous tissues often as a result of disease is the most common cause of ED

• Diseases such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease can cause ED. Almost 50 percent of men with diabetes may have erectile dysfunction.

• Surgery (prostate and bladder surgery) or injury to the penis, spinal cord, prostate, bladder, and pelvis

• Hormonal abnormalities

• Medicines used for treating blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine an ulcer drug can lead to ED as a side effect 

• Being overweight and lack of exercise are possible causes  

Psychological factors that can lead to erectile dysfunction

• Stress related to work or family issues
• Anxiety associated with sex because of a prior bad experience
• Anger or frustration with partner

• Inability to communicate openly with your partner

• Feeling that your partner has negative feelings for you

Self-care tips 

• Reduce smoking, alcohol, and drugs

• Lose excess weight

• Exercise and take a healthy diet

• Talk it out with your partner. Communicate your anxiety related to your sexual performance or resolve any anger or conflict before you make love

   

When to approach a doctor? 

• You continue to experience erection problem in spite of taking the self-care measures listed above

• You think that a medicine that you are taking could be causing the problem

• The problems begin after an injury or prostate surgery.

• You have other symptoms such as low back pain or abdominal pain

 How is erectile dysfunction treated?

• The treatment of erectile dysfunction depends on the underlying cause.

• Some men benefit from making lifestyle changes such as quitting smoking, losing excess weight, and increasing physical activity

• Stopping or changing a medicine may be enough if erectile dysfunction is occurring solely as a side effect of the medication

• Psychological counseling is helpful if erectile dysfunction is associated with anxiety

• Medicines for treating erection problems include pills, injections into the penis, and pellets inserted in the urethra

• Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) are used to treat mild to moderate cases. There is a false notion that they boost sexual performance even in men without erection problems. These medicines should not be used without consulting a doctor as they can have serious side effects. When taken along with some blood pressure medicines (nitroglycerine/ alpha-blockers), they can cause a dangerous fall in blood pressure, which in certain instances may be fatal.

• If pills do not help, your doctor may suggest an injection or a testosterone patch. Many men who do not benefit from pills respond to injections or pellets inserted into the urethra.

• In cases that do not respond to above mentioned therapies, vacuum devices or implants may be required. Implants can restore erection in many men with erectile dysfunction.