Problems of erectile dysfunction?

Erectile dysfunction (= "impotence") is the inability of a man to achieve or maintain an erection sufficient for his sexual needs or the needs of his partner. An erection occurs as a hydraulic effect due to blood entering and being retained in sponge-like bodies within the penis. Erectile dysfunction is indicated when an erection is consistently difficult or impossible to produce, despite arousal.

Erectile dysfunction has a big incidence. According to the National Institutes of Health in 2002, about 20 million men in the United States experience it. What's more, approximately 22 out of every 1000 men in the United States sought medical attention for ED in 1999. Incidence of the disorder increases with age. Chronic ED affects about 5% of men in their 40s and 15–25% of men by the age of 65. Most men usually experience this by age 40 and are not psychologically affected by it.

There are various and often multiple underlying causes, some of which are treatable medical conditions. It is important to realize that erectile dysfunction can signal underlying risk for cardiovascular disease. Frequent erectile dysfunction can cause emotional and relationship problems and often leads to diminished self-esteem. There is often a contributing and complicating and sometimes a primary psychological or relational problem.

Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility; this can often be helped. Besides treating the underlying causes and psychological consequences, the first line treatment of erectile dysfunction consists of a trial of PDE5 inhibitor drugs (the first of which was Viagra). Treatments work on a temporary basis: they enable an erection to be attained and maintained long enough for intercourse, but do not permanently improve the underlying condition.

Counseling is often a consideration, both where a psychological cause is suspected or must be ruled out, or to assist in management of any distress. Often, as a last resort if other treatments have failed, the most common procedure is prosthetic implants which involves the insertion of artificial rods into the penis.