February 8, 2017

Erectile dysfunction is more common than you might think, and there’s help at any age.


Is erectile dysfunction cramping your sex life? You may be wondering how common the problem is. Between 15 million and 30 million men in the United States experience it, and by age 65, almost 25 percent of men have trouble getting or keeping an erection at least one out of every four times they have sex, says the U.S. Department of Health and Human Services.

Causes of erectile dysfunction

Erectile dysfunction has several causes, including depression, anxiety or stress, and it is a common side effect of some medications (like antidepressants). But you might be unaware of two major causes, said Douglas Milam, M.D., associate professor of urologic surgery at Vanderbilt University Medical Center.

The No. 1 risk factor is poor diabetes control. “If someone has diabetes,” he said, “he needs to have as tight of control as possible.” Milam explained that diabetics should maintain a glycosylated hemoglobin (A1c) level of less than seven. “Anybody above that is at such high risk that we expect them to get erectile dysfunction by middle age.”

The No. 2 risk factor is high blood pressure, which also can cause heart disease. In fact, erectile dysfunction can be an early warning sign of serious heart conditions. “Erectile dysfunction is probably the earliest indicator in men of damage to the inside of the blood vessels,” Milam said. “Any man with erectile dysfunction in his 40s has more than 10 times the risk for having a heart attack than a man with normal erectile function.” If you have high blood pressure, take steps to lower it, and if you smoke, talk to your doctor about the best method for quitting. (Also, find a wealth of resources here.)

Men with a combination of risk factors have a very high risk of erectile dysfunction. For instance, a 60-year-old man with diabetes, high blood pressure and heart disease has more than an 80 percent chance of having severe erectile dysfunction, Milam said.

How can erectile dysfunction be treated?

Erectile dysfunction can be treated at any age, and various options exist. First, many doctors will prescribe pills like Viagra or Cialis. These tend to be effective in most individuals who have erectile dysfunction that is bothersome, but not completely impeding their sex lives. Other treatments include vacuum devices (penis pumps, which increase blood flow), penile injection therapy or suppositories (which dissolve when inserted into the urethra). If these treatments aren’t effective, surgical implantation of an inflatable penile prosthesis is very effective and has a high satisfaction rate, Milam says.

Vanderbilt Urology Clinic offers the latest, most comprehensive care for a wide range of urologic diseases and conditions, including cancers of the prostate, bladder and kidneys and other urologic cancers; incontinence and other bladder-control problems; kidney stones; and sexual health problems, including erectile dysfunction (impotence). Details: 615-322-2880.