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Impotence (Erectile Dysfunction, ED) FAQs

Reviewed by Melissa Conrad Stöppler, MD

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Q:Erectile dysfunction (ED) can be caused by both physical and psychological conditions. True or False?

A:True. Risk factors for ED can include the following: Advanced age, cardiovascular disease, diabetes mellitus, high cholesterol, cigarette smoking, recreational drug use, and/or depression or other psychiatric diseases.

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Q:By what age have most men have experienced erectile dysfunction?

A:45. By age 45, most men have experienced erectile dysfunction.

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Q:What is the definition of erectile dysfunction?

A:The inability to achieve or sustain an erection. Erectile dysfunction (ED), also known as impotence, is the inability to achieve or sustain an erection for satisfactory sexual activity. Erectile dysfunction is different from other conditions that interfere with male sexual intercourse, such as lack of sexual desire (decreased libido) and problems with ejaculation and orgasm (ejaculatory dysfunction).

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Q:How many men in the U.S. suffer from erectile dysfunction?

A:30 million men. The variations in severity of erectile dysfunction make estimating its frequency difficult. Many men are reluctant to discuss erectile dysfunction with their doctors due to embarrassment, and thus the condition is probably underdiagnosed. Nevertheless, experts have estimated that erectile dysfunction affects 30 million men in the United States.

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Q:Which of these is NOT a cause or risk factor for erectile dysfunction?

A:Genetics. Erectile dysfunction is not an inherited (genetic) condition. Common risk factors for ED include advanced age, cardiovascular disease, diabetes mellitus, high cholesterol, cigarette smoking, recreational drug use (including marijuana), and depression or other psychological or psychiatric diseases.

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Q:Kidney disease and erectile dysfunction may be related. True or False?

A:True. Kidney disease can cause chemical changes in the body. These changes can affect hormones, circulation, nerve and muscle function, and energy level, all of which can affect a man's ability to achieve and maintain an erection.

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Q:What remedies or medications are available to treat erectile dysfunction?

A:Prescriptions pills such as Cialis, Levitra, and Viagra, Intracavernosal injections and intraurethral suppositories and Penile prosthetics and vacuum pumps. The following are current treatments for erectile dysfunction: working with doctors to select medications that do not impair erectile function; making lifestyle improvements (for example, quitting smoking and exercising more); taking drugs to treat ED such as sildenafil (Viagra), vardenafil (Levitra), or tadalafil (Cialis); inserting medications into the urethra (intraurethral suppositories); injecting medications into the corpora cavernosae (intracavernosal injections); vacuum constrictive devices for the penis; and penile prostheses, psychotherapy, and surgery.

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Q:To achieve and sustain an erection, the following must be in working order?

A:Sexual desire and an appetite for stimulation and the pubococcygeus muscle. As fat accumulates on the lower abdomen, the apparent size of the penis changes. In addition to shrinkage the penis tends to undergo an actual (and irreversible) reduction in size. The reduction, in both length and thickness, typically isn't dramatic but may be noticeable. At least two mechanisms are involved in shrinkage: one is the slow deposition of fatty substances (plaques) inside tiny arteries in the penis, which impairs blood flow to the organ. This process causes the second mechanism for shrinkage known as atherosclerosis. Atherosclerosis is the same disorder that contributes to blockages inside the coronary arteries — and is a leading cause of heart attack.

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Q:Which is true about ED?

A:Some prescription medications may be blamed for ED. There are more than 200 kinds of prescription drugs that may be associated with ED. ED may be a side effect of medications, including certain blood pressure drugs, antidepressants, tranquilizers, and antihistamines.

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Q:In terms of ED, what does an aging penis do?

A:Shrinks due to weight gain and decreased sensitivity and undergoes irreversible reduction in size. As fat accumulates on the lower abdomen, the apparent size of the penis changes. In addition to shrinkage, the penis tends to undergo an actual (and irreversible) reduction in size. The reduction, in both length and thickness, typically isn't dramatic but may be noticeable.

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Q:Surgery to remove prostate cancer can lead to ED. True or False?

A:True. Surgery to treat prostate cancer can result in erectile dysfunction, even though prostate cancer alone does not cause ED. It is important to understand that all current treatments for prostate cancer -- including external beam radiation, internal radiotherapy (brachytherapy), and hormone therapy -- may result in erectile dysfunction.

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Q:Which is NOT a usual result of erectile dysfunction?

A:Low testosterone. Low testosterone is not a result of, but may actually lead to, erectile dysfunction. In adulthood, low testosterone may lead to decreased sexual function and desire, infertility, and erectile dysfunction.

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Q:Erectile dysfunction can be a warning sign for which disease(s)?

A:High blood pressure (hypertension). Erectile dysfunction may be associated with diabetes, high blood pressure, high cholesterol, and all the other risk factors for a coronary event, which may not have been detected. Erectile dysfunction may indicate risk factors, and men may be treated before the onset of major problems such as heart attack and stroke.

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Q:Men who suffer from ED may also suffer from coitophobia, which is defined as what?

A:Fear of premature ejaculation, Fear of failure to achieve orgasm (anorgasmy) and Fear of sexual intercourse. Coitophobia is an abnormal and persistent fear of sexual intercourse. Sufferers of coitophobia experience undue anxiety because they are preoccupied with failing in some way while having intercourse. Among the symptoms of coitophobia are failure to achieve an erection (erectile dysfunction) and failure to achieve orgasm (anorgasmy). Coitophobia is a hybrid word derived from the Latin coitus, which is the past participle of the verb coire (to come together), and the Greek phobos (fear).

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Q:Which factors increase a man's risk factors for ED?

A:Being more than 60 years of age, Lack of education and Obesity. The risk of impotence increases with age. It is fourfold higher in men in their 60s compared with those in their 40s. Men with less education are also more likely to experience impotence, perhaps because they tend to have less healthy lifestyles, eat a less healthy diet, drink more alcohol, and exercise less. Physical exercise tends to lessen the risk of impotence. Additionally, being overweight or obese is linked to a lack of sexual enjoyment, desire, and difficulties with sexual performance.

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Q:Surgical methods, devices, and/or procedures for ED include?

A:Flexible implanted rods, Inflatable implants and Artery repair. Implantable devices can cause erections in many men with impotence. Bendable implants which are inserted surgically into the twin chambers of the penis can also help with ED. Lastly, surgery to repair arteries (penile arterial reconstructive surgery) can reduce impotence caused by obstructions that block the flow of blood to the penis.

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