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Erectile dysfunction isn’t the easiest subject to talk about, for men or women, but it is a health issue not to be taken lightly. In many cases, erectile dysfunction (ED) is an effect of another, more serious health concern. It can also be a sign of future health problems.

“Erectile dysfunction is not normal. Men and women who want to maintain intimacy in light of other medical issues should seek help,” says Sidney Rubenstein, M.D., urologist at Mount Auburn Hospital in Cambridge, a teaching hospital of Harvard Medical School.

ED is the repeated inability to achieve or maintain an erection sufficient enough for sexual intercourse. More than 30 million men in the United States experience ED at some point in their life.

Dr. Rubenstein says there are a number of health-related reasons why a man may experience ED. The main cause is dysfunction of the arteries, veins and smooth-muscle fibers within the penis. This is usually caused by the same disease processes, which are associated with the development of heart disease, namely diabetes, hypertension, high cholesterol and smoking.

Blood vessels in the penis are even smaller and more delicate than the vessels that supply blood to the heart and other organs. An organ can’t function properly if it doesn’t get adequate oxygen supply from good blood flow.

Other conditions which may cause or contribute to ED include depression; testosterone deficiency; injury, trauma, radiation or surgery to pelvic organs; dysfunction of the thyroid, liver, kidneys or pituitary gland, and certain prescription medications and other drugs. It has been known for years that competitive bicycle racers can have ED and other problems related to repeated trauma to a man’s bottom.

Dr. Rubenstein says ED can actually serve as a warning sign of unrecognized ongoing diseases. “Erectile dysfunction can be an early sign of other serious diseases, including coronary heart disease,” says Dr. Rubenstein. “During the evaluation process, we look for underlying medical issues. Sometimes men will have difficulties getting or keeping an erection before they have a heart problem.”

The treatment of ED can include counseling and life-style changes; medications in the form of a tablet, injection or urethral suppository; physical devices or surgery. Oral medications include: Viagra®, Cialis®, and Levitra®, which belong to a family of medicines called phosphodiesterase-type 5 (PDE5) inhibitors. They work by sustaining the relaxation of smooth muscle fibers deep within the penis, which allows the penile veins to be compressed, and thus keeping the blood within the penis.

Not all men are candidates for oral medications, for example, men who are already taking nitrate medications. If oral medications cannot be used, or are not giving the desired results, a urologist can thoroughly discuss other treatment options, including minimally-invasive options, and up to the ultimate option of surgery to place a mechanical implant inside the penis. Nearly all insurances cover the costs of ED treatments, including surgery.

“Thankfully, the discussion of ED health issues has become mainstream. Couples need not feel embarrassed, and certainly should no longer suffer in silence. A comprehensive evaluation and a full menu of treatment options are available in the urologist’s office. We’re here for our patients in a very supportive way,” says Dr. Rubenstein.

To schedule your free prostate exam, please call us at 617-499-5722.