Every man is occasionally unable to achieve an erection; this is normal. Erectile dysfunction occurs when the problem is frequent or continuous.
Erectile dysfunction can range from mild to severe. A man with mild erectile dysfunction may occasionally achieve a full erection, but more often he achieves an erection that is inadequate for penetration. He may frequently be unable to achieve an erection at all. A man with severe erectile dysfunction is rarely able to achieve an erection.Erectile dysfunction becomes more common with age but is not part of the normal aging process. About half of men 65 years of age and three fourths of men 80 years of age have erectile dysfunction.
Causes
To achieve an erection, the penis needs both an adequate inflow of blood and a slowing of blood outflow. Disorders that narrow arteries and decrease blood inflow (such as atherosclerosis, diabetes, or a blood clot) or surgery on the blood vessels can cause erectile dysfunction. Also, abnormalities in the veins of the penis can sometimes drain blood back to the body so rapidly that erections cannot be sustained despite adequate blood inflow.Neurological damage is another possible cause of erectile dysfunction. Damage to the nerves leading to or from the penis produce erectile dysfunction. Such damage could result from surgery (most commonly prostate surgery), spinal disease, diabetes, multiple sclerosis, peripheral nerve disorders, stroke, alcohol, and drugs.Occasionally, hormonal disturbances (such as abnormally low levels of testosterone) cause erectile dysfunction. Also, factors that decrease a man’s energy level (such as illness, fatigue, and stress) can make erections difficult.
Many drugs can interfere with the ability to achieve an erection, especially among older men. Drugs that commonly cause erectile dysfunction include antihypertensives, antidepressants, some sedatives, cimetidine, digoxin, lithium, and antipsychotics.Psycho logic issues (such as depression, performance anxiety, guilt, fear of intimacy, and ambivalence about sexual orientation) can impair the ability to achieve erections. Psycho logic causes are more common in younger men. Any new stressful situation, such as a change of sex partners or problems with relationships or at work, can also contribute.
