Erectile dysfunction: The hard facts about the soft truth

Erectile dysfunction – the inability to achieve or maintain an erection sufficient for sexual performance – affects as many as 40 percent of 40-year-old men and 70 percent of 70-year-old men, yet less than 10 percent of those with erectile dysfunction (ED) will discuss it with their doctor.

That’s a problem for a few reasons.

Erectile dysfunction is often an early warning sign of other more serious physiological problems, not to mention the serious impact erectile dysfunction can have on relationships and self-esteem.

The good news is that erectile dysfunction can be treated and, oftentimes, reversed completely.

How do I know if I have erectile dysfunction?

Whether at 20 or 70 years of age, inevitably, most men will lose an erection at an inopportune time at some point in their lives.  This doesn’t necessarily mean you’re dealing with erectile dysfunction. However, if you have a reduced desire for sex and a persistent inability to achieve or maintain an erection, you may have erectile dysfunction.

What causes erectile dysfunction?

Erectile dysfunction can occur for many different reasons. Sometimes it’s as simple as the side effect of a particular medication; other times it can be caused by more complex issues such as vascular disease, neurological disease, diabetes, hormone or testosterone deficiencies, or prostate-related treatments or surgeries.

Psychological factors are also a common cause of ED and account for about 10 percent of all cases. Anxiety about sexual performance is a common psychological factor that primarily affects men younger than 40 years of age. Anxiety can build up prior to a sexual encounter. If expectations are not met, this results in even more anxiousness, which can lead to a vicious cycle of doubt and decreased confidence. This type of “performance anxiety” is becoming increasingly prevalent in young men, with more and more men in their 20s and 30s struggling to get an erection.

Other factors that can lead to erectile dysfunction include alcohol and illicit drug use, certain prescription medications, stress and fatigue.

How can I prevent erectile dysfunction?

Whether you’re currently suffering from ED or are hoping to prevent the condition altogether, there are several things that can be done to reduce the chances of it occurring.

Start by making healthy lifestyle choices, such as eating right and exercising regularly. Maintaining a healthy body weight is one of the best defenses against ED as obesity raises the risk for vascular disease and diabetes – two of its major causes. Pay attention to your vascular health including blood pressure, blood sugar and cholesterol and triglyceride levels. Poor vascular health can damage arteries in the heart and brain, which can lead to ED.

There has also been evidence to suggest that pelvic muscle training may be helpful to prevent and treat ED, as a strong pelvic floor helps keep blood from leaving the penis by pressing on a key vein. Talk to your Copeman kinesiologist for more information on strengthening your pelvic muscle.

Finally, it’s important to eliminate other risk factors by eliminating smoking and limiting alcohol.

Do I need the blue pill now?

Treatment for erectile dysfunction depends on the severity of the condition and the factors triggering it.

Medication such as Viagra is a typical first-line treatment. (In fact, the twentieth anniversary of Viagra was celebrated last year; it has no doubt contributed to transforming sex and relationships.) These types of medication are oral PDE-5 inhibitors that help to maintain the erection by enhancing the vasodilator effects of endogenous nitric oxide.

There are different types of PDE-5 inhibitors; typically, they are all effective within one hour of dosing. Sexual stimulation is still needed to produce an erection, and it won’t boost sex drive. Common adverse side effects of these types of medication include flushing, dyspepsia and headaches.

Psychosexual counselling is becoming increasingly prominent in treating psychological factors related to erectile dysfunction, however it’s also important to rule out any physiological causes.

The issue of erectile dysfunction is often avoided among men, but it’s important for men with ED to not feel ashamed or isolated. Most importantly, don’t hesitate to talk with your doctor about ED if it is affecting you.

Dr. Gene Vitug has a special interest in men’s health, testosterone deficiency syndrome and erectile dysfunction.