What is Erectile Dysfunction

Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex. Having erection trouble from time to time isn't necessarily a cause for concern. Younger people can have ED problem 20% of the time and older people can have this problem 50% of the time. However if the ED problem is more than this then it can cause stress and affect your self-confidence leading to relationship problems. Problems getting or keeping an erection also can be a sign of an underlying health condition that needs treatment and a risk factor for heart disease down the road.

Erectile dysfunction symptoms might include persistent:

Trouble in getting an erection

Trouble in keeping an erection

Reduced sexual desire

When To See A Doctor

A family doctor is a good place to start when you have erectile problems. See your doctor if:

You have concerns about your erections or you're experiencing other sexual problems, including ejaculatory dysfunction, such as premature or delayed ejaculation

You have diabetes, heart disease or another known health condition that might be linked to erectile dysfunction.

The physicians are best suited to be seen primarily as they would evaluate the primarily cause and the severity of ED. If you fall in the most severe category then you might be referred for a urologist. Consulting a urologist or andrologist in the first instance will not help your cause as ED can be caused by physiological as well as psychological reasons. The physician is fully competent to medically treat any level of ED.

Examination and Diagnosis

For many men, a physical exam and answering questions (medical history) are all that's needed for a doctor to diagnose erectile dysfunction and recommend a treatment. If you have chronic health conditions or your doctor suspects that an underlying condition might be involved, you might need further tests or a consultation with a specialist.

Tests for underlying conditions might include:

Physical exam - This might include careful examination of your penis and testicles and checking your nerves for sensation.

Blood tests - A sample of your blood might be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health conditions.

Urine tests (urinalysis)- Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions.

Penile Doppler Test - In this test a colour doppler machine is used to see and measure the flow of blood into the penis. Normally the test is done before giving a papavarine injection and after giving the injection.

Overnight erection test - Most men have erections during sleep without remembering them. This simple test involves wrapping a special device around your penis before you go to bed. This device measures the number and strength of erections that are achieved overnight. It can help to determine if your erectile dysfunction is related to psychological or physical causes.

Psychological exam - Your doctor might ask questions to screen for depression and other possible psychological causes of erectile dysfunction.

Causes and Risk Factors

Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from both physiological or psychological reasons.

Physical Causes of ED

In most cases, erectile dysfunction is caused by something physical. Common causes include:

Heart disease

Clogged blood vessels

High cholesterol or High BP

Diabetes

Obesity

Metabolic syndrome

Parkinson's disease

Multiple sclerosis

Peyronie's disease

Certain prescription medications

Tobacco use

Alcohol or other intoxicants

Sleep disorders

Prostate treatment

Surgeries or injuries to pelvic region or spinal cord

Prolonged cycling

Psychological Causes Of ED

Depression, anxiety or other mental health conditions

Stress

Relationship problems due to stress, poor communication or other concerns

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