Erectile dysfunction, also termed impotence, refers to the inability to obtain or maintain an erection that is firm enough or lasts
long enough to have satisfactory sexual intercourse. The problem affects almost all men at one time or another in their lives.
It affects as many as 30 million American men, including 30% of men between the ages of 40 and 70. While erectile dysfunction often
devastates those affected by it, out of fear, embarrassment, or countless other reasons, few men seek treatment. However, the problem
is almost always treatable. It has definite physical and/or psychological causes. It is not a "natural" consequence of aging nor is
it "all in your head." Most importantly, erectile dysfunction is not a condition you should accept or learn to live with.
Most men who seek help benefit from treatment. We can help.
The Male Sexual Health Clinic at Johns Hopkins offers a full range of services, with a special expertise in the most complex cases of
erectile dysfunction. Our comprehensive approach begins with expert diagnosis to determine, first, the precise cause of the problem and,
then, the treatment option that best suits you. A number of therapies are available, as is sexual counseling.
PHYSIOLOGY
A successful erection involves several parts of the body working together: the brain, blood vessels, nerves, and certain hormones.
Sexual stimulation resulting from various erogenous thoughts or stimuli or local genital contact triggers the erectile process.
The brain and nerves of the nervous system course in the pelvic region to the genitalia and direct chemical messages that result in penile erection.
The process importantly involves blood flow to the penis. The erectile tissue and blood vessels supplying the penis open up and
allow blood entry to cause engorgement and rigidity of the penis under the control of chemical signals. Depending upon the level
of stimulation, the chemical signals determine whether the penis is in its flaccid or erect state.
CAUSES
In most cases, erectile dysfunction is a symptom or result of a medical
condition or other physical problem. Listed below are common physical causes
and medical conditions associated with erectile dysfunction.
Vascular disorders
heart disease
high blood pressure
high cholesterol levels
smoking
Neurological disease
stroke
multiple sclerosis
Parkinson's disease
spinal cord injury
Chronic illnesses
diabetes
liver disease
kidney disease
Hormonal problems
low testosterone (androgen) levels
pituitary gland disease
testicle loss or atrophy
Pelvic or genital injury
prostate surgery
rectal surgery
Peyronie's disease
priapism (prolonged erections)
pelvic irradiation
Medications
blood pressure agents
anti-androgen drugs
antipsychotics
recreational drugs
Psychological causes
depression
stress
"performance anxiety"
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