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U.S. News and World Report: America's Best Hospitals, Urology, 2014-2015

 

Erectile Dysfunction (ED)

UW Health Urologist Dan Williams, MD, discusses the sensitive topic of erectile dysfunction.

The UW Health Men’s Health program offers comprehensive and compassionate expertise for a wide array of men’s urological needs, including erectile dysfunction, hypogonadism (low testosterone) and urinary problems.
 
Definition of Erectile Dysfunction
 
Erectile dysfunction can encompass several different conditions of reproductive health and sexual dysfunction. It is a very common condition, but is also a very emotional and sensitive topic to discuss. Erectile dysfunction is defined as the inability to maintain an erection sufficient for sexual intercourse.
 
Achieving an erection is a complex process involving the brain, hormones, nerves, muscles and blood circulation. If something interferes with this process, the result may be erectile dysfunction. In some cases, erectile dysfunction is the first sign of other serious underlying health conditions, such as cardiovascular problems, that need treatment because erectile dysfunction can share the same risk factors for heart attacks and strokes.
 
How common is Erectile Dysfunction?
 
About 5 percent of men that are 40 years old have complete erectile dysfunction, and that number increases to about 15 percent of men at age 70. Mild and moderate erectile dysfunction affects approximately 10 percent of men per decade of life (i.e., 50 percent of men in their 50s, 60 percent of men in their 60s). Erectile dysfunction can occur at any age, but it is more common in men that are older. Older men are more likely to have health conditions that require medication, which can interfere with erectile function. Additionally, as men age, they may need more stimulation to get an erection and more time between erections.
 
Three Components of Male Sexual Function
 
There are three essential components of male sexual function:
  • Interest and desire for sexual activity (libido)
  • The ability to obtain and maintain an erection
  • Ejaculation and climax (orgasm)
During an initial visit, the urologist will help to differentiate which components of the male sexual function are affected. This is an important step because treatment options for differ depending on the affected components.
 
Causes of Erectile Dysfunction
 
There are many possible causes of erectile dysfunction, both physical and psychological, including:
 

Psychological/Environmental

Physical/Organic

  • Poor communication with partner
  • Alcoholism
  • Stress
  • Anxiety
  • Depression
  • Fatigue
  • Smoking
  • Drug abuse
  • Injury to the penis
  • Prostate cancer treatment
  • Spinal cord injury 
  • Neurological diseases 
  • Heart disease 
  • Peyronie's disease
  • Kidney disease 
  • Atherosclerosis 
  • Diabetes 
  • Obesity 
  • Low testosterone 
  • High cholesterol and lipid levels 
  • Hypertension (high blood pressure) 
  • Hormonal disorders
  • Certain medications
  • Lower urinary tract symptoms due to benign prostatic hyperplasia
 
Preventing Erectile Dysfunction

There are several steps men can take to reduce their risk for erectile dysfunction, including:
  • Quit smoking 
  • Exercise regularly 
  • Maintain a healthy weight and healthy diet
  • Limit or avoid the use of alcohol 
  • Reduce stress 
  • Get help for anxiety or depression 
  • Discontinue drugs with harmful side effects
  • Have regular check-ups with a primary care physician to monitor blood pressure, blood sugar and cholesterol levels
Treating Erectile Dysfunction
 
UW Health urologists with advanced training offer medical and surgical treatment options for men and their partners affected by erectile dysfunction. There are several different ways that erectile dysfunction can be treated. For some men, making a few healthy lifestyle changes may solve the problem. Your urologist will help determine the most effective course of treatment for your condition. 

Treatment options for ED include: