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Impotence (Erectile dysfunction) - Highlights

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of erectile dysfunction.

Alternative Names

Highlights:

Erectile Dysfunction

Erectile dysfunction, also called impotence, can affect men of all ages, although it is much more common among older men. It is normal for men to occasionally experience erectile dysfunction. However, if the problem becomes chronic, it can have adverse effects on relationships, emotional health, and self-esteem. Erectile dysfunction may also be a symptom of an underlying health condition. If erectile dysfunction becomes an on-going problem, it is important to talk to your doctor.

Causes of Erectile Dysfunction

Physical causes are the main reasons for erectile dysfunction in up to 85% of cases. They include heart disease, high blood pressure, diabetes, neurological disease, and other health conditions. Some of the medications used to treat these conditions can also cause erectile dysfunction.
Psychological causes of erectile dysfunction occur in up to 15% of cases. They include anxiety, depression, stress, and problems in relationships.
Lifestyle factors that increase risk for erectile dysfunction include smoking, alcohol use, and other substance abuse.

Treatment

Many treatments are available for erectile dysfunction. They include oral medications, injections, mechanical devices, surgery, and psychotherapy. Any health condition that may be associated with erectile dysfunction should also be addressed. Doctors recommend that a man� ' s partner be involved in the discussion of treatment options.

PDE5 Inhibitors

The most common medical treatment for erectile dysfunction is PDE5 inhibitor drugs:

Sildenafil (Viagra)
Vardenafil (Levitra)
Tadalafil (Cialis)

These drugs are generally safe and effective for most men. These medications may not be appropriate for men with certain health conditions, such as severe heart disease, heart failure, history of stroke, or uncontrolled high blood pressure or diabetes. Men who take nitrate drugs cannot use PDE5 inhibitors, and these drugs can also interact with other medications. Talk to your doctor about whether PDE5 inhibitor drugs are a safe choice for you.

Resources

www.niddk.nih.gov -- National Kidney and Urologic Diseases Information
www.auanet.org -- American Urologic Association
www.urologyhealth.org -- Urology Health

References

Babaei AR, Safarinejad MR, Kolahi AA. Penile revascularization for erectile dysfunction: a systematic review and meta-analysis of effectiveness and complications. Urol J. 2009 Winter;6(1):1-7

Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, et al. Testosterone therapy in adult men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2006 Jun;91(6):1995-2010. Epub 2006 May 23.

Boloña ER, Uraga MV, Haddad RM, Tracz MJ, Sideras K, Kennedy CC, et al. Testosterone use in men with sexual dysfunction: a systematic review and meta-analysis of randomized placebo-controlled trials. Mayo Clin Proc. 2007 Jan;82(1):20-8.

Lindau ST, Schumm LP, Laumann EO, Levinson W, O'Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007 Aug 23;357(8):762-74.

McVary, K. T.. Clinical practice. Erectile dysfunction. N Engl J Med. 2007 Dec; 357(24): 2472-81.

Melnik T, Soares BG, Nasselo AG. Psychosocial interventions for erectile dysfunction. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004825.

Miles CL, Candy B, Jones L, Williams R, Tookman A, King M. Interventions for sexual dysfunction following treatments for cancer. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005540.

Müller A, Mulhall JP. Cardiovascular disease, metabolic syndrome and erectile dysfunction. Curr Opin Urol. 2006 Nov;16(6):435-43.

Nehra A. Erectile dysfunction and cardiovascular disease: efficacy and safety ofphosphodiesterase type 5 inhibitors in men with both conditions. Mayo Clin Proc. 2009 Feb;84(2):139-48.

Saad F, Grahl AS, Aversa A, Yassin AA, Kadioglu A, Moncada I, et al. Effects of testosterone on erectile function: implications for the therapy of erectile dysfunction. BJU Int. 2007 May;99(5):988-92. Epub 2007 Feb 19.

Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007 Feb;120(2):151-7.

Vardi M, Nini A. Phosphodiesterase inhibitors for erectile dysfunction in patients with diabetes mellitus. Cochrane Database Syst Rev. 2007 Jan 24(1):CD002187.

Reviewed last on: 7/8/2009
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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