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Erectile Dysfunction, or ED, is the repeated inability to get or keep an erection firm enough
for sexual intercourse. Erectile dysfunction is sometimes referred to as impotence, a
more general term used to describe other sexual dysfynctions such as lack of sexual
desire and problems with ejaculation or orgasm; however, the term erectile dysfunction
refers specifically to the inability to achieve or maintain an erection.
Symptoms of erectile dysfunction, or ED, range from a total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections. Causes of ED are varied. It is associated with a number of organic disorders and diseases. In diabetes, for instance, it occurs in up to 40% of men. Erectile dysfunction may also occur with cardiovascular disorders (especially in men with angina or after myocardial infarction), neurological disorders, after pelvic surgery or trauma, and as a side effect of certain prescribed medications. Any disorder that causes injury to the nerves or impairs blood flow in the penis also has the potential to cause ED. Because the causes and severity of symptoms varies among individuals, erectile dysfunction has been difficult to define, and thus the total affected population is difficult to identify. Estimates of the number of men affected with this disorder range from 15 million to 30 million, depending on the definition used. An estimated 10 percent of all men (making this condition common) experience erectile dysfunction, yet over 50 percent of men between 50 and 70 years of age are affected. ED is not, however, an inevitable part of aging. It is treatable at any age, and awareness of this fact has been growing. 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 ED in 1985. By 1999, that rate had nearly tripled to 22.3. More men have been seeking help and returning to normal sexual activity due to improved, successful treatments, such as vacuum devices and injectable drugs. Perhaps the most publicized advance in the treatment of erectile dysfunction 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 ED. Tadalafil (Cialis®) is another prescription drug that seems to be an effective treatment for erectile dysfunction. A new analysis of data published in the June 2004 issue of British Journal of Urology shows that tadalafil, a PDE5 inhibitor developed by Lilly ICOS for the treatment of erectile dysfunction, improved erections and rates of successful intercourse attempts for up to 36 hours after taking the pill. On average, 73% of intercourse attempts by men in the 20 mg tadalafil study group were successful from 24 to 36 hours after taking the tablet. Eighty-four percent of men in the 20 mg group also reported improved erections, compared with 33 percent in the placebo group (P <.001). The most common side effects reported in the British Journal study were headache, upset stomach and back pain. Most side effects were mild or moderate and generally decreased in frequency during treatment. The mean age of men in the study was 56 years; 29 percent had hypertension, and 20 percent had diabetes. |
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