Erectile dysfunction (ED), also called impotence, is characterized by a man’s inability to have an erection hard enough to have sex or to keep an erection long enough to finish having sex.
Erectile dysfunction can be caused by psychological or physical factors.
Psychological factors are the cause approximately 10% of the time. This is commonly due to anxiety, stress, depression, excess fatigue or dissatisfaction with the relationship with the partner.
Physical causes can include any disorder that prevents the nervous system or vascular system from responding appropriately to arousal. That includes injuries to spinal cord, or damage to the nerves in the genital area from diabetes, multiple sclerosis or surgery. Vascular problems can be caused by medications, diabetes, high blood pressure. Hormonal problems, kidney disease, liver disease, excessive alcohol ingestion, and infections can also cause ED.
Treatment of erectile dysfunction is tailored to each individual and depends upon the cause. Psychological causes may be treated with therapy or medication and proper treatment can result in improved sexual function. A six to twelve week course of sex therapy has been useful in such cases as well.
Various medications can be used to improve penile blood flow and allow for an erection. A relatively new class of drugs, called PDE5 inhibitors, create increased blood flow by enhancing the levels of nitric oxide in the blood vessels in the penis. The first drug of this new class,Viagra, has received widespread attention and use. More recently, a new drug in this class, Levitra, was approved which functions using the same mechanism. Both drugs require sexual arousal in order to work.
Viagra should be taken on an empty stomach 30 to 60 minutes prior to the desired time of effect. Levitra can be taken, with or without an empty stomach, 30 to 60 minutes prior to sex. About 70 to 80% of men who take the drugs experience longer and more rigid erections. Side effects for both drugs include headaches, flushing, indigestion, dizziness, and stuffy or runny nose. Neither drug should be used by patients taking nitrates, such as nitroglycerine, or in patients with recent heart attack or stroke. Neither drug should be taken more than once every 24 hours.
Devices such as vacuum devices or penile implants may also be recommended by your doctor depending upon the specific cause of ED or your medical condition.