Erectile dysfunction (ED)
Erectile dysfunction (ED) refers to the consistent inability to achieve or maintain an erection for sexual intercourse. ED can be treated at any age, however, the occurrence of ED is increasingly common as the person ages, but should not be considered a natural part of aging. In older men, there may be physical or medical conditions that contribute to ED, including a variety of diseases, physical injury or side effects from prescription medications. Psychological factors and certain life choices such as smoking, obesity, stress, anxiety, guilt and fear of poor sexual performance can all contribute to ED.
For an erection to occur, a specific sequence of event needs to take place, allowing blood to enter the penis while restricting the outflow of blood. The pressure created by this “trapped” blood is what maintains an erection. If there is a consistent breakdown in any steps in the sequence, ED is the result.
ED is diagnosed by evaluating a patient’s medical and psychological history, performing a physical evaluation and conducting a series of laboratory tests. These tests include blood counts, lipid profiles and testosterone measurements. A psychosocial evaluation is used to examine possible psychological factors.
ED can be treated with medication, psychological therapy, or vacuum devices. Surgical implantation of an inflatable prosthesis is also an option. During this procedure, the surgeon implants a device that simulates erection by pumping fluid from a reservoir into inflatable tubes in the penis. Consult your physician to evaluate your options and decide which treatment method would work best for you.
About half of all infertile couples suffer from one or more compromised factors in the male partner. For this reason, during the initial evaluation the male partner will be tested for sperm production and health, including sperm count, motility and morphology; semen volume and viscosity; antibody and white blood cell count; physical abnormalities (azoospermia, blocked epididymis); and other factors that might affect the sperm’s ability to penetrate the egg. In some cases a biopsy of the testicle may be necessary. If a problem is found, treatment may involve sperm retrieval, surgery or donor insemination.