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Erectile dysfunction isn't easy to talk about. Yet some 5% of 40-year-old men and up to 25% of 65-year-old men experience ED. WebMD's experts use plain, explicit language to give you information on erectile dysfunction causes, tests, treatments, and support. Here's where you and your partner can start building a better sex life.
Erectile Dysfunction Medication and Treatment
Sildenafil can cause hypotension (abnormally low blood pressure that can lead to fainting and even shock) when given to patients who are taking nitrates. Therefore, patients taking nitrates daily, even patients taking nitrates only once a day, should not take sildenafil. Nitrates are used most commonly to relieve angina (chest pain due to insufficient blood supply to the heart muscle because of narrowing of the coronary arteries); these include nitroglycerine tablets, patches, ointments, sprays, and pastes, as well as isosorbide dinitrate, and isosorbide mononitrate. Other nitrates such as amyl nitrate and butyl nitrate also are found in some recreational drugs called "poppers".
What causes male infertility?
Uncontrolled, potentially life-threatening abnormal heart rhythms
Physical Medicine
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Increases width of penis when activated
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What are barrier methods?
Penile erection is mainly mediated by the parasympathetic nervous system, which when stimulated causes arterial dilation and relaxation of the cavernosal smooth muscle. The increased blood flow into the corpora cavernosa in association with reduced venous outflow results in penile rigidity.
Tests such as the bulbocavernosus reflex test are used to determine if there is sufficient nerve sensation in the penis. The physician squeezes the glans (head) of the penis, which immediately causes the anus to contract if nerve function is normal. A physician measures the latency between squeeze and contraction by observing the anal sphincter or by feeling it with a gloved finger inserted past the anus. Specific nerve tests are used in patients with suspected nerve damage as a result of diabetes or nerve disease.
The bite from the Brazilian wandering spider (Phoneutria nigriventer) causes a painful erection that can last for many hours and later lead to impotence, researchers from the United States and Brazil noted.
Hormonal Testing and Pharmacologic Treatment of Erectile Dysfunction: A Clinical Practice Guideline From the American College of Physicians
Results: Almost one in 10 of the respondents (9.1%) reported erectile dysfunction that lasted for at least one month over the previous year. More than a quarter (27.2%) of respondents were current smokers, with 20.9% smoking ? 20 cigarettes per day, and 6.3% smoking > 20 cigarettes per day. Compared with non-smokers, the adjusted odds ratios for erectile dysfunction were 1.24 (95% confidence interval (CI) 1.01 to 1.52, p ?=? 0.04) for those smoking ? 20 cigarettes per day and 1.39 (95% CI 1.05 to 1.83, p ?=? 0.02) for those smoking > 20 cigarettes per day, after adjusting for other confounding factors. Older age, low level of education, and taking medications for cardiovascular disease were also independently and positively associated with erectile dysfunction. In contrast, moderate alcohol consumption (1–4 drinks per day) significantly reduced the likelihood of having erectile dysfunction.
Erection begins with sexual stimulation. Sexual stimulation can be tactile (for example, by touching the penis), or mental (for example, by having sexual fantasies). Sexual stimulation generates electrical impulses along the nerves going to the penis and causes the nerves to release nitric oxide, which in turn increases the production of cyclic GMP (cGMP) in the smooth muscle cells of the corpora cavernosa. The cGMP causes the smooth muscles of the corpora cavernosa to relax, and allow rapid blood flow into the penis. The in-coming blood fills the corpora cavernosa, making the penis expand.
PSA levels: PSA (prostate specific antigen) blood levels and prostate examination to exclude prostate cancer is important before starting testosterone treatment since testosterone can aggravate prostate cancer.
Nocturnal penile tumescence (NPT) This is a simple test of normal erections during sleep. Their absence may indicate a problem with nerve function or blood supply in the penis. There are two methods used to test for nocturnal erection changes: snap gauge and strain gauge. The presence of NPT tends to signify physically functional systems, but the absence of NPT may not be conclusive.
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ED is a very common condition, particularly in older men. It is estimated that half of all men between 40 and 70 years of age will experience ED at least once.