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Erectile Dysfunction: Causes and Treatment Options

Watch this video to learn about the causes and treatment of erectile dysfunction.

Causes and Treatment of Erectile Dysfunction

Erectile dysfunction (ED) is defined as the inability to attain and/or maintain an erection for satisfactory sexual activity. It is a common problem, affecting up to 30 million men in the United States. Many men do not seek medical help for this problem, believing it to be a natural part of aging. Others are too embarrassed to discuss the problem with their doctor. However, ED can be a sign of a more serious underlying medical condition, such as cardiovascular disease, diabetes, or low testosterone.

There are many possible causes of ED, including psychological factors such as stress, anxiety, or depression; physical factors such as diabetes, high blood pressure, or high cholesterol; and medical conditions such as Parkinson’s disease, multiple sclerosis, or Peyronie’s disease.

Treatment for ED depends on the underlying cause. In some cases, such as psychological factors, counseling may be effective. In other cases, medication or surgery may be necessary. If you are concerned about ED, talk to your doctor to find out if treatment is right for you.

Causes of Erectile Dysfunction

There are many possible causes of erectile dysfunction (ED). These include psychological factors such as stress, anxiety, or depression; physical factors such as diabetes, high blood pressure, or high cholesterol; and medical conditions such as Parkinson’s disease, multiple sclerosis, or Peyronie’s disease.

Risk Factors for Erectile Dysfunction

Certain factors may increase your risk of developing ED, including:

  • Age: ED is more common in older men, but it can occur at any age.
  • Family history: ED is more common in men who have a family history of the condition.
  • Lifestyle: Smoking, excessive alcohol use, and drug use can all contribute to ED.
  • Medical conditions: Conditions such as diabetes, high blood pressure, or high cholesterol can all cause ED.
  • Medications: Certain medications, such as certain antidepressants, can cause ED.

Symptoms of Erectile Dysfunction

The main symptom of ED is the inability to attain or maintain an erection for satisfactory sexual activity. Other symptoms may include:

  • Reduced libido (sex drive)
  • Difficulty achieving orgasm
  • Anxiety about sexual performance

Diagnosis of Erectile Dysfunction

ED is diagnosed by taking a medical history and performing a physical examination. Your doctor may also order blood tests to check for underlying medical conditions. In some cases, such as psychological factors, counseling may be recommended.

Treatment of Erectile Dysfunction

Treatment for ED depends on the underlying cause. In some cases, such as psychological factors, counseling may be effective. In other cases, medication or surgery may be necessary. If you are concerned about ED, talk to your doctor to find out if treatment is right for you.

The Men’s Sexual Health Clinic at Brigham and Women’s Hospital (BWH) treats men with a range of sexual problems, including erectile dysfunction and ejaculatory dysfunction. Michael P. O’Leary, MD, MPH, Director, BWH Mens’ Sexual Health Clinic, discusses the most common causes of erectile dysfunction and treatment options, including medications and surgery.

Learn more about the Men’s Sexual Health Clinic and erectile dysfunction:—– teqol.com/male/

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Video transcription:

The men 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 in and so forth. The main cause of erectile dysfunction is vascular. It’s blood flow issues and those are common in aging men in general, high blood pressure, vascular disease, cardiovascular disease, peripheral vascular disease, all of 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 then, who have prostate cancer and it had radiation or surgery. Some of those men will have difficulty with erections patients who have had colon surgery some of them, but the main the main causes is what 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 Doc’s 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 four men, but they don’t work for everybody. They work for, probably I would say 50 to maybe 70% of men. All 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 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 entry, referral 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 surgical options. Penile implants are penile prosthetics, which I don’t encourage men to think about as an initial treatment option. But for many minutes 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 unsuccessful or really unhappy with them about 10% of men who start with other treatment options but find them unsatisfactory, will will eventually end up having a penile implant and 95% 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, and in a lot of men that the problem is a psychological one. Now it isn’t to say that there 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 problem that can be dealt with by a sex therapist having access to two 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 multidisciplinary approach in in the past. If you had sexual dysfunction, erectile dysfunction, you went Sol urologist. If you had a cardiovascular problem, you would go 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.

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