Getting older doesn’t have to mean dealing with ED

Q. Anyone watching male-oriented TV programs would get the impression that erectile dysfunction is rampant. How common is it?

Erectile dysfunction is very common. Depending upon how you define ED, there are 15 million to 30 million men who have it. ED ranges from complete impotence to unsatisfactory performance.

But it doesn’t have to be a part of getting older. As you age, you may need more stimulation and more time, but older men should still be able to get an erection and enjoy sex.

The incidence of ED increases with age. Between 15 and 25 percent of 65-year-old men experience this problem. In older men, ED usually has a physical cause, such as a drug side effect, disease or injury. Anything that damages the nerves or impairs blood flow in the penis can cause ED.

The following are some leading causes of erectile dysfunction: diabetes, high blood pressure, atherosclerosis (hardening of the arteries), prostate surgery, hormone imbalance, and alcohol and drug abuse.

And, of course, there are your emotions. It should be no surprise that if you’re having a relationship problem with your sex partner, you can suffer from ED. Here are some other psychological influences: anxiety over a previous failure, everyday stress, depression, and feeling unattractive to your partner. If you’re suffering from ED, you should see your doctor for a discussion and physical exam.

Monitoring erections that occur during sleep can help the diagnosis. Healthy men have involuntary erections during sleep. If nocturnal erections do not occur, then ED is likely to have a physical rather than a psychological cause. Tests of nocturnal erections are not completely reliable, however.

The cause of the ED will determine the treatment. Some ED medicines are injected into the penis. Other medicines are taken orally. In addition to medicines, there are vacuum-pump devices and surgery.

Millions of men have benefited from three drugs that treat ED. These three, which are advertised endlessly, are Viagra, Levitra and Cialis. All of them increase blood flow to the penis, which produces an erection. Viagra, Levitra and Cialis improve the response to sexual stimulation, but they do not trigger an automatic erection as injections do.

Oral testosterone can reduce ED in some men with low levels of natural testosterone, but it is often ineffective and may cause liver damage. Nitroglycerin, a muscle relaxant, can sometimes enhance erection when rubbed on the penis.

Research on drugs for treating ED is expanding rapidly. If you have ED, you should ask your doctor about the latest advances.