Doctors on Demand - Dealing with Erectile Dysfunction

Strategies for Dealing with Erectile Dysfunction

Erectile dysfunction is a relatively common condition that can affect men of all ages. If you’ve experienced erectile dysfunction, you’ll want to find out more about it and get informed on what you can do to treat it. Issues with sexual dysfunction can be embarrassing to discuss, but it’s important to realise you’re not alone and there are potential solutions available to you.

What’s erectile dysfunction and how common is it?

Erectile dysfunction is also known as impotence, and it means you’re not able to get or maintain an erection sufficient for sexual intercourse with penetration. It can affect many men at different stages of their lives, and it can also come and go.

About one million Australian men experience erectile dysfunction, and though it tends to be more prevalent in older men, it can happen to men of all ages. Some studies suggest one out of four newly diagnosed cases of erectile dysfunction are in men under the age of 40. Others indicate as much as 40% of men in their 40s experience some form of sexual dysfunction, while for men in their 50s it’s around 50%.

Note: erectile dysfunction is generally understood not to be a disease. Instead, it’s a symptom of some other type of problem, which can be physical, psychological, or both.

What causes erectile dysfunction?

The causes of erectile dysfunction are varied and they can include both physical and psychological. Erectile dysfunction tends to happen over a period of months or years, resulting in a gradual loss of function. If it happens spontaneously overnight, the cause could most likely be psychological.

Psychological causes

Psychological problems account for only one in ten cases of persistent erectile dysfunction. Stress, problems at work, relationship difficulties, financial issues, depression, or anxiety could be some of the psychological factors causing erectile dysfunction.

Physical causes

In the majority of cases of erectile dysfunction, it’s likely a physical cause affecting the blood flow in the penis. These can include diabetes, high cholesterol, hypertension or high blood pressure, smoking, and/or obesity. Erectile dysfunction is also strongly linked to heart disease, as well as conditions like multiple sclerosis.

General ageing, conditions like prostate disease and hypothyroidism, Peyronie’s disease (scar tissue inside the penis), sleep disorders, and spinal cord injuries could also lead to erectile dysfunction. Other physical factors to consider are hormone imbalances, poor circulation, diet, and living a sedentary lifestyle. If you’re taking medication, this can also impact your ability to get or sustain an erection.

Combination of psychological and physical

Sometimes erectile dysfunction is caused by a combination of both psychological and physical problems.

Unknown

In some rare cases, it’s not obvious whether the causes are physical, psychological, or both, and in these cases vascular disease could be the causal factor.

When’s it not erectile dysfunction?

An occasional failure to get or maintain and erection is probably not serious enough to be erectile dysfunction. These occasional occurrences could be due to too much drinking, tiredness, or anxiety. However, always check in with your doctor if you have any doubts, or if the problem is prolonged.

What are the treatment options for erectile dysfunction?

Possible treatment options include oral medications, counselling, injections into the penis, and implants. Check with your doctor about getting a diagnosis first and discuss appropriate treatment options with them. Your doctor can carry out a range of checks, including checks for diabetes, heart and blood vessel issues, or cholesterol. Your doctor can also use a blood test to check if the blood flow to the penis is being affected, or if there’s an underlying hormone problem.

If it’s a physical cause, your doctor may recommend lifestyle changes or prescribe oral medication. Medication is effective in about 70% of cases, and these medications work by inhibiting a particular enzyme in the penis to boost erectile response.

If medication doesn’t help, you could be recommended to use a ring, constriction band, or a penis pump, or to get surgery for an implant. External vacuum penile pumps are designed to create blood flow to the area, while injections boost blood flow. Hormone therapy could be recommended in some rare cases.

Surgical treatments are more invasive, and they might be recommended only after less-invasive options fail. A penile prosthetic implant is surgically implanted into the penis, and these work by enabling erections when you squeeze on a specific part of the device. Vascular surgery, on the other hand, is designed to boost blood supply to the penis, and it might be suitable only where there’s been trauma to the area affecting the veins and arteries.

If it’s caused by psychological factors, your doctor might recommend counselling in the form of something like cognitive behaviour therapy, or you could be recommended sex therapy, which you attend with your partner.

What’s next?

If you’re suffering from erectile dysfunction, get advice from your doctor to discuss your options. The causes could be psychological, physical, or both, and you may have a range of treatment options available. Whether it’s lifestyle changes, medication, or other options, discuss what’s the best type of treatment for your case with your doctor. By getting your doctor’s help, you could end up addressing the problem and possibly improving your general health by making the right lifestyle changes.

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