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Erectile Dysfunction
(Male Impotence)
Questions, Answers, Facts and
Treatments
This guide is intended to provide answers to questions about male impotence (erectile dysfunction). You can browse the
menu on the left
for links to the most common questions.
What is
Male Impotence
(Erectile Dysfunction)?
Erectile
dysfunction, sometimes called impotence, is the inability to get
or keep an erection firm enough for sexual intercourse. The word "impotence"
may also be used to describe problems that interfere with sexual
intercourse and reproduction, such as lack of sexual desire and problems
with ejaculation or orgasm. Using the term erectile dysfunction makes it
clear those problems are not involved.
Erectile
dysfunction, or impotence, can be a total inability to achieve erection, an
inconsistent ability to do so, or a tendency to sustain only brief
erections. These variations make defining impotence and estimating its incidence
difficult. Estimates range from 15 million to 30 million, depending on the
definition used. According to the National Ambulatory Medical Care Survey (NAMCS),
for every 1,000 men in the United States, 7.7 physician visits were
made for impotence in 1985. By 1999, that rate had nearly tripled to 22.3. The
increase happened as treatments such as vacuum devices
and injectable drugs became widely available and discussing erectile
dysfunction became accepted.
Perhaps the most publicized advance was the
introduction of the oral drug sildenafil citrate (Viagra)
in March 1998. NAMCS data on new drugs show an estimated 2.6 million
mentions of
Viagra
at physician visits in 1999, and one-third of those occurred
during visits for issues other than male impotence.
In older
men, impotence usually has a physical cause, such as disease, injury, or side
effects of drugs. Any disorder causing injury to the nerves or impairing
blood flow to the penis could potentially cause impotence. Incidence increases
with age-about 5% of 40-year-old men and between 15 and 25%
of 65-year-old men experience impotence. But it is not inevitable with aging.
Impotence
is treatable at any age, and awareness of this is increasing. More
men have been seeking help and returning to normal sexual activity because
of improved, successful treatments for impotence. Urologists, who specialize
in urinary tract problems, have traditionally treated impotence.
However, urologists accounted for only 25 percent of
Viagra
mentions in 1999.
Hope Through Research
Advances in
suppositories, injectable medications, implants, and vacuum devices have
expanded the options for men seeking treatment for impotence. These advances have
also helped increase the number of men seeking treatment. Gene therapy for
impotence is now being tested in several centers and may offer a long-lasting
therapeutic approach to impotence.The
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
sponsors programs aimed at understanding the causes of erectile dysfunction
and finding treatments to reverse its effects. NIDDK's Division of Kidney,
Urologic, and Hematologic Diseases supported the researchers who developed
Viagra and continue to support basic research into the mechanisms of
erection and the diseases that impair normal function at the cellular and
molecular levels, including diabetes and high blood pressure.Points to Remember
- Erectile dysfunction
(ED) is the repeated inability to get or keep an erection firm enough for
sexual intercourse.
- Impotence affects 15 to 30
million American men.
- Impotence usually has a
physical cause.
- Impotence is treatable at all
ages.
- Treatments include
psychotherapy, drug therapy, vacuum devices, and surgery.
Acknowledgements
This report was adapted by The Impotence Guide. The facts contained in this report were obtained from the National
Kidney and Urologic Diseases Information Clearinghouse reviewed by both NIDDK scientists
and outside experts Arnold Melman, M.D., Montefiore Medical
Center, Bronx, NY, and Mark Hirsch, M.D., U.S. Food and Drug Administration.
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