Erectile dysfunction basics

Erectile dysfunction, commonly referred to as ED, or impotence, is the inability to achieve and sustain an erection sufficient for satisfactory sexual intercourse. This condition is not considered normal at any age and is different from other problems that interfere with sexual intercourse, such as lack of sexual desire and problems with ejaculation and orgasm.

How common is ED?

According the NHS, it is estimated that 50% of men between 40 and 70 years of age will experience ED at least once. Approximately 70% of men aged 70 and older will have ED.

A much more common problem that affects the majority of men at some point in their life is the occasional failure to achieve an erection. This can occur for a variety of reasons, such as from drinking too much alcohol or from being extremely tired.

Failure to achieve an erection less than 20% of the time is not unusual and treatment is rarely needed. Failure to achieve an erection more than 50%  of the time, however, generally indicates there is a problem requiring treatment.

What causes ED?

In order to achieve an erection three conditions must occur: The nerves to the penis must be functioning properly; the blood circulation to the penis must be adequate; there must be a stimulus from the brain. If there is something interfering with any or all of these conditions, a full erection will be prevented.

Common causes of ED include diseases that affect blood flow, such as atherosclerosis (narrowing of the arteries); nerve diseases; psychological factors, such as stress, depression and performance anxiety; and injury to the penis. Chronic illness, certain prescription drugs and a condition called Peyronie’s disease (scar tissue in the penis) can also cause ED.

Can ED be prevented?

For people who are at risk of developing ED due to personal behaviour, such as drinking too much alcohol, steps may be taken to prevent its occurrence. However, other causes of ED may not be preventable.

What sort of doctor treats ED?

The type of medical specialist who treats ED will depend on the cause of the problem. Based on your family’s medical history, as well as your own medical history and current health, your GP may treat you with oral drugs. If this fails, they may refer you to a urologist or psychologist.

What should I do if I am having problems achieving/maintaining an erection?

If you suspect you may have erectile dysfunction, see your GP. They can perform a variety of tests to identify what is causing your problem and refer you to a specialist if needed. Once the cause is identified, there are several treatments to consider.

How is erectile dysfunction treated?

There are many different ways ED can be treated, including oral drugs, psychosexual counselling, penile injections and insertions, vacuum pumps, hormone treatment and surgery. Each type of treatment has its own advantages and disadvantages. Talk to your doctor to determine the best treatment for you.