Erectile dysfunction (ED) is a condition in which it is difficult to get or to maintain an erection of sufficient firmness to have sexual intercourse. To achieve an erection, a healthy supply of blood to the penis is necessary along with a properly functioning nervous system and normal libido (sexual desire).
A number of medical and psychological conditions can affect any or all of the systems above, leading to ED and diminishing aspects of your sex life. It is important to know that many medical conditions that affect other body systems (e.g. heart, lungs, etc.) may also affect the penis and manifest as ED. For men over 40 who experience ED, there is a high chance (roughly 80%) that an underlying medical condition is to blame. The following is a look at the most common causes of ED.
High blood pressure, diabetes, obesity, and problems with cholesterol can all lead to narrowing (sometimes called hardening) of blood vessels. The same factors that lead to narrowing of the arteries that supply blood to the heart can also lead to damage to the arteries that supply blood to the penis. For men over the age of 40, ED may be the first symptom of an underlying condition that could lead to heart attack, stroke, or impotence.
In some cases, an imbalance of hormone levels can cause ED. In these situations, individuals often complain of lack of energy, sudden changes in weight, a decrease in libido, and a general feeling of malaise. In a small number of cases, ED is the only symptom of a hormone imbalance.
Problems that affect the nerves responsible for an erection include spinal trauma, systemic neurological diseases (e.g. Parkinson’s, multiple sclerosis, etc.), and prostate surgery. In these cases, neurological symptoms are often obvious and precede ED.
Changes in the structure of the penis can make it difficult to get an erection. Examples of such conditions include Peyronie’s (bending in the erect penis), phimosis (foreskin is too tight), and a tight frenulum (the skin the links the head of the penis to the shaft). In some of these conditions, corrective surgery will eliminate the problem.
Commonly prescribed medications, such as those used to treat heart disease, blood pressure, and prostate conditions, can lead to ED. Medications like SSRIs are also common culprits. Because these drugs are prescribed to treat serious medical conditions, they should not be stopped without a doctor’s consent. In the majority of cases, cessation of the drug will restore normal erectile function. Keep in mind that alcohol and non-prescription drugs can also lead to ED.
Depression, anxiety, stress, and other psychological conditions can lead to reduced libido and/or ED. Unfortunately, struggling to get an erection can often exacerbate underlying psychological conditions, leading to a negative spiral of worsening ED. Sometimes, prescription drugs for ED are used to improve self-esteem and overcome the negative spiral that starts with psychological stress while more conventional psychological treatments (e.g. counseling) take effect.
ED occurs more often in those who are overweight and do not exercise. It is also more common in those who smoke, drink excessively, or use illicit drugs. Lifestyle plays a major role in both the development and treatment of ED. For individuals with ED, identifying the underlying cause of the condition can lead to targeted treatment options.
Licensed physicians can assess the symptoms associated with ED and develop a customized treatment plan. Drugs such as Viagra and Cialis form the basis of most treatment regimens, but are far from the only options available. In many cases, an ED assessment can be performed without your needing to meet a health care provider in person and treatment can be purchased online.
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