Erectile dysfunction (commonly mis-spelled as erectile disfunction) is the repeated inability to achieve or maintain an erection long enough for sexual intercourse. Erectile dysfunction is also sometimes called impotence. Impotence may be used to describe other problems that interfere with sexual intercourse, for example lack of sexual desire, problems with ejaculation or problems achieving an orgasm.

Thus it is important to point out the difference, erectile dysfunction can be a total or inconsistent inability to achieve or maintain an erection, while impotence encompasses other problems that may interfere with sexual intercourse.

Causes of Erectile Dysfunction

An erection requires a precise sequence of events, and when any of these events are disrupted the end result is erectile dysfunction. The sequence includes nerve impulses in the brain, spinal column, the area around the penis, and response in muscles, fibrous tissues, veins, and arteries in and near the corpora cavernosa - the two major chambers in the penis. Damage to nerves, arteries, smooth muscles, and fibrous tissues, often as a result of disease, is the most common cause of erectile dysfunction. Diseases such as diabetes (between 35-50% of men with diabetes experience erectile dysfunction), kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, cardiovascular disease, and neurologic diseases account for about 70 percent of ED cases.

Smoking, being overweight, and avoiding exercise are possible causes of ED. Also, surgery (especially radical prostate and bladder surgery for cancer) can injure nerves and arteries near the penis, causing ED. In addition, many common medicines - blood pressure drugs, antihistamines, antidepressants, tranquilizers, and appetite suppressants can result in erectile dysfunction as a side effect.

Erectile Dysfunction Treatment

Erectile dysfunction treatment can either be pharmacological or non-pharmacological.For pharmacological treatment, Sildenafil, the first drug to be introduced, is part of a group of drugs called phosphodiesterase type-5 (PDE5) inhibitors. The two other drugs available in this class are tadalafil and vardenafil. Inhibition of the PDE5 enzyme leads to a chain of events that induce an erection. PDE5 inhibitors are considered first-line treatments for men with ED who may benefit from pharmacological intervention. All three of these oral drugs seem to have a similar efficacy and will help the majority of patients. However, if one PDE5 inhibitor does not work it may be worthwhile trying another.
Common adverse effects of PDE-5 inhibitors are:

  • headaches
  • flushing
  • gastric upset
  • diarrhea
  • nasal congestion
  • light-headedness
  • blue-tinged vision

    • Non-pharmacological treatments for erectile dysfunction have none of the side-effects mentioned above and may include herbal supplements, penile prostheses and vacuum constriction devices. Non-pharmacological treatments are often cheaper and safer than the medical alternatives.

    The key to either a medical or non-medical treatment for erectile dysfunction is improving blood flow to the genital area - and one is well advised to make lifestyle changes that will improve blood circulation such as exercise, avoiding tobacco, an improved diet low in saturated fat and reduced alcohol consumption.