By Edward Karpman, MD, Urologist and Co-Director, Men’s Health Program
How common is erectile dysfunction (ED)?
One in five, or roughly 30 million men in the United States, suffers from some degree of erectile dysfunction. The incidence is increasing, not only here in America, but also throughout the world.
At what age are men typically affected by ED?
Erectile dysfunction affects men of all ages. It can start when men are very young--in their 20s and 30s. More typically, causes of ED start to affect men in their 40s and, consequently, we see a significant rise in incidence in this decade of life.
Is ED an inevitable part of aging?
Erectile dysfunction is not an inevitable part of aging, but we do see a rising incidence as men get older. The reason is that the most common causes of ED (atherosclerosis, diabetes or certain medications) are increasingly prevalent in men as they age. This rise in certain common medical conditions later in life may cause some men to wrongly believe that ED is inevitable with age. However, understanding these risk factors and modifying lifestyle choices can lead to a decrease in risk of developing ED.
Is ED more often due to psychological or physical factors?
There are a variety of causes for ED. The big misconception among some is that when a man complains about his erections, it’s "all in his head" (i.e., psychological). The reality is that 90 percent of cases of ED are due to organic causes (physical factors). Normal erections arise from a synchronized and functional interplay among the arteries, veins, nerves and architecture of the penis. Normal hormone function is important for erections as well.
Dysfunction in any one of these processes can lead to erectile dysfunction. This is why it is important for physicians to look at things such as atherosclerosis, diabetes, prescribed medications, pelvic surgery, radiation and hormonal imbalances as possible root causes of ED.
How do you choose a treatment for ED?
Treatment for ED should always be tailored to each person's specific needs and only after a thorough evaluation of his condition. Recommendations for the treatment of ED can range from lifestyle modifications, oral medications and hormonal replacement to more advanced treatments such as vacuum devices, injection therapy, corrective surgery and penile implants.
For more information from Dr. Karpman on erectile dysfunction and the new Men's Health Program at El Camino Hospital Los Gatos, see our video.