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 also can be a sign of an underlying health condition that needs treatment and a risk factor for heart disease down the road.
Our Specialists for Treatment of ED
Symptoms of Erectile Dysfunction
Erectile dysfunction symptoms might include persistent:
Trouble getting an erection
Trouble keeping an erection
Reduced sexual desire
When to see a doctor
A family doctor is a good place to start when you have erectile problems. See your doctor if:
You have concerns about your erections or you're experiencing other sexual problems, including ejaculatory dysfunction, such as premature or delayed ejaculation
You have diabetes, heart disease or another known health condition that might be linked to erectile dysfunction
Examination and Diagnostic Tests
For many men, a physical exam and answering questions (medical history) are all that's needed for a doctor to diagnose erectile dysfunction and recommend a treatment. If you have chronic health conditions or your doctor suspects that an underlying condition might be involved, you might need further tests or a consultation with a specialist.
Tests for underlying conditions might include:
Physical exam. This might include careful examination of your penis and testicles and checking your nerves for sensation.
Blood tests. A sample of your blood might be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health conditions.
Urine tests (urinalysis). Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions.
Ultrasound. This test is usually performed by a specialist in an office. It involves using a wandlike device (transducer) held over the blood vessels that supply the penis. It creates a video image to let your doctor see if you have blood flow problems.
This test is sometimes done in combination with an injection of medications into the penis to stimulate blood flow and produce an erection.
Overnight erection test. Most men have erections during sleep without remembering them. This simple test involves wrapping a special device around your penis before you go to bed.
This device measures the number and strength of erections that are achieved overnight. It can help to determine if your erectile dysfunction is related to psychological or physical causes.
Psychological exam Your doctor might ask questions to screen for depression and other possible psychological causes of erectile dysfunction.
Diagnostic Tests at GNH Hospital
GNH Hospital offers a full range of tools for evaluating erectile dysfunction. Doctors will likely perform a physical exam and blood and urine tests. They might also use a sexual health questionnaire to help understand your problem.
Some men might require specialized tests. GNH Hospital provides both noninvasive and invasive testing for erectile dysfunction, which can include:
Color duplex Doppler ultrasonography
Injecting dye to see blood flow in arteries carrying blood to the penis (penile arteriography)
Magnetic resonance imaging (MRI)
Nocturnal penile erection monitoring
Causes & Risk Factors
Male 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 dysfunction
In most cases, erectile dysfunction is caused by something physical. Common causes include:
Clogged blood vessels (atherosclerosis)
High blood pressure
Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
Peyronie's disease — development of scar tissue inside the penis
Certain prescription medications
Alcoholism and other forms of substance abuse
Treatments for prostate cancer or enlarged prostate
Surgeries or injuries that affect the pelvic area or spinal cord
Prolonged cycling, which can compress nerves and affect blood flow to the penis, may lead to temporary or permanent erectile dysfunction
Psychological causes of erectile dysfunction
The 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
Relationship problems due to stress, poor communication or other concerns