We know: All About Erectile Dysfunction

What is erectile dysfunction?

Erectile dysfunction (ED) is the repeated inability to get or keep an erection firm enough for sexual intercourse. ED can be a total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections.

How common is erectile dysfunction?

Estimates are that between 15 million and 30 million men may be affected, depending on the definition used.

What causes 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-account for about 70 percent of ED cases.

In older men, ED usually has a physical cause, such as disease, injury, or side effects of drug. Incidence increases with age: About 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience ED.

What drugs have side effects that can cause ED?

Many common medicines-blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug)-can produce ED as a side effect.

Can stress cause ED?

Experts believe that psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause 10 to 20 percent of ED cases.

How is ED treated?

Most physicians suggest that treatments proceed from least to most invasive. Cutting back on any drugs with harmful side effects is considered first.

Psychotherapy and behavior modifications in selected patients are considered next if indicated, followed by oral or locally injected drugs, vacuum devices, and surgically implanted devices. In rare cases, surgery involving veins or arteries may be considered.

What kind of oral drugs are there for ED?

Drugs for treating ED can be taken orally, injected directly into the penis, or inserted into the urethra at the tip of the penis.

Viagra, and Levitra are two oral drugs that have been approved by the Food and Drug Administration for treatment of ED.

Taken an hour before sexual activity, Viagra and Levitra work by enhancing the effects of nitric oxide, a chemical that relaxes smooth muscles in the penis during sexual stimulation and allows increased blood flow.

Neither Viagra nor Levitra should be used more than once a day. Men who take nitrate-based drugs such as nitroglycerin for heart problems should not use either drug because the combination can cause a sudden drop in blood pressure. Also, Levitra should not be taken with any of the drugs called alpha-blockers, which are used to treat prostate enlargement or high blood pressure.