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Erectile Dysfunction

Erectile Dysfunction (ED) is defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual intercourse. This condition affects one in two adult males to various degrees. Even though effective treatments for Erectile Dysfunction had been available for at least a decade before Viagra® was released in March 1998, it had been difficult for the afflicted individual to know where to seek help. Since the successful launch of Viagra®, talking about sexual dysfunction and seeking help became less taboo. Nonetheless, the topic remains sensitive for most men.

The advent of Viagra®, Levitra® and Cialis® has helped many men restore sexual performance. For many others, the high hope in such oral medications has quickly been deflated in light of certain side-effects or lack of efficacy. For these men, to re-confront these problems becomes more challenging than the first time.

The above referenced medications are not for everybody and are not without risks. It is estimated that between 30-70 % of men do not respond to these drugs, depending on their age and underlying health problems, and at least 15% suffer from undesirable side-effects.

Signs of Erectile Dysfunction:

  • Difficulty achieving or maintaining an erection at least once in every four times of attempting sexual intercourse and problem persists for more than one month.
  • Sexual erection becomes weaker or less rigid.
  • Achieving an erection takes longer than usual or becomes more difficult in certain positions.
  • Maintaining an erection becomes a conscious effort or becomes more difficult.
  • Morning erections become less frequent and less rigid.
  • Climaxing becomes more rapid or occurs with an incomplete erection.

How Common Is Erectile Dysfunction?

Erectile Dysfunction is very common. Although it tends to be more common in men over 40 years of age, it can affect all ages. In mid 1992, the results of the world's largest Erectile Dysfunction study called "The Massachusetts Male Aging Study" (MMAS) became available. These results showed that:

  • 52% of all men between the ages of 40 and 70 have some degree of Erectile Dysfunction. (Classified as mild, moderate, or severe)
  • At least one (1) in ten (10) men cannot get an erection at all (Severe ED)
  • The majority of cases of Erectile Dysfunction are physical in nature.
  • There is a strong association between age and Erectile Dysfunction; the prevalence of Erectile Dysfunction increases with age - 39% of men at 40 and 67% of men at 70 are affected.

What Causes Erectile Dysfunction?

There are psychological and physical causes of Erectile Dysfunction.

Psychological Erectile Dysfunction

Contrary to popular belief, only about 10% of cases of Erectile Dysfunction are psychological in nature, which are mostly the result of nervousness, lack of confidence or performance anxiety. In response to these situations, the sympathetic nervous system is activated, causing the blood vessels to constrict (vaso-constriction), temporarily reducing the blood flow to the penis, resulting in erectile difficulties.

Psychological Erectile Dysfunction can be self-perpetuating: each failure increases the associated anxiety levels and frequently leads to a continual failure, and eventually physical Erectile Dysfunction. Other psychological causes include stress, guilt, sexual boredom, depression etc.

Physical or Organic Erectile Dysfunction

It is now known that 90 % of cases of Erectile Dysfunction are caused or contributed by physical factors, most of which are related to impaired circulation, a condition generally referred to as "vascular insufficiency".

Risk factors:

The penis requires a healthy blood flow to be completely erect. A marginally reduced blood flow can cause significant difficulties. Therefore, the risk factors for Erectile Dysfunction are primarily vascular risk factors. They include:

  • Diabetes
  • Hypertension
  • High blood cholesterol
  • Cardiac diseases
  • Smoking
  • Arterial sclerosis (age-related thickening and hardening of the arteries)
  • Poor overall circulation and certain types of medication

Note: According to FDA's alert May 2005, risk factors for developing sudden blindness in association with (though not conclusively proven) the use of Viagra®, Levitra® and Cialis® are: men above 50, diabetes, hypertension, high blood cholesterol, cardiac diseases and smoking. These are the same risk factors for developing Erectile Dysfunction at the first place!

Other physical causes are not common but can be readily diagnosed. They include:

  • Hormonal disturbances caused by testicular disease, liver disease or thyroid problems
  • Neurological diseases such as Multiple Sclerosis, stroke, Parkinson's Disease etc.
  • Trauma to the pelvic area experienced during certain types of surgery, e.g. prostate surgery, bowel operation; pelvic radiation therapy or an automobile accident that damages the pelvic structures

Erectile Dysfunction can affect apparently healthy individuals as well.

Should Erectile Dysfunction Be Treated?

Yes! Like any medical problem, Erectile Dysfunction should be treated promptly. The sooner it is diagnosed and treated, the better the outcome, for the following reasons:

Recent studies indicate that couples with a healthy sex life are affected less by problems such as depression, anxiety, hypertension, diabetes, ulcers, chronic fatigue, virus illness and other ailments. They also have a greater life expectancy.

  • First, the underlying problem needs to be identified and corrected to prevent further damage.
  • Second, lack of treatment may cause progressive loss of normal healthy tissue and progressive loss of erectile function. A mild ED problem can become severe and irreversible. This condition is called "disuse atrophy" and should be avoided.
  • Third, Erectile Dysfunction is more than just a sexual problem that affects the couple; its impact can extend to one;s family, social, and work environments. In addition, good sex means good health.