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What is Erectile Dysfunction?
Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It can be a total inability to achieve an erection, an inconsistent ability to do so, or a tendency to sustain only brief erections.
Erectile dysfunction is not a disease, but a symptom of some other problem, either physical or psychological or a combination of both.
Causes of Erectile Dysfunction
Although most cases of ED have a physical cause, psychological factors can be a significant contributing factor in up to 10% of cases. The most common physical causes are:
- Vascular disease – problems with blood supply to the penis, most commonly due to atherosclerosis (hardening of the arteries).
- Nerve damage – damage to the nerves that control erection can occur as a result of diabetes, spinal cord injury, surgery or trauma (such as pelvic fracture).
- Hormonal problems – low levels of the hormone testosterone can interfere with sexual function.
- Medications – certain drugs can cause or contribute to ED, such as antihypertensive medications, antidepressants, antipsychotics and some chemotherapy drugs.
Psychological Causes of Erectile Dysfunction
In some men, psychological factors such as anxiety, depression, relationship problems or performance anxiety can be the primary cause of ED.
In other cases, ED may be a sign of an underlying medical condition such as diabetes, high cholesterol or low testosterone.
Risk Factors for Erectile Dysfunction
Some risk factors for ED are more common in older men, such as a gradual decline in testosterone levels with age. Other risk factors include:
- Having diabetes
- Having high blood pressure
- Taking certain medications, such as beta blockers or SSRIs
- Having surgery to remove the prostate gland
- Having a spinal cord injury
- Having a psychiatric condition, such as depression or anxiety
Diagnosing Erectile Dysfunction
If you are experiencing ED, make an appointment to see your doctor. He or she will ask about your medical history, your current medications and any recent psychological stressors you may have.
Your doctor may also recommend a blood test to check for low levels of testosterone, as well as a physical examination to check for signs of circulation problems or nerve damage.