Erectile Dysfunction: The Causes and Treatments
6 of 14 in Series: The Essentials of Men’s Sexual Health
Erectile dysfunction (ED), also called impotence, is the term used when a man is unable to have an erection. Erectile dysfunction is the second most common male sexual problem. Although ED can strike at any age, it becomes much more common as men grow older. Among men in their late 70s and beyond, some symptoms of ED are almost universal. ED doesn’t necessarily mean the end of a man’s sex life. Depending on the cause of the problem, several possible solutions are usually available, so take heart.
Causes of erectile dysfunction
The causes of ED can be either psychological or physical, while the degree of ED can vary from a simple loss of rigidity to a total inability to have an erection.
Fewer psychogenic erections does not mean you are impotent. Some men worry this means they are impotent and begin to avoid sex. This can cause a rift in a longtime relationship. Instead, adding foreplay can solve this problem.
As a man gets older, his erections begin to get weaker and weaker, and he may need more and more stimulation to get an erection. Some older men can get an erection but can’t keep it long enough to have intercourse. Sometimes they can get an erection, but the erection isn’t stiff enough to allow for penetration.
Eighty percent of ED problems occur as a result of serious medical conditions including diabetes, hypertension, or prostate cancer surgery. These conditions are much more common in older men, though they can happen in men of any age. These are all real, physical problems, but they don’t necessarily spell the end of a man’s sex life. If men are willing to take appropriate action, many men can continue to have sexual relations through their 90s.
Treatments for ED
The morning cure: Have sex in the morning instead of at night. Because you’re probably retired and have no children at home, you have no reason to always try to have sex at night, except the force of habit. However, blood flow and testosterone, both key to erections, tend to be at higher levels in the morning.
The older you are, the longer it takes you to get your body warmed up for activity. Because you probably don’t have to be on a rigid schedule, try waking up, having a light breakfast, getting your blood flowing, and then taking your partner back to bed for a sexual interlude.
The stuff technique: Have sex without first having an erection. After stuffing a nonerect penis into the vagina, a man begins to thrust. Sometimes, the blood then flows into his penis and causes an erection.
This technique doesn’t always work — or may never work for some men. Try it for a few minutes, and if it doesn’t seem like an erection will occur, then drop it.
Oral medications: Viagra, developed by Pfizer, is the most commonly known prescription drug for treating ED. Other companies have similar drugs. These drugs may have side effects and should only be taken after prescribed by a doctor.
Men with heart conditions who take nitrates such as nitroglycerin should never take Viagra because the combination of the two drugs can be deadly.
Penile implants: Non-hydraulic prostheses (semi-rigid rods that surgically implant within the erectile chambers) are reliable but leave the penis always in a rigid state. Hydraulic prostheses are now becoming more reliable and allow a man to create an erection only when desired using a mechanic pump into a fluid reservoir (also surgically implanted).
Injection therapy: A man injects his penis with a medication that relaxes the muscles, thus allowing blood to flow into the penis and cause an erection. The penis is relatively insensitive to pain, so you can barely feel the injections. Most men who use this system have reported good results although side effects are possible. This method may be appropriate for men who can’t take a pill.
Vacuum constriction: Vacuum-constriction devices, placed over the penis, allow blood to flow into the penis as air is pumped out, creating an erection. A ring at the base of his penis holds the blood in place. This does not require surgery (like prostheses) but may not provide as rigid an erection and may result in bruising.
A couple should decide together which method will work best for them and when to use one of these ED therapies, instead of the man making the decision on his own.