Stanford Expert Explains What Erectile Dysfunction Really Means

Stanford, Calif. (PRWEB) June 12, 2012

To support National Mens Health Week, Michael Eisenberg, MD, director of the Male Reproductive Medicine and Surgery program at Stanfords Department of Urology, is urging men and their loved ones to seek expert help if they are worried about erectile dysfunction.

Not only should men expect to have the physical ability for good and adequate sex function as they age, they should also know that dysfunction can be an important early warning sign for other serious health conditions. In fact, Eisenberg said, most cases of erectile dysfunction stem from a physical cause, not a psychological one.

Large epidemiologic studies estimate that dysfunction affects probably about 50 percent of all men in this country between age 40 and 70, he said. In the past, it was thought that most of this dysfunction was psychological. We now know that probably 85 to 90 percent is due to an organic cause that we can identify. The predominant causes are cardiovascular disease, high blood pressure, diabetes, smoking and obesityand those conditions have increased in recent years.

Certain medications for blood pressure and psychiatric illnesses can also have a negative impact on function, Eisenberg said. There are some psychological causes of erectile dysfunction. Typically, it can become a self-fulfilling prophecy so that performance anxiety does become an issue. But anytime somebody comes in, we first try to rule out an organic cause. We look at the whole patient.

Eisenbergs research has brought new understanding to the complexity of mens health, looking in particular at the relationship between fatherhood and cardiovascular disease. He initiated the largest-ever study in the U.S. to examine that interaction. The study, of 135,000 men tracked for 10 years, showed a 17 percent increase in the likelihood of a childless mans dying of a condition related to cardiovascular disease. Since fertility issues can surface well before any obvious outward symptoms of cardiovascular disease, such a link could help flag cardiovascular risk sooner, leading to earlier and more effective intervention, he said. Understanding more about sexual dysfunction can be an important first step.

All men should know that it is often a precursor to other medical problems. It can actually precede cardiovascular disease by three to four years, he said. So even if they do consider themselves otherwise healthy, this may be a warning sign to take their health a little bit more seriously, to make sure they see their primary doctor on a regular basis.

Treatment for erectile dysfunction has also improved greatly in recent years. The first thing we do is try and identify any modifiable causes, he said. We also usually look at a hormone profile. For instance, low testosterone has been linked to problems with sexual function. Thats something that could also be corrected. Then we move on to some of the different medications that we have, familiar ones like Viagra and Levitra, and Cialis, which work very well. If those dont work, we move on to some other options that are more invasive, like injection therapy or urethral suppositories. Theres also something called a vacuum erection device. And, if none of these approaches work, there is surgery we can do to put an inflatable prosthesis in the penis, which also has very high patient and partner satisfaction rates.

There are also non-medical approaches to be tried, Eisenberg said. Some men find that their erectile dysfunction very situational and want to learn different techniques or get psychological help. Most crucial, he said, is to get help. Erectile dysfunction has a large impact on emotional life, on overall quality of life. Ive seen relationships end. Once we initiate treatment, new relationships can begin.

Advances have also been made in the preservation of function as part of treatment for prostate and other cancers. At Stanford, weve found that there are things we can do before surgery or radiation to preserve function and expedite recovery, Eisenberg said. What weve learned also is that in the immediate post-operative period, an aggressive rehabilitation program is very important for maintaining penile health. If a normal oxygenated erection does not occur every day, natural erections either will not recover as fully as they were before, or the recovery can be delayed.

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Stanford Expert Explains What Erectile Dysfunction Really Means