What is Erectile Dysfunction?
Erectile dysfunction (ED) is the inability to achieve or maintain an erection adequate for sexual function. Approximately 50% of men ages 40 and older have some element of erectile dysfunction. ED is also common among younger men, especially those who are struggling with fertility or hormone issues. ED is prevalent among the LGBTQ+ community, as studies have shown that gay and bisexual men have higher rates of ED compared to heterosexual men. ED is often associated with other health issues, such as diabetes or cardiovascular disease. ED affects not only the sexual health of the individual, but also has an impact on psychological well-being, relationships, and quality of life. Thankfully, there are many effective treatment options available.
Diabetes and Erectile Dysfunction
Erectile dysfunction affects about 50% of all men with diabetes within 10 years of being diagnosed. The high levels of blood sugar associated with diabetes can damage the nerves that control erections. Elevated blood sugar may also cause damage to vessels necessary for blood flow to the penis that is vital to achieve and maintain an erection. Men with diabetes and ED will often first take oral medication for ED, but many will require more aggressive treatment. Penile implants have the highest success rate.
Cardiovascular Disease and Erectile Dysfunction
ED is often a precursor or warning sign of heart disease. In fact, almost 70% of cases of coronary heart disease are preceded by ED. This is because the arteries of the penis are very small compared to those in the rest of the body. For this reason, we often refer patients to a cardiologist to check for any underlying cardiovascular disease.
You can reduce your risk of erectile dysfunction by improving your heart health. This can be achieved through an increase in exercise and physical activity in general, stopping the use of any tobacco products, maintaining a healthy weight, and adopting a healthy diet.
Prostate Cancer and Erectile Dysfunction
Treatment for prostate cancer often causes erectile dysfunction. The nerves controlling erections are located very close to the prostate and are often injured during radiation or surgical treatment for prostate cancer. The good news is that even if you are suffering from ED after treatment for prostate cancer, it is still possible to resume a healthy sex life with the help of medication or surgery.
Causes of Erectile Dysfunction
- Altered erectile tissue
- Increased venous leakage
- Diabetes, atherosclerosis, vasculitis, tobacco use
- Peyronie’s Disease
- Parkinson Disease
- CVA (Stroke)
- Spinal Cord Injury
- Alzheimer’s Disease
- Hyperprolactinemia (High Prolactin Levels)
- Hypogonadism (Low Testosterone)
- Antiarrhythmics (e.g. Digoxin)
- Antidepressants (SSRIs), Tricyclic antidepressants
- Antihypertensives (Thiazide diuretics, beta-blockers, calcium channel
blockers, angiotensin-converting enzyme (ACE) inhibitors)
- H2 receptor antagonists (e.g. Cimetidine)
- Leuprolide, Flutamide, Finasteride, Dutasteride
- Antiandrogens (Testosterone Blockers)
- Tobacco products
- Prostate surgery
- Penile surgery
- Rectal surgery
- AAA repair (Abdominal aortic aneurysm repair)