Erectile dysfunction (ED), sometimes called impotence, is the inability to get and keep an erection firm enough for sexual intercourse. ED is a common condition that affects many men to some degree as they age. When a man becomes sexually excited, muscles in their penis relax. This relaxation allows increased blood flow through the penile arteries. This blood fills two chambers inside the penis called the corpora cavernosa. As the chambers fill with blood, the penis grows rigid. Erection ends when the muscles contract, and the accumulated blood can flow out through the penile veins. ED can occur because of problems at any stage of the erection process. For example, the penile arteries may be too damaged to open properly and allow blood in. Some potential causes include:
- Atherosclerosis - Hardening of arteries that can restrict blood flow to the penis
- Diabetes - Which can trigger nerve damage
- Medications - Such as those taken for high blood pressure
- Injuries/surgery - Involving the pelvis, bladder, spinal cord, or penis
- Lifestyle habits - Such as smoking cigarettes
- Oral medications like sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis) - which help muscles in the penis relax to allow blood flow. These have proven effective for many men.
- Injections - can be injected into the penis when pills aren't effective. The medication alprostadil (Caverject, Edex) relaxes blood vessel tissue to enhance blood flow into the penis.
- Vacuum devices - use a pump to help achieve an erection mechanically.
- Penile implants - can be an option for severe cases when other treatments have not worked. An inflatable device or semirigid rod is implanted into the penis. This allows manipulation into an erect or non-erect position.