Erectile Dysfunction

What is erectile dysfunction?

Erectile dysfunction (ED) is the inability to achieve or maintain an erection in 75% of sexual contacts. Men who experience only occasional erection problems don’t belong to patients with ED.

For many years, the appearance of sexual problems with age was perceived as a rule. Fortunately, new drugs and a change in attitude towards the problem have destroyed this myth.

Now, it is possible to freely discuss your sexual issues with a urologist and choose the most convenient treatment options. There are no reasons why a man under the age of 70 and even older should refuse a full-fledged sex life.

Erectile dysfunction is the most common sexual problem among men. The international study, which was attended by 27,839 men from eight countries (USA, UK, Germany, France, Italy, Spain, Mexico, and Brazil) aged 20 to 75 years, showed that the overall prevalence of ED is 16%. At the same time, 8% of men from 20 to 30 years old and 37% of men from 70 to 75 years old have ED.

Erectile dysfunction causes and types

There are two types of ED: organic and psychogenic.

Organic erectile dysfunction is a physiological disorder. This type of dysfunction includes urological, endocrine and vascular diseases.

Physiological pathology usually progresses slowly. Erection problems occur occasionally; however, gradually failures become more frequent. In the case of organic erectile dysfunction, sexual attraction to a partner, relative erection and ejaculation during sexual intercourse is present, but there are no spontaneous night and morning erections.

Psychogenic erectile dysfunction is a mental disorder in the form of neurosis, depression with its accompanying neurotic condition. Such a disease occurs suddenly with the preservation of spontaneous night and morning erections. In this case, the problems are episodic. Treatment of erectile dysfunction of this type requires the initial identification and removal of its cause.

In many cases, the disease occurs in the result of the combination of emotional and physiological factors. If a man experiences small changes in sexual reactions, for example, due to vascular insufficiency, he can be terrified by this circumstance. The resulting anxiety can cause more severe difficulties compared to minor physiological changes.

Erectile dysfunction symptoms

Doctors identify six diagnostic criteria by which they can assume that a man has such a disorder:

  • inability to experience sexual desire;
  • failure to achieve a sufficient erection with the presence of sexual desire;
  • failure to put the penis into the vagina after erection appearance;
  • failure to make frictional movements for the required time;
  • failure to achieve ejaculation as a result of frictional movements;
  • inability to orgasm as a result.

Erectile dysfunction diagnosis (ICD 10 Diagnosis Category N52)

To determine the cause of erectile dysfunction, the urologist needs to interview the patient about the history of sexual relations, conduct an examination, and complete blood tests to determine diseases such as diabetes or a low testosterone level.

Sometimes the doctor may prescribe more specific studies like an ultrasound examination of the blood supply to the penis during pharmacologically induced erections.

Questions that will interest the urologist:

  • How did erectile dysfunction develop? Did it happen gradually, or did the disease arise unexpectedly?
  • Do you notice a morning or night spontaneous erection?
  • Do you have problems with your sexual partner?
  • Do you have risk factors for erectile dysfunction, such as smoking, diabetes, hypertension, high cholesterol, alcohol or drug dependence, depression?

In addition to the routine inspection, the doctor can:

  • check pulsation in the groin and legs;
  • examine the breast for atypical formations (a condition called gynecomastia);
  • inspect the testicles for tumors;
  • evaluate nerve reflexes (contraction of the scrotum when touching the inner surface of the thigh);
  • conduct a digital rectal examination.