What Is ED?
Erectile dysfunction (ED) happens when a man has ongoing problems getting and keeping an erection. Without treatment, ED can make sex difficult. The problem is reported by 1 in 5 men, and that number gets bigger with age.
Symptoms of ED
Symptoms of ED include:
- Erections that are too soft for sex.
- Erections that are don’t last long enough for sex.
- An inability to get an erection.
If you can’t get or keep an erection that lasts long enough or is rigid enough for sex, you have erectile dysfunction.
Who Gets ED?
Sexual dysfunction and ED become more common as you get older. Only about 5% of men age 40 have it. But the number rises to 15% of men age 70. This doesn’t mean growing older is the end of your sex life. Doctors can treat ED no matter your age. Age isn’t the only cause. Type 2 diabetes, obesity, smoking, and high blood pressure all make it more likely.
The Mechanics of ED
You get an erection when blood fills two chambers known as the corpora cavernosa. This causes your penis to expand and stiffen, much like a balloon as it is filled with water. Impulses from the brain and genital nerves start the process. Anything that blocks these impulses or restricts blood flow to the penis can cause ED.
Causes of ED:
chronic disease: The link between chronic disease and ED is most striking for diabetes. Men with diabetes are two to three times more likely to have erectile dysfunction. And it could start 10 to 15 years earlier. But blood sugar control can lower this risk.
Lifestyle : Lifestyle choices can contribute to ED. Smoking, heavy drinking, and drug use disorder can damage the blood vessels and reduce blood flow to your penis.
Medication: ED may be a side effect of medication, including certain blood pressure drugs and antidepressants.
ED and Bicycling: Research suggests that avid bikers are more likely to get ED than other athletes. Some bicycle seats put pressure on the perineum, an area between the anus and scrotum full of arteries and nerves vital to sexual arousal. If you bike for many hours each week, get a seat designed to protect this area.
Diagnosing ED: Physical Exam
To diagnose ED, the doctor will ask about your symptoms and medical history. They’ll do a complete physical exam to look for signs like poor circulation or nerve trouble. They’ll also check for problems in your genital area that could cause trouble with erections.
Diagnosing ED: Lab Tests
Lab tests can help diagnose ED. Blood cell counts, blood sugar levels, cholesterol levels, and liver tests can reveal medical conditions that play a role in ED.
Treating ED: Lifestyle Changes
You may be able to improve your sex life with a few lifestyle changes. Giving up smoking, losing weight, and exercising more often can improve your blood flow. If you suspect a medication could be to blame, talk to your doctor about adjusting the dosage or switching to another drug.
Treating ED: Oral Medications
You’ve probably heard of sildenafil (Viagra), but it isn’t the only pill for ED. This class of drugs also includes avanafil (Stendra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn). All work by improving blood flow to the penis during arousal. They’re generally taken 30-60 minutes before sexual activity and should not be used more than once a day. You can take tadalafil up to 36 hours before sexual activity. It also comes in a lower, daily dose. All require an OK from your doctor first for safety.
Treating ED: Surgery
If ED comes from a blocked artery leading to the penis, surgery can restore blood flow. The procedure usually works best on men under 30. Doctors don’t recommend it for older men with widespread narrowing of the arteries
Treating ED: Psychotherapy
Even when ED has a physical cause, psychotherapy can help. A therapist can teach the man and his partner techniques to reduce performance anxiety and improve intimacy. Therapy can also help couples adjust to the use of vacuum devices and implants.
ED: Lowering Your Risk
These simple things can help lower your odds of ED:
- Exercise and maintain a healthy weight.
- Stop smoking.
- Avoid alcohol and substance abuse.
- Keep diabetes under control.