Healthtips

Erectile dysfunction, commonly referred to as ED, is the inability to achieve and sustain an erection suitable for sexual intercourse. It is estimated that about one in ten adult males suffer from ED on a long-term basis. However, a much more frequent problem that affects the majority of men at some point in their life is the occasional failure to achieve an erection, which can occur for a variety of reasons, such as from drinking too much alcohol or from being extremely tired. Failure to achieve an erection less than 20% of the time is not unusual and treatment is rarely needed. Failure to achieve an erection more than 50% of the time, however, generally indicates there is a problem requiring treatment.

In order to achieve an erection three conditions must occur --- the nerves to the penis must be functioning properly, the blood circulation to the penis must be adequate, and there must be a stimulus from the brain. If there is something interfering with any or all of these conditions, a full erection will be prevented.

Common causes of ED include diseases that affect blood flow, such as atherosclerosis (hardening of the arteries), nerve diseases, psychological factors, such as stress, depression, and performance anxiety, and injury to the penis. Chronic illness, certain medications (there are over 200 medications that may cause ED), and a condition called Peyronie’s disease (scar tissue in the penis) can also be responsible for ED.

For people who are at risk of developing ED due to personal behavior, such as drinking too much alcohol, or being overweight or extremely stressed or depressed, steps may be taken to prevent its occurrence. However, other causes of ED may not be preventable.

If you suspect you may have erectile dysfunction, see your doctor. He or she can perform a variety of tests to identify what is causing your problem and refer you to a urologist. Once the cause is identified, there are several treatments to consider, including oral medications, sex therapy, penile injections and surgery. Each type of treatment has its own advantages and disadvantages.

Treatment for ED depends on the cause of the problem, which may be psychological, physical, or a combination of both. Erection problems that have one or more major physical causes also often have psychological factors that make the problem worse and treatment more complicated.

Many urologists take a stepwise approach to treating erection problems, using the least invasive treatments first. These steps include discovering and then eliminating medications that may be causing your condition. In some cases a different medication can be tried. Your specialist may recommend that you try an oral medication (such as phosphodiesterase-5 inhibitors [Viagra, Levitra or Cialis]), unless an easily treated cause—such as a medication side effect or testosterone deficiency—has been identified. Other treatments might include trying a vacuum device or getting counseling if a psychological cause is suspected. Other options that your urologist may recommend could entail trying medications that are injected or inserted into the penis, penile implant surgery or an external penile splint.

Counseling (also called psychotherapy) or behavioral therapy may be appropriate even if your erection problem has a physical cause. It may be offered if your urologist suspects psychological issues play a role in your erection problems.

Insurance coverage of ED depends upon the type of treatment prescribed. If there is a documented medical condition that is shown to be causing ED, insurance will usually cover at least some of it. Sex therapy and medications that have not yet been approved by the FDA, however, are generally not covered. Along with sexual therapy and medications not approved by the FDA, Medicaid does not cover vacuum constriction devices or penile implants. As with any medical procedure it is recommended that you talk to your insurance provider to determine if the treatment you are considering will be covered.