Clinical Condition

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Impotence/Erectile Dysfunction

WHAT IS ERECTILE DYSFUNCTION (ED)?

Erectile dysfunction (ED) is defined as the consistent inability to obtain or maintain an erection for satisfactory sexual relations. Data from the Massachusetts Male Aging Study has indicated that the prevalence of erectile dysfunction of any degree is 39% in men 40 years old, and 67% in those aged 70 years. This extrapolates to over twenty million men in the United States alone with ED. Effective therapy has been available for some time and currently includes pills, urethral suppositories, vacuum devices, penile injection and a variety of surgical treatment including penile implants.

MEDICAL CONDITIONS ASSOCIATED WITH ERECTILE DISFUNCTION

Atherosclerosis is the cause of approximately 40% of erectile dysfunction in men older than 50 years. Among the most commonly recognized conditions associated are high blood pressure, lipid problems (cholesterol, triglycerides), diabetes and cigarette smoking. In patients with diabetes mellitus, irrespective of type, the prevalence of erectile dysfunction is approximately 50% (range 20 to 75%) with the prevalence dependent on patient age, duration of diabetes and severity of the diabetes. Other chronic disease states associated with a high prevalence of erectile dysfunction include chronic renal failure, hepatic failure, multiple sclerosis, Alzheimer’s disease, sleep apnea, and chronic obstructive pulmonary disease. Endocrine disorders such as low testosterone, and thyroid problems may be associated also with ED. Pelvic trauma, pelvic surgery (major prostate, bladder and bowel operations), and pelvic radiation therapy are associated with erectile dysfunction. Direct trauma to the perineum (bicycle injury) can cause vascular problems in the penis and lead to erectile dysfunction that may be treatable by penile artery bypass surgery.

Many medications including certain blood pressure pills, cold medications, hormones, antidepressants, tranquilizers, alcohol, tobacco, heroin, and cocaine are associated with erectile dysfunction.

COMMON CONDITIONS ASSOCIATED WITH ERECTILE DYSFUNCTION

Diabetes

High blood pressure

Lipid disorders

Cigarette smoking

Coronary artery disease

Heart attack

Stroke

Parkinson’s disease

Multiple sclerosis

Herniated lumbar disc

Medications (see above)

Thyroid problems

Low testosterone level

Major prostate surgery

Major bladder surgery

Major rectal surgery