Erectile dysfunction

Erectile dysfunction (ED), or impotence, is the inability to get or keep an erection long enough for satisfactory intercourse. Erectile dysfunction isn’t a disease, but a symptom of some other problem – physical, psychological or a mixture of both.

It is normal to experience the occasional bout of ED. Unless it persists, there is no reason to be concerned. Ongoing ED should be investigated by a doctor.

Treatments for erectile dysfunction include medications given orally (by mouth), vacuum devices, counselling, injections directly into the penis or penile prosthetic implants.

Causes of erectile dysfunction

It was once thought that erectile dysfunction was mainly caused by psychological factors, such as anxiety or depression. In fact, most cases of erectile dysfunction are actually caused by physical illness.

Erectile dysfunction can be considered due to:

• Physical illness – ED is frequently associated with conditions affecting the blood flow in the penis. Diabetes, high cholesterol, hypertension, cigarette smoking and obesity are frequently involved and there is a strong association between ED and cardiac disease.
• Psychological factors – a man’s sexual drive or performance can be affected by stress such as problems at work, relationship difficulties or financial worries. Psychiatric conditions and feeling depressed or anxious about poor sexual performance can also result in a failed erection. About one in ten cases of impotence are caused by psychological factors only.
• A combination of physical illness and psychological factors – physical problems with maintaining an erection may cause the man to feel anxious about lovemaking, which makes the problem worse.
• Unknown – in a few cases, neither physical nor psychological causes are obvious. More often it is now assumed that vascular disease is the underlying cause.

Occasional erectile dysfunction is normal

Don’t worry about the occasional failure to get or keep an erection. Occasional ED is normal. Some of the causes include drinking too much alcohol, anxiety and tiredness. In fact, one of the most common causes of impotence in middle-aged men is lack of sleep.

Ongoing ED should be investigated by a doctor

While occasional ED is normal, ongoing ED can be a symptom of a serious physical illness. It is important that any ongoing problems are fully investigated by a doctor to check for any underlying medical cause that may also require treatment. This may include heart and blood vessel diseases, diabetes, high blood pressure or high cholesterol.

Once you find out whether your ED stems from physical or psychological causes, you can get the proper course of treatment.

Treatment

There are many treatments for erectile dysfunction. These include:

• Changing your prescription drugs if they are the cause
• Psychotherapy and counselling
• Oral medications (tablets) such as Viagra, Cialis and Levitra
• External vacuum devices to create blood flow
• Injections directly into the penis (penile injections)
• Hormone therapy (rarely given)
• Penile prosthetic implants.

The initial approach is to directly treat the underlying cause if reasonable, otherwise to use treatments to promote a better erection.

It is usual to start with the least invasive treatment, such as tablets, and to recommend more complicated injection treatments or surgery if the tablets fail.

Treat any non-prescription products that claim to treat or cure erectile dysfunction with caution and use only under the supervision of a doctor. Some products are expensive and may not have been adequately tested for either their side effects or results.

Where to get help

• Your doctor
• Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619 www.mshc.org.au
• Family Planning Victoria Tel. (03) 9257 0100 or 1800 013 952 www.fpv.org.au

Things to remember

• Most cases of ED are physical in origin.
• It is normal for a man to experience occasional bouts of ED, perhaps from tiredness or drinking too much alcohol.
• Ongoing erectile dysfunction should be investigated by a doctor.
• Common treatments include counselling, oral medications, vacuum devices, penile injections and implants.

You might also be interested in:

• Diabetes and erectile dysfunction.
  
• Erectile dysfunction treatments.
  
• Libido - medical issues.
  
• Libido - relationship issues.
  
• Men's health.
  
• Reproductive system.
  

Want to know more?

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Andrology Australia

Last reviewed: April 2011

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<a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Impotence?open">Erectile dysfunction - Better Health Channel</a><br/>
Erectile dysfunction (ED), or impotence, is the inability to get or keep an erection. It used to be thought that ED was psychological in origin but now we know that most cases are caused by a physical problem. Occasional erectile dysfunction is normal, but ongoing ED should be investigated by a doctor.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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