Erectile Dysfunction

What is ED?

Erectile dysfunction (ED) is a common male sexual disorder. It is the inability to get or keep an erection that allows for satisfying sexual activity. It can happen occasionally or regularly, with or without any clear reason. Some men with ED are not able to get an erection  at all.

ED is not a life-threatening disorder, but it can have a negative impact on your quality of life and that of your partner.

How common is ED?

Erectile dysfunction (ED) is a common condition in men of all ages and ethnicities. The risk of having ED increases with age.

What causes ED?

A common cause of ED is heart disease. Other common causes are:

  • Diabetes
  • Nerve damage to the penis or the pelvic area
  • Pelvic surgery
  • Radiation therapy to the pelvic area
  • Low levels of testosterone
  • Neurologic disease, like Parkinson’s

What is an erection?

Getting an erection is a process that includes physical, hormonal, and psychological elements. The penis is made of soft, spongy, elastic tissue that fills with blood to make it grow in size and become rigid. Around the spongy tissue and the prostate, there are nerves that send signals so that the blood vessels supply the blood (Fig. 1). These signals are controlled by the male hormone testosterone.

Cardiovascular disease and ED

ED and cardiovascular disease share common risk factors, like obesity, smoking, high cholesterol, high blood pressure, and lack of exercise. ED can be an early sign of heart disease because problems with blood flow affect erectile function. This is why men who experience ED should go to the doctor to get checked for heart disease.

Urinary symptoms and ED

ED is often associated with urinary symptoms, such as urinary frequency,  nocturia, and urgency. Often these symptoms are related to benign prostatic enlargement (BPE). It is unclear if the urinary symptoms cause ED, but generally ED gets worse when urinary symptoms worsen.

Psychological risk factors for ED

Several psychological conditions have been associated with ED. These include:

  • Anxiety
  • Depression
  • Feelings of self-inadequacy
  • Low self esteem
  • Inability to describe emotions
  • Stress

Social ideas of how men and women are supposed to interact can also contribute to ED. These can include unrealistic expectations about love and sexuality, and inappropriate male and female role models.

ED is sometimes the cause and sometimes the result of unsatisfying or dysfunctional relationships. It is often difficult to find out which started first.

Fig. 1. Anatomy of the penis.
Fig. 1. Anatomy of the penis.