Erectile dysfunction is the inability to achieve or maintain an erection adequate for sexual intercourse. It refers only to the ability to have erections and does not affect normal sensation, sex drive, or the ability to have an orgasm.
According to the American Foundation for Urologic Disease, erectile dysfunction affects an estimated 18 million men in the United States. Data suggests that only a small percentage of men actually seek and receive treatment, even though erecti le dysfunction can usually be treated successfully.
The penis is a complex structure of muscle, blood vessels, and nerves.
When a man becomes aroused, nerves signal the smooth muscle of the penis to relax. This allows arteries to pump more blood into the chambers inside the muscle. As the penis lengthens, the veins stretch and shut themselves off, which traps blood inside the penis.
After ejaculation, the smooth muscle contracts, the veins loosen their hold so blood can leave the penis, and the erection fades away.
Most erectile dysfunction is caused by a physical condition that affects the nerves or blood vessels responsible for erections.
Causes include diabetes, vascular disease, multiple sclerosis, Parkinson’s disease, surgery or radiation therapy for prostate cancer, or the side effects of medication. Psychological causes include anxiety, depression, or stress.
The physician typically interviews the patient about many physical and psychological factors. The patient must be as frank as possible for his physician to make a diagnosis. He should not interpret these questions as intrusive or too personal if he expects to obtain help. These questions are very relevant and important for determining the proper approach. Even when erectile dysfunction has a clear physical cause, relationships and psychological factors can also have an effect.
The physician will take a medical and personal history and may ask about:
In addition, the physician will ask about the patient’s sexual history, which may include:
If appropriate, the physician might also interview the sexual partner. In fact, including the partner in the interview process may help the physician to better decipher underlying causes and in turn better recommend treatment choices.
Our urologists offer a variety of treatments for erectile dysfunction. Treatment is based on the underlying causes of the condition.