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Erectile Dysfunction is a common problem with some reports showing 1 in 5 American men ≥ 20 years old affected, or approximately 30 million American men.
How an Erection Occurs
In order to understand what causes ED, we have to understand how the penis works normally. The initial stage of erection involves the release of chemicals from NERVES supplying penile tissue. These chemicals (neurotransmitters) cause penile BLOOD VESSELS to relax and increases the blood flow to the two large balloons (corpora) that fill up with blood and become firm, making the penis firm.
What Causes ED?
As you read the above paragraph, you can see the importance of nerves and blood vessels in the production of an erection. Thus almost all causes of ED involve either damage of nerves, blood supply to the penis or both.
Heart and blood vessel problems (like cholesterol plaque blocking blood flow or high blood pressure damaging small arteries) cause poor blood flow to the penis causing weak erections or troubles maintaining a firm penis. This is the most common source of ED and it correlates with heart disease, meaning, that if a middle-age person is having severe ED, this may be a sign of silent blockage of heart blood vessels that could lead to a heart attack. Thus, men with ED, should also have a heart check up.
Diabetes is the next most common cause of ED. Diabetes causes high levels of sugar in the blood stream. Over time, high blood sugar levels causes major damage to small blood vessels AND nerves; thus, being a double threat to erections.
Medications, including some for high blood pressure, depression, pain can all interfere with blood flow to the penis. Some men are caught in a bind, where both their medical problem like depression or high blood pressure can cause ED, but so are the medications to treat their medical problems. We often have to work together with primary care doctors to figure out which medication combinations might improve the medical conditions and prevent ED.
Other less common problems include psychological conditions such as severe stress, depression. Hormone problems cause by kidney or liver failure may lead to ED. Spinal cord injury can stop nerve impulses from reaching the penis.
Trauma, radiation or surgery in the prostate, bladder, colon or rectal area can damage nerves and blood vessels and cause ED.
Treatment Options
There are a variety of different treatment alternatives, including oral medications, vacuum erection devices, penile injections, urethral suppositories and penile prosthesis surgery.
Read more below on the details of ED treatments.
Oral Medications
There are a number of prescription medications available that may improve blood flow to the penis. Combined with sexual stimulation, this can produce an erection.
Learn MoreVacuum Erection Devices
A plastic cylinder is placed over the penis, and a pump creates a vacuum suction within the cylinder, drawing blood into the penis to create an erections. A stretchable rubber ring can be placed a the base of the penis can help maintain the erection.
Learn MorePenile Injections
With injection therapy, a small needle is used to inject medication directly into the penis. This medication allows blood to flow into the penis, creating an erection.
Learn MoreUrethral Suppository
A small pellet (suppository) containing medication, is inserted into the urethra (pee hole) of the penis, the medication then dissolves releasing the chemicals inside the pellet and causing an erection.
Learn MorePenile Prosthesis
In use for more than 30 years, penile prostheses provide the most effective ED treatment. This option is the go-to operation when all other treatments fail.
Learn More