Clearing Up Confusion About Erectile Dysfunction

By Craig Rinder, MD

It was not too long ago that almost all cases of erectile dysfunction were attributed to anxiety, stress or other psychosocial factors. But now we understand that with almost every male who experiences erectile dysfunction, it is caused by a physical or biological problem, and sometimes can be a symptom of a serious medical condition.

Erectile dysfunction is most often a sign of a circulatory problem. You’ve got to have good blood flow in order to get an erection. Poor blood flow is most commonly brought on by cigarette smoking. But high blood pressure, high cholesterol and diabetes are also frequent causes for the condition.

In other words, the condition is highly affected by a person’s lifestyle. As such, it can be prevented by eating a healthy diet and engaging in regular cardiovascular exercise. Prevention is always the best route. But once a man suffers from erectile dysfunction altering your habits won’t make it go away. Quitting smoking might stop it from getting worse, but some of the damage to the arteries will be permanent.

While it is true that some men are genetically predisposed to having high cholesterol or high blood pressure, all that means with respect to erectile dysfunction is that these men really need to pay attention to those problems. Especially since these conditions present no outwardly detectable symptoms in their early stages. Difficulty getting and maintaining an erection could be a first sign of diabetes, atherosclerosis, an aneurysm, or vascular disease, among other conditions that could become life-threatening if they go undetected.

Fortunately, there are prescription drugs available for treating erectile dysfunction and most primary health practitioners are accustomed to prescribing them. There are going to be some men who don’t have success but the majority will respond well to the medication, with little more side effects than a headache.

It should be noted also, with respect to medication, that people should really avoid over-the-counter products that claim to do the same things as prescription drugs like Viagra or Cialis. Likewise, do not buy drugs from online pharmacies that claim to be selling these drugs for less. These products have been studied and many have been found to contain toxic substances. They often don’t contain what they claim to contain and some of them are actually dangerous.

If a patient isn’t responding to the medication or is experiencing side effects that don’t allow him to continue taking them, a primary provider might refer him to a specialist. Some erectile dysfunction might indicate a disease of the nervous system, and a neurologist should be consulted. A urologist like me would check testosterone levels to determine if a patient has hypogonadism, a syndrome that causes an abnormal decline in testosterone. Hypogonadism is often reversible through appropriate replacement of a patient’s testosterone. Other tests are performed to test for diabetes, high cholesterol, anemia and other conditions that could affect a man’s ability to get an erection. Other treatment options, including surgery, may be considered. Sometimes an operation to restore normal blood flow can be performed. Only patients who have specific blood flow abnormalities because of trauma or because they were born with abnormal blood vessels are candidates for this kind of surgical intervention.

Older men naturally may take longer to get an erection or have fewer of them. That is a normal part of the aging process and is different from the inability to get or maintain an erection. Talking to your primary health practitioner is the best way to determine if you have a problem. They know your medical history and can help you figure out whether what’s occurring is normal or needs treatment.

Craig Rinder, MD, is a board-certified urologist and Director of the Men’s Health program at Brattleboro Memorial Hospital.