You are here

It’s More Common than You Think: Urologist Dr. Charles Walker Gets Candid about Erectile Dysfunction


Part 1 of a 2 Part Series

Erectile dysfunction (ED) or the persistent inability to achieve and maintain an erection that is satisfactory to perform intercourse is a common affliction affecting middle age and older men.  Unfortunately, there are many misconceptions about ED and these misconceptions often prevent men from seeking medical attention.

The first misconception that men have about ED is that it is only a disease of older men. While it is true that the risk of ED increases as men age, there are an increasing number of younger men who also suffer from the condition. The causes for ED among younger men are often different from those among older men and tend to be more commonly attributable to psychological causes (performance anxiety) or hormonal conditions such as low testosterone (low-T). Among older men, ED is more likely due to organic or physical causes that prevent adequate blood flow from reaching the penis. Common causes include high cholesterol, diabetes, obesity, hypertension, and cigarette smoking, all of which lead to atherosclerosis or clogging of the arteries limiting the available blood flow to the penis in the same way they impair blood flow to the heart. ED in older men can also be the result of pelvic surgery or Peyronie’s Disease, a condition that causes painful curvature of the penis in addition to ED.

The relationship between ED and heart disease is not limited to the common risk factors that the two diseases share. It turns out that ED occurs more frequently in men who will go on to have a heart attack and in that respect can serve as a predictor of heart disease in older men. For men, recognizing this relationship and bringing your problems with ED to the attention of your doctor can prove to be life-saving.

As difficult as the diagnosis of ED can be for men, it’s extremely important for men to recognize that there are effective treatments for the condition and if diagnosed early, ED can potentially be reversed through lifestyle modification.  It’s also important for men to realize that they are not alone.  Studies have shown that ED is more common than suspected. In fact, it has been estimated that more than 300 million men globally will suffer from the condition by 2025.

A second misconception that men have about erectile dysfunction is that it will go away if ignored.  Except for men with psychogenic causes of ED, the great majority of men with ED will not experience improvement without treatment. In fact, the disease will be progressive if the risk factors are not removed.

In other words, no matter what the underlying cause of ED is, the first step is going to the doctor—the earlier, the better.  Of course, going to the doctor for sexual problems can be difficult for men. For many men the stigma associated with ED can be humbling and men with ED often feel that they cannot discuss these matters with their friends and even their partners. The best advice I can give men who are unable to take that first step is to remind them that they are not alone and to assure them that there is help. Urologists and other men’s health specialists are highly-trained at helping them overcome this anxiety in a non-judgmental way so that they can seek the treatment they need.

The importance of being evaluated early in the course of one’s erectile dysfunction also cannot be overestimated because this is when the medications are most effective and when the best chance exists to reverse or halt the progression of the disease.