According to MayoClinic, erectile dysfunction is the inability to get an erection firm enough to have sexual intercourse. Erectile dysfunction can include reduced sexual desire, as well as having trouble keeping an erection or trouble getting an erection. There are many different causes of erectile dysfunction, listed below from ClinicalKey:
- Psychogenic → anxiety, depression, stress
- Drugs → beta blockers, thiazides, SSRIs, and antiandrogens
- Endocrine → hypogonadism, thyroid disease
- Neurologic → stroke, spinal cord disorder, multiple sclerosis
- Vascular → atherosclerotic disease, cancer, trauma
Other risk factors for erectile dysfunction include diabetes, high cholesterol, metabolic syndrome, hypertension, obesity, alcoholism, smoking, and recurrent UTIs. Erectile dysfunction can lead to stress or anxiety about the erection, embarassment, problems with your relationship, infertility, and an unsatisfactory sex life with your partner.
To treat erectile dysfunction, your provider will look at all of the potential causes, your risk factors, and may prescribe you medication. If you are a current smoker, your provider may recommend smoking cessation. Weight loss may also be helpful if you are obese and experiencing erectile dysfunction. The first line medical treatment for erectile dysfunction includes phosphodiesterase-5 inhibitors, like Viagra (Sildenafil) or Cialis (Tadalafil). It is important to know that if you are taking phosphodiesterase-5 inhibitors that you should NOT take any drugs that contain nitrates, like nitroglycerin. It could cause your blood pressure to drop, and may be fatal.
Your provider may also check your hormone levels to make sure that testosterone levels are normal and do not need to be supplemented. Other medications you may be prescribed include a self-injection or urethral suppository. Penile implants and penis pumps are also available as treatment options. With a wide variety of treatment options available, it is necessary to discuss your goals and options in detail with your provider in order to get the greatest benefit possible.
This article reviewed by Dr. Jim Liu, MD and Ms. Deb Dooley, APRN.
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April 8, 2023