Erectile Dysfunction: It's More Common Than You'd Think

Erectile Dysfunction can be frustrating for both partners, but there are options to help.

If you or your partner is concerned about erectile dysfunction, you’re not alone. Dr. Mark Newton, a urologist with UnityPoint Health, says he sees men daily who are concerned about it. He defines erectile dysfunction as the inability to get or keep an erection for satisfactory sexual performance. The erectile dysfunction causes typically worsen over time and can progress from mild to complete impotence, if not treated appropriately.

What Age Does Erectile Dysfunction Start?

Dr. Newton says you might be surprised by how many men have erectile dysfunction. He says it affects about 50 percent of men over the age of 40 and is even more common as men age.

“Many men are hesitant to bring it up with their doctor,” Dr. Newton says. “They should remember it is very common, and they are certainly not the first, nor will they be the last, to have this issue. We try to ask about it regularly so they don’t have to bring up the topic. But, if we don’t know about it, we can’t help.”

Do I Have Erectile Dysfunction?

“Most men who come in concerned with erectile dysfunction do have it,” Dr. Newton says.
He says there are three questions you can ask to help determine if you have erectile dysfunction.

  1. Do you have trouble getting an erection when desired?
  2. Does the erection last long enough for satisfactory performance?
  3. Is the erection too soft for penetration?

If the answer is yes to any of these questions, it’s a great idea to talk to your doctor.

“The number one question I get when talking about erectile dysfunction is, ‘Is it common?’ Most guys feel isolated and alone with this problem, in large part because despite the frequent commercials, most men don’t talk about it. That makes this an area of men’s health that is often neglected and ignored, even with the substantial emotional stress it causes,” Dr. Newton says.

What Are Erectile Dysfunction Causes?

Dr. Newton says while many medical conditions have a genetic aspect, erectile dysfunction does not follow that trend. Here are a few main causes:

  • Low testosterone. A man with low testosterone might also notice symptoms including fatigue, depression, decreased interest in sexual intercourse, changes in muscle mass and changes in body hair.
  • Diabetes. This occurs when your body can’t appropriately handle sugar. Diabetes is one of the most frequent causes of erectile dysfunction.
  • Peripheral vascular disease. This involves the narrowing of blood vessels. It is also one of the most frequent causes of erectile dysfunction.
  • Obesity. A healthy diet and weight loss will help decrease the risk of multiple health issues, including erectile dysfunction.
  • Psychosocial stress. Due to the amount of anxiety about erectile dysfunction, mild erectile dysfunction and intermittent difficulty can lead to constant erectile dysfunction in some patients. Addressing the stress around the disorder with a psychiatrist or psychologist can help improve function.
  • Smoking. Not smoking or stopping smoking can help reduce the risk of multiple medical conditions, including erectile dysfunction.

“There are a large number of patients with obesity, diabetes and vascular disease, which can organically cause erectile dysfunction. Therefore, patients with erectile dysfunction should also be screened for coronary artery disease and other common diseases, including low testosterone,” Dr. Newton says.

Are There Erectile Dysfunction Cures?

“In many cases, losing weight and exercising regularly can improve blood flow and erectile dysfunction,” Dr. Newton says.

Dr. Newton says men can get rid of erectile dysfunction tied to obesity or stress. However, erectile dysfunction related to nerve damage from diabetes or vascular disease typically is not reversible and often progressively gets worse.

What Tests Will Help Determine Erectile Dysfunction?

There are several tests available for further evaluation of erectile dysfunction, such as the noninvasive penile Doppler ultrasound. But, Dr. Newton says many providers don’t use this test because it’s expensive, and the treatment strategy is typically the same regardless of the results. Blood and urine tests can also help providers figure out what’s going on.

What Treatments Are Available for Erectile Dysfunction?

  • Medication. Viagra, Levitra and Cialis are all medications called phosphodiesterase inhibitors. They are usually how providers start treatments; however, patients on nitrates for heart disease cannot use these. The combination of the medications can cause a severe drop in blood pressure.
  • Vacuum erection device. This is an option for patients who are not on blood thinners. The device uses a battery-powered vacuum to pull blood into the penis. A constriction band put around the base of the penis is used to maintain the erection.
  • Penile injection therapy. If neither of the above options works, then penile injection therapy is a third option. It involves using a tiny needle to inject a small amount of medication directly into the penis each time the patient engages in intercourse. Again, this is not for patients on blood thinners.
  • MUSE pellets. These are administered into the tip of the penis (urethra). MUSE pellets are one of the few advanced, non-surgical options patients on blood thinners can use.
  • Penile prostheses. It is implanted surgically and is usually the last option providers recommend. However, patients who go this route are usually very satisfied.

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