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Erectile Dysfunction – Causes, Diagnosis and Treatment

Erectile dysfunction is a problem that affects more than 50% of men over 60 years of age, although many times a doctor is not consulted because of embarrassment. It can be due to multiple factors, as much physical as psychological.

What is erectile dysfunction?

Erectile dysfunction is the inability to maintain an erection solid enough to have a satisfactory sexual relationship.

Although it is a problem that is commonly associated with aging, this is not the only factor that comes into play. It is a disease in which both physical and psychological factors are involved. As a matter of fact, certain habits such as smoking, alcoholism, drug addiction and a sedentary lifestyle are risk factors for this disease.

Some pathologies are also factors that affect erectile dysfunction. The most common are those related to the heart, hypertension and diabetes. Even psychological factors such as stress, anxiety, depression and even trauma from past events can lead to erectile dysfunction.

Who is affected by erectile dysfunction?

It is estimated that erectile dysfunction affects between 10 and 52% of men ranging in age between 40 and 70 years old. In general, this condition is more frequent in older adults, so that more than 50% of men over 60 suffer from it.

Erectile dysfunction and age

With the passing of time, the strength of the erection decreases and the time needed to achieve it increases, as well as the period for which it stays hard; However, all these changes are neither pathological nor diminish people’s sexuality.

What can cause erectile dysfunction?

  • Age
  • The pathologies mentioned above:
    • Depression, apathy, anhedonia and sadness diminish the desire to have sex and the pleasure it produces. In addition, depression causes a sharp decrease in libido.
  • Taking drugs, such as medicines to treat high blood pressure, excess cholesterol, among others. Also affecting this condition are certain treatments such as chemotherapy, radiotherapy, dialysis and some surgical interventions.
  • Traumatic spinal injuries. Even so, not all disabled patients are unable to have sex. The ability to have an erection or an orgasm depends on the exact point at which the injury has occurred.
  • The consumption of alcohol and drugs. Although alcohol acts as a disinhibitor, in reality, it is one of the main factors that hinders an erection.


  • Clinic history. This should be exhaustive and address all possible causes. It is also important to interview the sexual partner.
  • Physical examination (which includes the genitals and a digital rectal exam).
  • Lab tests. Since these serve to rule out a hormonal alteration, measure testosterone levels and those of prolactin.


Normally, sexual problems are a source of embarrassment and in many cases, people do not consult with a specialist; therefore, they do not receive treatment on time. In this sense, it must be remembered that, when facing any health problem, whether sexual or not, one must go to a specialist and be open in order to easily find the solutions.

However, it is not only patients who feel shame when it comes to dealing with these issues. Many specialists feel qualms or shyness when it comes to asking their patients about their sexual life, which makes it difficult to correctly approach the disease. Fortunately, this is not always the case.

Regarding the treatment of erectile dysfunction, the patient should know that there are multiple options. The doctor will determine which is the most recommended, based on the results of the physical examination and laboratory tests, as well as the patient’s medical history.

Oral Drugs

Sildenafil citrate (better known as Viagra) is the first-line treatment. And, it is a powerful vasodilator of the blood vessels in the penis, these being the mechanism by which an erection occurs.

It has some disadvantages. It should be taken thirty minutes before the act and also requires sexual stimulation. It is completely not recommended for people with cardiac issues and for those treated with nitroglycerin.

Other therapies

  • Intracavernosal therapy. This consists of using injections, which are placed directly on the cavernous sinuses of the penis (in the body). It is not a suitable method for all patients, nor highly demanded by them.
  • Vacuum devices. This is one of the first choices for the treatment of erectile dysfunction. The penis is inserted into a cylinder, at the end of which, there is a suction mechanism. When activated, blood enters the penis and an erection occurs. After this, a silicone ring is placed at the base of the penis, preventing the blood from leaving, thus maintaining the erection.
  • Prosthesis implant in the penis. This treatment is reserved for serious cases.

Via: MayoClinic | HealthLine | MedBroadcast

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