Overview
What is erectile dysfunction? A Mayo Clinic expert explains
Learn more from Matthew Ziegelmann, M.D.
I'm Dr. Matthew Ziegelmann, a urologist at the Mayo Clinic. In this video we cover the basics of erectile dysfunction. What is it? Who gets it? The symptoms, diagnosis and treatments. Whether you are looking for answers for yourself or a loved one, we are here to provide you with the best information available. Erectile dysfunction, also known as impotence, is defined as problems getting and keeping an erection. It can be embarrassing to talk about it. It has been reported that more than half of men between the ages of 40 and 70 experience some form of erectile dysfunction. So take comfort in knowing that you are not alone. Experiencing occasional erection problems is usually nothing to worry about. However, persistent problems can cause stress, affect self-esteem and contribute to relationship problems. Sometimes it can indicate an underlying condition. The bottom line is that if you're experiencing erectile dysfunction, you should talk to your doctor about it, even if you're embarrassed, because we have a number of ways to treat erectile dysfunction effectively. ED can be caused by physical or psychological problems. Sexual arousal is a complicated process. It concerns your brain, your hormones, your nerves, your muscles and your blood vessels. A hiccup in any of these can cause a problem.
It is a fact that erectile dysfunction affects men of all ages. But as you get older, your risk may increase. This is not only because it takes longer for an erection to develop, but also because other factors may play a role. Physical problems such as heart disease, high cholesterol, high blood pressure, diabetes, obesity, and smoking can all cause erectile dysfunction. On the other hand, depression, anxiety, stress, relationship problems and other mental health issues can also interfere with sexual feelings. And this can cause or worsen your erection problems. Often it is a bit of both. So, it is important to understand one's physical and mental condition to know the underlying cause of one's erectile dysfunction.
Unlike many medical conditions, the symptoms of erectile dysfunction are quite simple. If you have persistent problems getting or maintaining an erection, you may be suffering from erectile dysfunction. If you're dealing with any of these symptoms, a primary care physician or internist is usually a good place to start.
Usually, the hardest part of diagnosing erectile dysfunction is overcoming the shame that comes with talking about your erectile dysfunction. But once you talk to your doctor, you'll find that it's common and a diagnosis can be made quickly. For many people, all that is needed is a physical exam and answering some basic questions about your medical history. If you have chronic health conditions or your doctor suspects an underlying condition, you may need additional testing or a consultation with a specialist like me.
Millions of men can successfully treat their erectile dysfunction. Oral prescription medication is a popular route. Taking medication does not automatically lead to an erection. These tablets enhance the effects of nitric oxide. This is a chemical your body produces that relaxes the muscles in the penis. Sexual stimulation releases this chemical and these drugs enhance its effect, making an erection possible. Other less common but effective medications for erectile dysfunction include self-injections or urethral suppositories. If medication is not effective, your doctor may recommend a vacuum penis pump. This device uses a hollow tube to create a vacuum that draws blood into your penis. Penile implants are another option and involve the surgical placement of a device that allows the penis to achieve an erection. If your ED is affecting your mental health or your relationship, your doctor may also recommend that you and your partner see a psychologist or sex therapist. What your treatment ultimately looks like will depend on the cause and severity of your erectile dysfunction, as well as any underlying health conditions. Your doctor can work with you to find the right solution.
Erectile dysfunction can be an uncomfortable topic to discuss with your doctor, your partner, and your friends. But don't assume you're alone. Involve your partner and communicate openly and honestly about your condition. Try to remember that this is very common. And more importantly, it is highly treatable. If you want to learn more about erectile dysfunction, here are some other related videos. Or you can visit mayoclinic.org. We wish you all the best.
Flaccid and erect penis
Flaccid and erect penis
The penis contains two cylindrical, mushroom-like structures called corpora cavernosa. During sexual arousal, nerve impulses increase blood flow to both cylinders. This sudden influx of blood causes an erection by expanding, straightening and stiffening the penis.
Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex.
Having occasional erection problems is not necessarily a cause for concern. However, if erectile dysfunction is an ongoing problem, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.
