Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex.Having erection trouble from time to time isn't necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease. If you're concerned about erectile dysfunction, talk to your doctor — even if you're embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.
SymptomsErectile dysfunction symptoms might include persistent:
Trouble getting an erection
Trouble keeping an erection
Reduced sexual desire
See your doctor if:
You have concerns about your erections or you're experiencing other sexual problems such as premature or delayed ejaculation
You have diabetes, heart disease or another known health condition that might be linked to erectile dysfunction
You have other symptoms along with erectile dysfunction
CausesMale sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction. Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.
Physical causes of erectile dysfunctionIn many cases, erectile dysfunction is caused by something physical. Common causes include:
Heart disease
Clogged blood vessels (atherosclerosis)
High cholesterol
High blood pressure
Diabetes
Obesity
Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
Parkinson's disease
Multiple sclerosis
Certain prescription medications
Tobacco use
Peyronie's disease — development of scar tissue inside the penis
Alcoholism and other forms of substance abuse
Sleep disorders
Treatments for prostate cancer or enlarged prostate
Surgeries or injuries that affect the pelvic area or spinal cord
Low testosterone
Psychological causes of erectile dysfunctionThe brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:
Depression, anxiety or other mental health conditions
Stress
Relationship problems due to stress, poor communication or other concerns
Risk factorsAs you get older, erections might take longer to develop and might not be as firm. You might need more direct touch to your penis to get and keep an erection. Various risk factors can contribute to erectile dysfunction, including:
Medical conditions, particularly diabetes or heart conditions
Tobacco use, which restricts blood flow to veins and arteries, can — over time — cause chronic health conditions that lead to erectile dysfunction
Being overweight, especially if you're obese
Certain medical treatments, such as prostate surgery or radiation treatment for cancer
Injuries, particularly if they damage the nerves or arteries that control erections
Medications, including antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate conditions
Psychological conditions, such as stress, anxiety or depression
Drug and alcohol use, especially if you're a long-term drug user or heavy drinker
ComplicationsComplications resulting from erectile dysfunction can include:
An unsatisfactory sex life
Stress or anxiety
Embarrassment or low self-esteem
Relationship problems
The inability to get your partner pregnant
More Information
Erectile dysfunction care at Doral Cardiology, Doral, FL
Erectile dysfunction: A sign of heart disease?
PreventionThe best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health conditions. For example:
Work with your doctor to manage diabetes, heart disease or other chronic health conditions.
See your doctor for regular checkups and medical screening tests.
Stop smoking, limit or avoid alcohol, and don't use illegal drugs.
Exercise regularly.
Take steps to reduce stress.
Get help for anxiety, depression or other mental health concerns.
Male infertility care at Doral Cardiology our caring team of Doral Cardiology experts can help you with your health concerns.
Shock Wave Therapy for ED
Low-intensity extracorporeal shock wave therapy (Li-ESWT) is safe and effective for improving mild-to-moderate vasculogenic erectile dysfunction (ED). Shockwave improve blood flow to the penis, remove micro-plaque, and stimulate the growth of new blood vessels.
Low-intensity extracorporeal shock wave therapy (LI-ESWT) is a novel modality that has recently been developed for treating erectile dysfunction (ED). Unlike other current treatment options for ED, all of which are palliative in nature, LI-ESWT is unique in that it aims to restore the erectile mechanism in order to enable natural or spontaneous erections. Results from basic science experiments have provided evidence that LI-ESWT induces cellular microtrauma, which in turn stimulates the release of angiogenic factors and the subsequent neovascularization of the treated tissue. Extracorporeal shock wave therapy (ESWT) has been clinically investigated and applied in several medical fields with various degrees of success.
Since one of the underlying functional causes of ED is poor cavernosal arterial blood flow, we hypothesized that inducing neovascularization by LI-ESWT could potentially improve cavernosal arterial flow which in turn would improve erectile function. If this hypothesis could be proved, LI- ESWT could then become an effective and noninvasive treatment for ED.
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PATIENT INSTRUCTIONS Sexual health is an important part of an individual's overall physical and emotional well-being. Erectile dysfunction, also known as impotence, is one type of very common medical condition affecting sexual health. Fortunately, there are many different treatment options for erectile dysfunction. This questionnaire is designed to help you and your doctor identify if you may be experiencing erectile dysfunction. If you are, you may choose to discuss treatment options with your doctor. Each question has several possible responses. Circle the number of the response that best describes your own situation. Please be sure that you select one and only one response for each question. OVER THE PAST 6 MONTHS: VERY LOW LOW