What is erectile dysfunction?
Erectile dysfunction, often referred to as impotence, is the inability to have or maintain an erection sufficient for sexual activity. It is a common problem affecting around one in every 10 men at some time in their lives and tends to affect men increasingly as they get older. Erectile dysfunction used to be regarded as an entirely psychological problem, but it is now known that in about 90% of sufferers there is a physical cause.
What causes erectile dysfunction?
Most men will suffer occasional episodes of erectile dysfunction at some time in their lives, which may be caused by factors such as excess alcohol or stress and anxiety. Previous erectile failure for one of these reasons may cause anxiety and so the problem can repeat itself. If you can achieve an erection on some occasions and not others, the cause is likely to be psychological. There are many possible psychological causes, including depression or sexual boredom or conflicts with a partner, which may lead to temporary sexual dysfunction with that partner. In addition, uncertainty about sexual orientation (i.e., whether heterosexual or homosexual), can cause problems. Excessive stress and anxiety at work may cause a temporary or long-term problem depending on whether the stress is short-term or permanent.
If erectile dysfunction is the result of a physical problem, the decline in sexual function is usually gradual. A number of physical conditions may result in erectile dysfunction. For example, if the arteries supplying the penis become blocked (atherosclerosis) the blood supply to the penis may not be sufficient to sustain an erection. The arteries can become blocked in the same way that arteries to the heart become blocked, as a result of smoking or high cholesterol levels.
Neurological diseases or disorders of the nerves that go to the penis, eg, in spinal cord injury, can also affect sexual function, as can a stroke. There are several other conditions that can cause erectile dysfunction, including diabetes, kidney failure, liver failure, hypogonadism (low levels of male hormone testosterone), high blood pressure and alcoholism.
Erectile dysfunction may also occur as a side effect of some drug treatments, for example, some treatments for high blood pressure. If you are taking medicine for high blood pressure and are experiencing erection difficulties, do not stop taking the tablets without consulting your GP. High blood pressure must be controlled and stopping the medication can put you at risk of other problems. Alternative treatments for high blood pressure are available and the problem may be resolved by a change in medication. Some drugs, particularly antidepressants, can cause lethargy or weight gain and may affect libido (sexual interest). Some medications given for serious mental illness may also affect the ability to achieve orgasm, while some medicines for anxiety or high blood pressure may delay or prevent orgasm. Use of certain illegal drugs may also cause sexual problems.