Erectile Dysfunction

Erectile dysfunction can be caused by physical or psychological factors.

Physical factors include:

• Certain prescription drugs, such as blood pressure drugs and antidepressants
• Chronic illnesses, such as diabetes, cardiovascular (heart) diseases, hypertension (high blood pressure), nerve damage and multiple sclerosis (autoimmune disease affecting the nerves). These illnesses can affect the nerves and blood flow to the penis, thus causing erectile dysfunction
• Low levels of testosterone, and injured or damaged nerves and arteries near the penis (eg. due to pelvic surgery)
• Poor lifestyle, which includes smoking, excessive alcohol consumption, drug abuse, lack of physical activity and being overweight

Psychological factors include:

• Fear of sexual failure
• Guilt
• Low self-esteem
• Previous traumatic sexual experiences
• Stress, anxiety or depression

The prevalence of erectile dysfunction increases with age, from 5% in men aged 45 years to 50% in men aged over 75 years.

Various treatment options are available for erectile dysfunction. Your doctor will evaluate your condition and suggest a suitable treatment for you, depending on the cause of your erectile dysfunction and your general health. Treatments include:

• Oral medication – usually a 1^st line treatment and effective in about 80% of patients. However, it may not be suitable for everybody as it can interact with some prescription medications you may be taking
• Injection therapy – the 2^nd line of treatment if oral medications are unsuccessful. The patient can self-inject a drug (prostaglandin E1) into the shaft of the penis to achieve an erection
• External suction devices – used to pull blood into the penis to achieve and maintain an erection for intercourse
• Penile prosthesis (implants) – surgically fitted for some patients to artificially create an erection

Erectile dysfunction could be a sign of various underlying diseases, such as:

• Early diabetes
• Heart diseases
• Neurovascular diseases

Heart attacks or strokes can develop after taking medications to treat erectile dysfunction.