ERECTILE DYSFUNCTION -
INCIDENCE AND DEFINITION
Erectile dysfunction (ED) affects millions of men in the United States. In the field of sexual health, ED is the most common challenge reported to doctors. Worldwide, one in ten men report problems with erectile dysfunction. However, the true number is thought to be much higher. Many men are not comfortable discussing sexual issues with their health practitioner, regardless of how common the problem may be.*
ED IS THE INABILITY TO CONSISTENTLY INITIATE AND MAINTAIN AN ERECTION SUBSTANTIAL ENOUGH FOR INTERCOURSE
Typical symptoms of ED include:
Erections too soft for penetration
Erections too brief for penetration
An inability to achieve erections
While it is normal to have occasional difficulty obtaining an erection, routinely struggling to initiate or maintain an erection sufficient for intercourse or progressively worsening quality of erections can be classified as erectile dysfunction. Additionally, any issues that interrupt overall sexual health or confidence - i.e. premature ejaculation or Peyronie’s Disease - can be classified as erectile dysfunction.
ED can be distressing and a serious obstacle to a satisfying sex life. Additional symptoms that might interfere with a gratifying sexual experience include low desire/low libido, loss of penile sensation or difficulty achieving orgasm. As time goes on, erectile dysfunction may lead to undue stress, low self-confidence, and relationship issues.
* According to the Male Massachusetts Aging Study, the prevalence of impotence (minor, moderate and complete) actually hovers above 50% for men aged 40-70.
MOST COMMON CAUSES OF ERECTILE DYSFUNCTION.
The natural aging process is a predominant factor in developing ED – as men age it’s exceedingly common to notice some decline in the quality of erections. By and large, erectile dysfunction results from nerve damage or limited blood flow to the penis. In fact, over 80% of erectile dysfunction issues are vasculargenic in nature. However, additional health conditions might exacerbate or accelerate the development of erectile issues. Conversely, maintaining excellent cardiovascular health through nutrition and exercise can help a man avoid a decline in sexual performance.
The following are the leading causes of ED:
Aging
Diabetes
Obesity
Cardiovascular disease / Clogged blood vessels (atherosclerosis)
High blood pressure
High cholesterol
Medications’ side effects (i.e. antidepressants and high blood pressure medications)
Metabolic diseases (diabetes, insulin resistance, heart disease, obesity)
Anxiety
Depression
Surgeries (i.e. prostatectomy or spinal cord)
Injuries (to spinal cord or pelvis)
Low testosterone
Sleep disorders (sleep apnea)
Relationship issues
RISK FACTORS FOR ERECTILE DYSFUNCTION
Many of the following are listed above as causes, but risk factors that can contribute to ED include:
Medical conditions (e.g. metabolic disorders and neurological disorders)
Tobacco use
Substance abuse
Alcoholism / heavy alcohol use
Obesity
Psychological issues
TESTOSTERONE, THYROID AND ERECTILE DYSFUNCTION
Hormones play a key role in erectile dysfunction. Low testosterone levels and thyroid abnormalities are two of the most common hormone issues that contribute to erectile dysfunction.
Testosterone plays an important role in signaling from the sexual centers of the brain to the penis and is a key component of the physiological reactions essential for initiating an erection. Additionally, adequate testosterone levels are essential for healthy sexual desire or libido. Patients should confirm that their testosterone levels are optimal as part of a comprehensive approach to treating ED. Testing testosterone is part of our clinical protocol for all ED patients.
An overactive thyroid (i.e. hyperthyroidism) or hypothyroidism might contribute to erectile dysfunction. For men struggling with ED, it is recommended that thyroid levels be checked.
PSYCHOLOGICAL WELL-BEING
ED is also linked to emotional issues. Depression and anxiety can be associated with ED, as are the pharmaceuticals often prescribed to treat these emotional disorders. Relationship conflicts and poor communication can lead to sexual performance issues. Stress from work, home, social, religious, or cultural contexts can all contribute to erectile dysfunction and sexual dysfunction in general.
REASONS TO TREAT ERECTILE DYSFUNCTION
Erectile dysfunction on its own does not typically lead to other problems. However, men who are able to be sexually active tend to report better satisfaction in their own lives and relationships as well as higher levels of confidence and sense of well-being. For many men and women, a healthy sexual relationship is critical to overall quality of life - helping couples feel vital and connected. Also, one thing to consider is that ED can sometimes be indicative of overall decline of cardiovascular or metabolic health.
IS ERECTILE DYSFUNCTION REVERSIBLE?
Erectile dysfunction is often treatable and sometimes reversible. Addressing underlying causes and risk factors can be a powerful tool in improving erectile function. Additionally, we engage patients in comprehensive treatment programs that include lifestyle interventions, medication options (both oral and injectable) and regenerative treatments like low-intensity shockwave therapy and PRP.
