| Erectile dysfunction, sometimes called "impotence," is
the repeated inability to get or keep an erection firm enough for
sexual intercourse. The word "impotence" may also be used
to describe other 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 that those other problems are not involved.
Erectile dysfunction, or ED, 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 ED 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 office visits were made for ED in 1985. By 1999, that
rate had nearly tripled to 22.3. The increase happened gradually,
presumably as treatments such as vacuum devices and injectable drugs
became more 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 office visits in 1999, and one-third of those mentions
occurred during visits for a diagnosis other than ED.
In older men, ED usually has a physical cause, such as disease,
injury, or side effects of drugs. Any disorder that causes injury
to the nerves or impairs blood flow in the penis has the potential
to cause ED. Incidence increases with age: About 5 percent of 40-year-old
men and between 15 and 25 percent of 65-year-old men experience
ED. But it is not an inevitable part of aging.
ED is treatable at any age, and awareness of this fact has been
growing. More men have been seeking help and returning to normal
sexual activity because of improved, successful treatments for ED.
Urologists, who specialize in problems of the urinary tract, have
traditionally treated ED; however, urologists accounted for only
25 percent of Viagra mentions in 1999.
|
