Men rarely want to talk about it, but erectile dysfunction is a common men’s health issue. Approximately 30 million men, including 50% of men over the age of 40, have some erectile dysfunction, and 5% of men in the same age group have complete erectile dysfunction. The percentage increase with age — around 15% of men over the age of 70 have complete erectile dysfunction.
Basically — it happens to everyone occasionally. However, if you’re consistently unable to achieve or maintain an erection, it could be a sign of a health problem.
HOW AN ERECTION HAPPENS
Your penis has two chambers (the corpora cavernosa) that contain a maze of blood vessels and spongy muscle tissue. The chambers are surrounded by the tunica albuginea, a membrane that provides the pressure needed to keep the blood in your penis. Your urethra runs along the underside of the chambers.
When you’re aroused, the blood vessels in your corpora cavernosa dilate and fill with blood, which gets trapped there with pressure, creating an erection.
However, when something interferes with this process, you aren’t able to achieve or maintain an erection that’s rigid enough for sex.
CAUSES OF ERECTILE DYSFUNCTION
Many factors contribute to erectile dysfunction. While it used to be considered a psychological issue, today we know that erectile dysfunction is often a physiological problem.
BLOOD VESSEL PROBLEMS
Vascular diseases reduce your circulation, including blood flow to your penis when you’re aroused. Blood vessel problems could be the cause of up to 70% of erectile dysfunction cases. Conditions like atherosclerosis clog your arteries and reduce the space available for blood to move. Conditions like high cholesterol are common causes of hardened and blocked arteries. While less commonly related to erectile dysfunction, conditions like peripheral artery disease also restrict blood flow to your extremities.
HIGH BLOOD PRESSURE
High blood pressure can prevent the arteries in your corpora cavernosa from dilating and allowing the spongy tissue of your penis to fill with blood. High blood pressure also interferes with the ability of the smooth muscle tissue in your penis to relax enough to allow sufficient blood flow to achieve an erection.
While some medications for high blood pressure can reduce erectile dysfunction — sildenafil (Viagra® was originally a hypertension drug — other medicines, including diuretics and beta-blockers, can contribute to erectile dysfunction.
Between 35-75% of men with diabetes also have erectile dysfunction. Uncontrolled diabetes damages your blood vessels and your nerves, which interferes with the physiological process of getting an erection. It also interferes with your hormone health and muscle function, which adds to your problem.
PROSTATE CANCER TREATMENTS
While prostate cancer doesn’t cause erectile dysfunction itself, treatments like prostatectomy, radiation, and hormone therapy can all interfere with your ability to achieve an erection. In many cases, as time passes, you may regain your erectile function.
OTHER MEDICAL CONDITIONS
Many other medical conditions can interfere with your ability to get an erection, including:
- Kidney disease
- Liver disease
- Multiple sclerosis
- Parkinson’s disease
- Injury to your pelvis, bladder, spine, or penis
- Tobacco, alcohol, or drug use
Any condition that affects your nervous system, circulation, or hormones can contribute to erectile dysfunction.
In addition to the physical issues that affect your erections, psychological factors can also play a role. It’s estimated that mental and emotional issues are responsible for up to 20% of erectile dysfunction. Stress, for example, is a libido killer. Additionally, depression and anxiety can not only contribute to the mental and emotional erection factors, but they also affect your brain chemistry and hormones.
TESTOSTERONE AND ERECTILE DYSFUNCTION
Testosterone is your primary sex hormone and affects your sex drive, as well as your ability to get an erection. However, low testosterone is not a common cause of erectile problems. In most cases, the condition is due to vascular health issues. While low testosterone isn’t a primary cause of erectile problems, it is related to many of the other health problems that do interfere with your erections like diabetes, obesity, and heart disease.
WHEN TO TALK TO A DOCTOR ABOUT ERECTILE DYSFUNCTION
As mentioned, sometimes stress can interfere with your erections and sex drive. If you occasionally have erection trouble or reduced interest in sex, don’t worry and do your best to relax and take care of your overall health.
However, if you consistently have trouble achieving or maintaining an erection, make an appointment with your doctor. Erectile dysfunction is a common early warning sign of hypertension and other health problems.
HOW DOCTORS EVALUATE ERECTILE DYSFUNCTION
Your doctor begins by reviewing your symptoms, medical history, and lifestyle. They’ll ask questions like:
- What prescription drugs, over-the-counter drugs, or supplements do you take?
- Do you use recreational drugs?
- Do you smoke?
- How much alcohol do you drink?
- Have you had surgery or radiation therapy in the pelvic area?
- Do you have any urinary problems?
- Do you have other health problems (treated or untreated)?
Then, they complete a physical exam, including blood tests, urinalysis, ultrasounds, X-rays, and nocturnal penile tumescence tests.
ERECTILE DYSFUNCTION TREATMENTS
When your physician understands the cause of your erectile dysfunction, they create a treatment plan to address the underlying issue that’s interfering with your sex life.
Many men benefit from oral medications like avanafil, sildenafil, tadalafil, and vardenafil. Your doctor might also recommend injectable medicines. While giving yourself a shot in the penis is probably the last thing you want to do, medications like alprostadil are often extremely effective.
Testosterone therapy is only appropriate if you have suboptimal testosterone levels. Having too much testosterone in your body is just as bad as having too little. You need to maintain a careful hormonal balance for your overall health, including your sexual health.
In severe cases, your physician might recommend surgery to address chronic erectile dysfunction. Depending on your needs, you could have an inflatable or semi-rigid implant to provide an erection when you need it.
Your doctor is also going to talk to you about lifestyle changes. Taking care of your body prevents many of the conditions that cause erectile dysfunction. For example, getting regular exercise and eating a nutritious diet helps you stay healthy and maintain a healthy body weight. If you use tobacco, you should give it up as it hurts every aspect of your health.
HRT Wellness offers hormonal screening and customized testosterone therapy to help you optimize your health. If you’re concerned about low testosterone, enroll today and start the hormone assessment process.