Erectile dysfunction, commonly referred to as ED, is the inability to achieve and sustain an erection suitable for sexual intercourse. This condition is not necessarily considered normal at any age and is different from other problems that interfere with sexual intercourse, such as lack of sexual desire and problems with ejaculation and orgasm.
According to the National Institutes of Health, approximately 5% of 40-year-old men and between 15% and 25% of 65-year-old men experience ED on a long-term basis.
A much more common problem that affects the majority of men at some point in their life is the occasional failure to achieve an erection, which can occur for a variety of reasons, such as from drinking too much alcohol or from being extremely tired.
Failure to achieve an erection less than 20% of the time is not unusual and treatment is rarely needed. Failure to achieve an erection more than 50% of the time, however, generally indicates there is a problem requiring treatment.
What Causes Erectile Dysfunction?
In order to achieve an erection, these conditions must occur:
The nerves to the penis must be functioning properly.
The blood circulation into the penis must be adequate.
The veins must be able to "trap and keep" the blood inside the penis.
There must be a stimulus from the brain.
If there is something interfering with any or all of these conditions, a full erection will be prevented.
Common causes of ED include diseases that affect blood flow, such as atherosclerosis (hardening of the arteries) or venous leakage (weak veins); nerve diseases; psychological factors, such as stress, depression, and performance anxiety; and injury to the penis. Chronic illness, certain medications, and a condition called Peyronie's disease (scar tissue in the penis) can also cause ED.
Can ED Be Prevented?
For people who are at risk of developing ED due to personal behavior, such as drinking too much alcohol, steps may be taken to prevent it. However, other causes of ED may not be preventable.
What Doctors Treat ED?
The type of medical specialist who treats ED will depend on the cause of the problem. Based on your family's medical history as well as your own medical history and current health, your doctor may treat you with oral medications such as Viagra or similar drugs. If this fails, he or she may refer you to a urologist or psychologist.
What Should I Do If I Am Having Problems Achieving/Maintaining an Erection?
If you suspect you may have erectile dysfunction, see your doctor. He or she can perform a variety of tests to identify what is causing your problem and refer you to a specialist if needed. Once the cause is identified, there are several treatments to consider.
How Is Erectile Dysfunction Treated?
There are many different ways erectile dysfunction can be treated, including oral medications, sex therapy, penile injections, suppositories, vacuum pumps, and surgery. Each type of treatment has its own advantages and disadvantages. Talk to your doctor to determine the best treatment for you.
Does Insurance Cover ED Treatment?
Insurance coverage of ED depends upon the type of treatment prescribed. If there is a documented medical condition that is shown to be causing ED, insurance will usually cover at least some of it. Sex therapy and medications that have not yet been approved by the FDA, however, are generally not covered. Talk to your insurance provider to determine if the treatment you are considering will be covered.