Erectile Dysfunction

Erectile dysfunction (ED), commonly known as “impotence,” is defined by the National Institute of Health as: “Inability of the male to attain and maintain erection of the penis to permit satisfactory sexual intercourse.” In other words, ED is the difficulty for a man to get and keep a firm penis for sexual activity.

This problem affects men of all ages, but as men get older, there is a greater chance of developing erection problems. Population studies show that nearly 20% of men over age 20 and about 50% of men over the age of 50 have ED.

What Causes Erectile Dysfunction?

The primary cause of ED is poor circulation to the penis. Just as poor circulation to the heart may result in a heart attack, so too in ED, the penis often suffers from lack of adequate circulation which results in poor erections.

Sexual dysfunction is known to be related to:

  1. Age
  2. High Blood Pressure
  3. Diabetes
  4. Smoking
  5. High cholesterol
  6. Cardiovascular disease such as previous heart attacks or strokes

Since the penis arteries are very small, they tend to become diseased prior to the larger coronary (heart) or carotid (neck) arteries. Thus, erectile dysfunction is yet another sign of vascular disease predating heart attacks and strokes. In other words, patients who develop ED, are at higher risk of having a heart attack or a stroke in the future.

We recommend that ALL of our patients with ED get a heart and stroke screening checkup with their primary doctor.

Less common causes of ED include:

  1. Low testosterone (male hormone) levels
  2. Peyronie’s Disease (penile curvature and plaque formation)
  3. Neurological diseases - like neuropathy, multiple sclerosis, spinal cord injury
  4. Drug Side Effects - most commonly implicated drugs are blood pressure medications (which may cause ED simply by doing what they are intended to do—lower blood pressure) and antidepressants, due to their neurological effects
  5. Psychogenic - only 10% of cases are related to a psychological problems like anxiety, post traumatic stress disorder, depression, stress, relationship problems

Cancer and cancer treatments that involve the pelvic area including colon cancer surgery, prostate cancer surgery or radiation treatments may cause neurological as well as vascular damage which may lead to sexual dysfunction as well.

Evaluation of a Man Presenting with ED

The evaluation of a man who presents to our office includes an open, honest and absolutely confidential discussion about the current sexual function and overall medical health. A thorough physical exam and generalized, as well as specialized, bloodwork are often done. We also offer patients blood circulation studies of the penis to further delineate the cause of ED.

Treatments of Erectile Dysfunction

At Broward Urology Center, we focus on a goal-oriented approach to erectile dysfunction treatment. The treatment options for ED include: