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Erectile Dysfunction: Causes and Treatment

Do you suffer from erectile dysfunction? Watch this video to learn about its causes and treatment.

Causes and Treatment of Erectile Dysfunction

Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It’s also sometimes referred to as impotence. Occasional ED isn’t uncommon. Many men experience it during times of stress. Often, erectile dysfunction is a symptom of underlying health problems, such as cardiovascular disease, diabetes, or psychological issues.

Causes

There are many possible causes of ED, and they can include:

  • Cardiovascular disease
  • Diabetes
  • Obesity
  • Metabolic syndrome
  • Parkinson’s disease
  • Multiple sclerosis
  • Low testosterone
  • Sleep disorders
  • Alcoholism and other forms of substance abuse
  • Smoking
  • Pelvic surgery
  • Prescription medications

Treatment

Treatment for ED will vary depending on the underlying cause. In some cases, making lifestyle changes may be all that’s needed to improve ED symptoms. These changes include:

  • Eating a healthy diet
  • Getting regular exercise
  • Limiting alcohol consumption
  • Quitting smoking
  • Managing stress

In other cases, medications or other direct treatments might be needed. Common ED medications include:

  • PDE5 inhibitors These drugs include sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). They work by relaxing muscle cells in the penis, allowing blood to flow in and causing an erection.
  • Alprostadil This drug can be injected into the penis or inserted as a pellet through the urethra. It’s effective, but can cause mild, temporary bruising.
  • Testosterone therapy This treatment is only recommended for men with low testosterone levels. It’s not clear if testosterone therapy is effective in men with ED caused by other factors.

In some cases, surgery might be needed. This might be done to repair damage from an injury, correct a birth defect, or treat an underlying condition such as diabetes.

There are many causes of erectile dysfunction. But all of them revolve around the single poor blood circulation in the penis.

Read our article on the causes and natural remedies of erectile dysfunction in this link.

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Video transcription:

The men’s sexual health clinic at brigham and women’s hospital is is geared toward men with all kinds of sexual problems. I primarily am interested in patients with erectile dysfunction, ejaculatory dysfunction and and so forth. The main cause of of erectile dysfunction is vascular, is blood flow issues and those are common in aging men in general, high blood pressure, vascular disease, cardiovascular disease, peripheral vascular disease, all the all, the kinds of things that that affect aging, both men and women. So that would be that would be number one. There are some other things that that can directly cause it that are the results of certain surgical procedures, for example, and men who have prostate cancer and have had radiation or surgery. Some of those men will have difficulty with erections patients. Who’ve had colon surgery some of them, but the main the main cause is is vascular in general, a man who’s complaining of difficulty, either obtaining or maintaining an erection will be treated with an oral agent, but there are many primary care doctors who don’t feel quite comfortable prescribing those, but those that we obviously do in our clinic and and those would be a first-line agent for for men, but they don’t work for everybody. They work, for, probably, I would say, 50 to maybe 70 percent of of men. All a erectile function is geared around blood flow, and so anything that improves blood flow to the penis will enable an erection if you will so when the oral medications whose job is to improve blood flow. Systemically meaning man takes a pill, it improves a blood flow to his penis and when they don’t work, we’ll try to deliver something directly to the organ. The traditional way to do it for doing that has been with a needle. Now, it’s scary, sound and men may initially be afraid of that treatment option. But it’s a very effective treatment option I’ll encourage most men to try. It and if, if it’s not satisfactory, then there are, there are some other options. There are intraurethral agents, meaning things that you can gels if that that you can place inside the urethra, which is the tube you urinate from a little bit easier, still slightly invasive, but effective and and then finally, there are surgical options, penile implants or penile prosthetics, which I don’t encourage men to think about as an initial treatment option. But for many men it’s it’s it’s very satisfactory. It just involves a surgical procedure, and so we would generally reserve that for men who have tried other options and been been unsuccessful or or really unhappy with them about 10 percent of men who start with other treatment options but find them unsatisfactory, will eventually end up having a penile implant and 95 percent of those men are happy with them. Not all sexual dysfunction in men is, is fixed with a with a pill or a shot or an operation in in in a lot of men. The the problem is a psychological one. Now it isn’t to say that they’re that they have psychological problems, but I tell patients all the time that the most important sex organ they have is not below their waist it’s sitting on their shoulders. If I have a 60 year old man, who’s had pelvic surgery. I know what the cause is. I know that that it’s not likely to be anything psychological, but if I have a 25 year old man, who’s was sexually functioning well until a year ago, and now because of a variety of different life, circumstances he’s not doing well and he has no other health problems. That’s much more likely a a problem that can be dealt with by a sex therapist having access to really good sex therapists, which we do here at brigham and women’s is a real benefit. I think the future of men’s health care is a wider, multi-disciplinary approach in in the past. If you had sexual dysfunction, erectile dysfunction, you went and saw a urologist. If you had a cardiovascular problem, you would go and and see a cardiologist. You had a diabetes problem or other hormonal issue. You’d go to see an endocrinologist we’re trying to bring together all of those specialties and we actually have them under one roof at this institution, but not in a place that men can directly access and that’s what that’s. What we’re trying to achieve. You.

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