Erectile Dysfunction medications and Physical Causes of Erectile Dysfunction and Impotence

Highlights

Erectile Dysfunction

Erectile dysfunction (ED), formerly called impotence, can affect men of all ages, although it is much more common among older men. It is normal for men to occasionally experience erectile dysfunction. However, if the problem becomes chronic, it can have adverse effects on relationships, emotional health, and self-esteem. Erectile dysfunction may also be a symptom of an underlying health condition. If erectile dysfunction becomes an on-going problem, it is important to talk to your doctor.

Causes of Erectile Dysfunction

• Physical causes are the main reasons for erectile dysfunction. They include heart disease, high blood pressure, diabetes, neurological disease, and other health conditions.
• Psychological causes of erectile dysfunction include anxiety, depression, stress, and problems in relationships.
• Lifestyle factors that increase risk for erectile dysfunction include smoking, alcohol use, and other substance abuse.

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PDE5 Inhibitors

The most common medical treatment for erectile dysfunction is PDE5 inhibitor drugs:

• Sildenafil (Viagra)
• Vardenafil (Levitra)
• Tadalafil (Cialis)

These drugs are generally safe and effective for most men. These medications may not be appropriate for men with certain health conditions, such as severe heart disease, heart failure, history of stroke, or uncontrolled high blood pressure or diabetes. Men who take nitrate drugs cannot use PDE5 inhibitors, and these drugs can also interact with other medications. Talk to your doctor about whether PDE5 inhibitor drugs are a safe choice for you.

Guidelines for Testing and Treatment of Erectile Dysfunction

In 2009, the American College of Physicians (ACP) issued guidelines concerning hormonal testing and drug treatment of ED. The ACP recommends that:

• A PDE5 inhibitor medication should be the first type of treatment. All three brands work equally well. The doctor should select a brand based on a patient’s personal preference, ease of use, and cost of medication.
• The ACP does not recommend for or against the routine use of hormonal blood tests or hormonal treatment. Studies have not conclusively shown that testosterone therapy is helpful for men with ED, even those who have low testosterone levels.

Review Date: 07/20/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).