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Approximately 52% of men between the ages of 40 and 70 have some degree of ED, according to the Massachusetts Male Aging Study (MMAS). In 1995, the worldwide prevalence of ED was 150 million and is expected to increase to 332 million by 2025.
- ED is defined as persistent or repeated inability to attain or maintain an erection sufficient for satisfactory sexual performance for a period of at least three months.
- ED is a form of sexual dysfunction, not to be confused with premature or rapid ejaculation, low sexual desire, or an inability to achieve orgasm and is strictly associated with erection difficulties.
- ED is more prevalent in older men because of related causes, such as injury, disease and medications, but is not an inevitable part of aging. Older men may need more stimulation or time between encounters, but they shoud be able to enjoy sexual intercourse.
- The ability to attain or maintain an erection can be impeded due to three physical causes, including:
- Not enough blood flow into the penis. Many conditions such as atherosclerosis (hardening of the arteries) can reduce blood flow into the penis, causing ED.
- The penis cannot store blood during an erection. Called venous leak, this problem prohibits a man from maintaining an erection. Venous leak may result from structural changes of the erectile tissue due to injury, disease, or damage to the veins in the penis.
- Nerve messages from the brain or spinal cord do not reach the penis. Diseases such as diabetes, multiple sclerosis and Parkinson's disease can prohibit nerve stimuli from reaching the penis, potentially causing ED. Injuries or genital or pelvic surgery (e.g., radical prostatectomy for prostate cancer or spinal cord injury) also can damage penile nerves.
There are numerous conditions or contributing factors that can lead to the development of ED, including:
- Illness such as high blood pressure, diabetes, high cholesterol levels and cardiovascular disease can, over time, lead to a degeneration of the penile blood vessels, leading to restriction of blood flow;
- Certain medications, including drugs for high blood pressure, depression and allergies;
- Patients undergoing surgery or radiation therapy for cancer of the prostate, bladder, colon or rectum;
- Illegal drugs, such as marijuana, cocaine and heroin;
- Smoking or alcohol abuse, especially over an extended period of time, can damage blood vessels in the penis;
- Lack of exercise and a sedentary lifestyle; or
- Depression, anxiety, stress and difficulties in a relationship.
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