Understanding Erectile Dysfunction, a Q&A with a urologist

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Dr. M. Francie James is a board-certified urologist with Roper St. Francis Healthcare. Here, Dr. James answers our questions about a topic that often remains behind the curtains in men’s health discussions: erectile dysfunction (ED). Through our Q & A, she breaks down the typical causes, the process of diagnosis, potential treatment options and preventive measures.

What is erectile dysfunction (ED) and who does it typically affect?
Erectile dysfunction (ED) is a condition defined by a man’s difficulty getting or keeping an erection firm enough for sexual activity. It’s very common. In fact, it affects more than half of men between 40 and 70.

What are some common causes of erectile dysfunction?
While it’s more prevalent in older men, age is not the cause. There are several factors that can contribute to ED: Impaired blood flow to the penis, damage to the nerves that control erections and underlying medical conditions such as high blood pressure, diabetes, heart disease and peripheral artery disease.

Some medications used to treat high blood pressure or conditions such as depression and anxiety can also result in ED. Surgeries used to treat prostate cancer or other pelvic cancers can damage the nerves controlling erections and lead to erection issues, too.

How is erectile dysfunction diagnosed?
An evaluation is necessary to determine the cause and treatment options. The assessment typically includes a detailed history, physical exam, lab tests or possibly more specialized testing.

What are the available treatment options for erectile dysfunction?
Treatment options for ED vary depending on the underlying cause and individual circumstances. The first steps often involve lifestyle changes, possible medication adjustments and addressing related medical issues.

If these initial measures are ineffective, medication or the use of a vacuum erection device may be recommended. For men who do not respond to medical or non-invasive treatments, penile injections or surgery, including the placement of a penile implant, may be offered as more advanced options.

Can you prevent or lower the risk of developing erectile dysfunction?
Yes! Regular exercise, maintaining a healthy weight, minimizing alcohol intake, completely avoiding illegal substances and not smoking are all important in reducing ED risk. Close monitoring and good control of chronic medical conditions such as high blood pressure, diabetes and heart disease can also help.

Seeking Help
Erectile Dysfunction is often a silent struggle, stoking self-doubt and distress. It’s more than a physical ailment – it’s an emotional weight that can cause relationship strain and mental health issues. There’s no shame in seeking help to improve your health and quality of life.

ED is not a personal failing; it’s a medical condition. Seeking help allows for appropriate treatment and can potentially uncover other underlying health issues. Remember, healthcare is a judgment-free zone.

If you are experiencing ED and would like to talk to a doctor, call (843) 402-CARE.

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