Erectile dysfunction (ED), also known as impotence, is defined as the inability to achieve and maintain an erection. Over 30 million men in the United States suffer from ED at some point in their lives.Just because you have trouble once in a while, may not necessarily mean you are experiencing symptoms of ED. If the symptoms are consistent, and you have lack of sex drive, ED may be a contributor.
A penile erection is achieved through psychological factors and hormonal status. Sexual stimulation to the nerves causes the release of neurotransmitters and an increase in blood flow to the penis. This traps the blood and expands the penis to an erect state.
Understanding the primary etiology of ED is important as the cause can be manifested because of physical causes, such as trauma or heart disease, or psychological causes. According to the National Institute of Health (NIH), approximately 75% of cases were associated to physical ED versus psychological etiologies.
Psychological ED refers to a mental state of a man that plays a role in the occurrence of ED. The brain plays a key role with sexual desire and the development of an erection.
Physical ED has been typically associated with risk factors or physical damage to the nerves. This can relate to a number of factors such as pre- existing conditions and lifestyle habits. Systemic diseases and aging also increases the risk as they can cause damage to nerves and the muscle tissues, which can be a leading cause of ED.
The prevalence of ED can depend on many characteristics. Age is a factor to consider. Everyone is going to age and you should know how your risk increases as you get older. According to a recent study, complete impotence rose from 5-15% between the age of 40 and 70 years.
Graph 1. Prevalence of ED may increase with age.
Your lifestyle may also affect your risk for ED. Lifestyle habits that may increase the risk for ED include:
1.Thompson IM; Tangen CM; Goodman PJ, et al. Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005;294(23) pgs 2996-3002.
2. Johannes CB, Araujo AB, Feldman HA, et al. Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the Massachusetts male aging study. The Journal of Urology. 2000 vol 163(2), pgs 460-463.
3. National Institutes of Health (NIH) Consensus Conference. NIH Consensus Development Panel on Impotence. Impotence. Journal of the American Medical Association. 1993;270:83-90.
4. Mayo Clinic. Available at http://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/basics/causes/con-20034244. Accessed June 17, 2015.
5. What to do about Erectile Dysfunction. A Harvard medical school special health report. 2009. Pg 10.
6. American Urological Association. Available at http://www.auanet.org/education/guidelines/erectile-dysfunction. Accessed April 1, 2015.
7. Walczak MK, Lokhandwala N, Hodge MB, et al. Prevalence of cardiovascular risk factors in erectile dysfunction. JGSM. 2002. 5(6). Pgs 19-24.
8. Lue TF. Erectile dysfunction. The New England Journal of Medicine. 2000. 342(24) pgs 1802-1813.
9. What is penile injection therapy. http://edguidance.com/what-is-penile-injection-therapy/. Accessed June 22, 2015.