If you're concerned about erectile dysfunction, talk to your doctor, even if you're embarrassed. Sometimes treating an underlying condition is enough to correct erectile dysfunction. In other cases, medications or other immediate treatments may be necessary.
products and services
- A book: Mayo Clinic on prostate health
- Men's Health Center: Vasectomy Reversal
Symptoms
Symptoms of erectile dysfunction can be persistent:
- Problems getting an erection
- Problems maintaining an erection
- Decreased sexual desire
When should you consult a doctor?
If you have erection problems, a doctor is a good place to start. Consult your doctor if:
- You are concerned about your erections or you experience other sexual problems, such as premature or delayed ejacul*tion
- You have diabetes, heart disease, or another known health condition that may be related to erectile dysfunction
- You have other symptoms besides erectile dysfunction
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Reasons
Male sexual arousal is a complex process involving the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can be caused by a problem with any of these. Likewise, stress and mental health problems can cause or worsen erectile dysfunction.
Sometimes a combination of physical and psychological problems causes erectile dysfunction. For example, a mild physical condition that slows your sexual response can cause concerns about maintaining an erection. The resulting anxiety can cause or worsen erectile dysfunction.
Physical causes of erectile dysfunction
In many cases, erectile dysfunction is caused by something physical. Common causes include:
- Heart disease
- Clogged blood vessels (atherosclerosis)
- Hoge cholesterol
- High bloodpressure
- Diabetes
- Obesity
- Metabolic syndrome – a condition involving high blood pressure, high insulin levels, body fat around the waist and high cholesterol
- Parkinson's disease
- Multiple sclerose
- Certain prescription drugs
- Use of tobacco
- Peyronie's disease - development of scar tissue in the penis
- Alcoholism and other forms of drug abuse
- Sleep problems
- Treatments for prostate cancer or enlarged prostate
- Surgeries or injuries that affect the pelvic region or spinal cord
- High testosterone
Psychological causes of erectile dysfunction
The brain plays a key role in initiating the series of physical events that cause an erection, starting with feelings of sexual arousal. A number of things can disrupt sexual feelings and cause or worsen erectile dysfunction. These include:
- Depression, anxiety or other mental disorders
- Spanning
- Relationship problems due to stress, poor communication or other concerns
Risk factors
As you get older, erections may take longer to develop and may not be as firm. You may need more direct contact with your penis to get and keep an erection.
Several risk factors can contribute to erectile dysfunction, including:
- medical conditions,especially diabetes or heart disease
- use of tobacco,that restrict blood flow to veins and arteries can, over time, cause chronic health problems that lead to erectile dysfunction
- Being overweight,especially if you are overweight
- Certain medical treatments,such as prostate surgery or radiotherapy for cancer
- Injury,especially if they damage the nerves or arteries that control erection
- Medicine,including antidepressants, antihistamines and medicines to treat high blood pressure, pain or prostate conditions
- psychological disorders,such as stress, anxiety or depression
- Use of drugs and alcohol,especially if you have a long-term drug addiction or are a heavy drinker
Complications
Complications of erectile dysfunction can include:
- An unsatisfactory sex life
- Stress of angst
- Shame or low self-esteem
- Relationship problems
- Inability to get your partner pregnant
Mere information
- Get Erectile Dysfunction Care at the Mayo Clinic
- Erectile Dysfunction: A Sign of Heart Disease?
Prevention
The best way to prevent erectile dysfunction is to make healthy lifestyle choices and manage existing health problems. For example:
- Work with your doctor to manage diabetes, heart disease, or other chronic health conditions.
- Consult your doctor for regular checkups and medical screening tests.
- Quit smoking, limit or avoid alcohol, and don't use illegal drugs.
- Practice regularly.
- Take steps to reduce stress.
- Seek help for anxiety, depression or other mental health issues.
Get Erectile Dysfunction Care at the Mayo Clinic
Our caring team of Mayo Clinic experts can help you with your health concerns. Visit Mayo Clinic Men's Health to get started.
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