Erectile Dysfunction (Impotence)

Common Questions, Answers, Facts and Treatments

This guide is intended to provide you answers to common questions about Male Impotence ( erectile dysfunction ). You can browse the left side for quick access to most common requested information.

What is Male Impotence (Erectile Dysfunction)?

Erectile dysfunction, sometimes called "impotence," is the repeated inability to get or keep an erection firm enough for sexual intercourse. The word "impotence" may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm. Using the term erectile dysfunction makes it clear that those other problems are not involved.

Erectile dysfunction, or impotence, can be a total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections. These variations make defining impotence and estimating its incidence difficult. Estimates range from 15 million to 30 million, depending on the definition used. According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for impotence in 1985. By 1999, that rate had nearly tripled to 22.3. The increase happened gradually, presumably as treatments such as vacuum devices and injectable drugs became more widely available and discussing erectile function became accepted.

Perhaps the most publicized advance was the introduction of the oral drug sildenafil citrate (Viagra) in March 1998. NAMCS data on new drugs show an estimated 2.6 million mentions of Viagra at physician office visits in 1999, and one-third of those mentions occurred during visits for a diagnosis other than impotence.

In older men, impotence usually has a physical cause, such as disease, injury, or side effects of drugs. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause impotence. Incidence increases with age: About 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience impotence. But it is not an inevitable part of aging.

impotence is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for impotence. Urologists, who specialize in problems of the urinary tract, have traditionally treated impotence; however, urologists accounted for only 25 percent of Viagra mentions in 1999.

Hope Through Research

Advances in suppositories, injectable medications, implants, and vacuum devices have expanded the options for men seeking treatment for impotence. These advances have also helped increase the number of men seeking treatment. Gene therapy for impotence is now being tested in several centers and may offer a long-lasting therapeutic approach for impotence.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) sponsors programs aimed at understanding the causes of erectile dysfunction and finding treatments to reverse its effects. NIDDK's Division of Kidney, Urologic, and Hematologic Diseases supported the researchers who developed Viagra and continue to support basic research into the mechanisms of erection and the diseases that impair normal function at the cellular and molecular levels, including diabetes and high blood pressure.

Points to Remember

* Erectile dysfunction (ED) is the repeated inability to get or keep an erection firm enough for sexual intercourse.
* impotence affects 15 to 30 million American men.
* impotence usually has a physical cause.
* impotence is treatable at all ages.
* Treatments include psychotherapy, drug therapy, vacuum devices, and surgery.

Acknowledgements

This report was adapted by Jeffrey D. Jordan. The facts contained in this report were obtained from the National Kidney and Urologic Diseases Information Clearinghouse reviewed by both NIDDK scientists, outside experts, Arnold Melman, M.D., Montefiore Medical Center, Bronx, NY; and Mark Hirsch, M.D., U.S. Food and Drug Administration.

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