What is ERECTILE DYSFUNCTION?
- Erectile dysfunction (impotence) is the inability of the male to attain and maintain an erection sufficient to allow sexual intercourse.
- Erectile dysfunction is but one condition of a number of male sexual dysfunctions including, reduced sexual drive or changes in libido, and orgasmic and ejaculatory dysfunction. 
- Erectile dysfunction is the most common health disorder to affect older men; greater than hypertension and arthritis.
- It is estimated that between 10 to 20 million males are affected with severe erectile dysfunction in the United States.
- Erection is a vascular event initiated by either psychosocial stimuli, such as sexual perception or desire, or genital stimulation. These stimuli are processed by the hypothalamus in the brain, which orchestrates the sympathetic and parasympathetic nervous systems response.
- Erectile dysfunction can occur following disruptions of one or more of the coordinated mechanisms required for normal erectile function.

Causes of ERECTILE DYSFUNCTION
- There are two categories of erectile dysfunction: 1) organic and 2) psychogenic. Organic causes can be grouped into endocrine, drug, local, neurologic, and vascular causes. 
- Some common causes of organic dysfunction are decreased testosterone levels, diabetes mellitus, diseases of the spinal cord, or penile diseases.
- Many drugs can cause erectile dysfunction such as beta-blockers, antidepressants, antiandrogens, anticholinergics, antipsychotics, central nervous system depressants, and drugs of abuse or addiction.
- Psychogenic cause of erectile dysfunction refers to the inability to obtain and/or sustain an erection without underlying organic pathology. Life stresses such as a change in social status, divorce, death of spouse, loss of job or family problems can cause or contribute to erectile dysfunction. Depression, anxiety, relationship problems, performance anxiety, and widower’s syndrome can also be causes of psychogenic dysfunction.
- At one time, psychogenic causes were considered to be responsible for 90% of all cases but with the availability of better diagnostic tests, psychogenic causes are now believed to account for less than 50% of cases.
- Most cases have an aspect of both organic and psychogenic causes.

Treatment of ERECTILE DYSFUNCTION
- It is important to look for reversible medical problems that may contribute to erectile dysfunction such as medication related causes. 
- Many pharmacologic treatments exist for the treatment of erectile dysfunction including oral medications and injections (by prescription only).
- Psychotherapy plays an important role in restoring sexual function in patients with psychogenic causes of erectile dysfunction.
- Certain products available without a prescription can be used to possibly prolong an erection and/or delay ejaculation. (Specific products may be recommended by a physician or pharmacist.)

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This information is of a general nature and may not apply to your special circumstances. If you have specific questions, please contact your physician or an appropriate health care professional.  These monographs are counseling aids for healthcare professionals only and are not to be used as a reference to diagnose or treat medical conditions.          Copyright 2005 RXinsider LTD