Erectile dysfunction is the repeated inability to get or keep an erection firm enough for sexual intercourse. In the past,
erection problems were simply called "
impotence." Now, the term "erectile dysfunction" is more commonly used, and sometimes people simply use the initials ED.
The word impotence may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as:
- Lack of sexual desire
- Problems with ejaculation or orgasm.
Using the term ED makes it clear that those other problems are not involved.
Understanding the Penis and Erections
Hormones, blood vessels, nerves, and muscles must all work together to make an erection. The brain starts an erection by sending nerve signals to the penis when it senses sexual stimulation or arousal. Touching may cause this arousal. Another trigger may be something a person sees or hears. It may even be a sexual thought or dream.
The nerve signals sent from the brain cause the muscles within the penis to relax and let blood flow into the spongy tissue within the penis. Blood collects in this tissue like water filling a sponge. As a result, the penis becomes larger and firmer, like an inflated balloon. The veins in the area then become closed off to keep blood from flowing out.
There are a number of causes for ED. In older men, the cause of ED is usually due to a physical problem, such as:
- Injury
- Side effects of drugs
- Disease.
Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED.
The incidence of ED increases with age. About 5 percent of 40-year-old men and between 15 percent and 25 percent of 65-year-old men experience ED. However, it is not an inevitable part of aging.
ED is treatable at any age, and awareness of this fact has been growing. More men have been seeking treatment and returning to normal sexual activity because of improved, successful ED treatments.
Treatment options for ED include:
- Lifestyle changes
- Counseling
- Medications
- Vacuum device
- Implanted devices.
ED can be a total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections. These variations make defining it and estimating its incidence difficult.
Depending on the definition used, anywhere from 15 million to 30 million American men are affected by ED. According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for ED in 1985. By 1999, the rate of visits for ED had nearly tripled to 22.3.
The increase happened gradually, presumably as treatments such as vacuum devices and injectable drugs became more widely available and discussing ED became more acceptable.
Perhaps the most publicized advance in ED treatment was the introduction of the oral drug
sildenafil citrate (
Viagra®) in March 1998. NAMCS data on new drugs show an estimated 2.6 million mentions of Viagra at physician office visits in 1999, and one-third of those mentions occurred during visits for a diagnosis other than ED.
Key information about ED includes the following:
- Erectile dysfunction is the repeated inability to get or keep an erection firm enough for sexual intercourse
- It affects 15 million to 30 million American men
- It usually has a physical cause
- It is treatable at all ages
- Treatments for ED can include psychotherapy, drug therapy, vacuum devices, and surgery.
