Dealing With ‘E.D.’

Erectile dysfunction may signal an underlying health problem

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When you hear medical stories on the news, do you ever wish the reporter had dug a little deeper? Does some health news sound too good—or too bad—to be true? To find out the real story, it’s a good idea to Ask Our Expert.

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It’s personal and often difficult to discuss. But erectile dysfunction (ED) is something men shouldn’t have to live with, and it shouldn’t be ignored. It may be a warning sign for other serious health problems.

ED, the consistent inability to achieve and maintain an erection firm enough for sexual activity, affects 15-30 million men over age 50. The key word here is “consistent.” “If it happens once or twice, don’t be alarmed,” says internist David Caccese, M.D., of Lehigh Valley Hospital and Health Network. “Stress or excess alcohol consumption may occasionally cause difficulty maintaining an erection.”

If the problem happens regularly, however, your body may be telling you something is wrong. The majority of ED cases are caused by high blood pressure, high cholesterol or some form of cardiovascular disease. “These conditions cause problems with blood flow,” says Caccese’s colleague, urologist Edward Mullin, M.D. “They prevent the sponge-like tissue of the penis from filling with blood or cause it to drain prematurely.” Because smoking, drinking and drug use raise the risk for heart disease, these same habits are linked with ED. “The younger you start and the more you use, the greater your risk for developing ED later in life,” Mullin says.

ED also may result from an enlarged prostate, pelvic trauma or a disease that affects nerves, such as diabetes or multiple sclerosis. The cause may be psychological—anything from workplace stress or relationship problems to clinical depression—but that’s only true in 10-20 percent of cases.

The first step in treatment is to see your doctor. Don’t be embarrassed to make the call, Caccese says. If the problem turns out to be psychological, your doctor can refer you to a counselor. “If it’s physically based,” he says, “simple lifestyle changes like quitting smoking, changing your diet, getting more exercise or lowering your alcohol intake can make a difference.” Your doctor may prescribe medication that allows the blood vessels to expand. If these options don’t work, a urologist can talk with you about other treatment options including a vacuum pump, self-administered injections prior to sexual activity, or a flexible penile implant.

Prevention is the key to a long and successful sex life, Caccese and Mullin agree: “The longer we keep our bodies strong by living a healthy lifestyle, the longer we can stay active in all aspects of life.”

Want to Know More about the effects of smoking on erectile dysfunction? Click on the link in the column on the right side of this page.

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