Dr. Dean Elterman, Urologic Surgeon

Duration: 3 minutes and 58 seconds

Erectile dysfunction, which is the the inability to either attain or maintain an erection sufficient for sexual activity happens to men quite commonly and it of course, occurs more commonly as men get older.

The number one risk factor for the development of erectile dysfunction or ED is simply age. The causes typically depends on your age. For most men, especially as they're getting older, it has to do with blood flow. It's vascular. And what we mean by that is the blood vessels in the penis are very, very small, and they are the first ones to get impacted by things like high blood pressure and cardiovascular disease.

So, if you think about men as they get older, you're worried about developing a heart attack or stroke by the buildup of plaque clogging arteries. All these changes that occur in your heart, well, those same changes occurred in the penis many years earlier. We actually think that erectile dysfunction can be a warning sign or a precursor of more severe cardiovascular illness.

The main issue is poor blood flow to the penis. Of course, there could be other causes such as nerve damage. For example, men who develop diabetes may have both changes to the blood vessels but also changes to the nerves. Neurological conditions can impact the nerves and of course, if someone has surgery, like having their prostate removed, or radiation for cancer, these things can also impact the nerves.

The third cause of erectile dysfunction beyond blood flow or nerves is psychological. Erections and sexuality have a very strong psychological component to them at any age and of course, things like mental stress, interpersonal stress with a partner, performance anxiety, all of these can negatively impact erectile function. We often see psychological causes of erectile dysfunction much more commonly in younger people.

So. if you have a teenager or someone in their 20s or 30s, they're much less likely to have problems with blood flow. If they're really having problems with their erections is much more likely to be what we call ‘psychogenic’ or psychological in nature. These people may be recommended for sexual health counseling to see what the underlying psychological issues may be.

The best treatment for erectile dysfunction will depend on it’s cause. But we generally say whatever is good for your heart is good for your penis. So if you are exercising, for example with aerobic exercise, and you're making sure you're healthy in that respect, it will help with blood flow everywhere.

If you are losing weight, if you quit or avoid smoking, or you don't drink too much and have a healthy diet, this will help. Getting adequate sleep is also important. If you know you are chronically sleep deprived, this will impact your erections.

Presenter: Dr. Dean Elterman, Urologist, Toronto, ON

Local Practitioners: Urologist