ED or Erectile Dysfunction

In the past, the term "impotence" was widely used to refer to men who were no longer capable of erections. When a man was termed "impotent," it meant he was completely sexually disabled in terms of his capacity for getting erections. He simply didn't get them anymore.

Today, the terminology has changed. The preferred term is "erectile dysfunction," or "ED," which is defined as follows: The consistent inability to achieve and/or maintain an erection sufficient for satisfactory sexual activity.

Men with erectile dysfunction have problems with their erections, but they may still experience sexual desire, and may still be able to achieve orgasm (sexual climax) and ejaculate.

The result of this broader definition was a tripling of the number of men defined as suffering from erectile dysfunction, from the former estimate of 10 million to the current estimate of 30 million. And now, especially since the introduction of Viagra, it appears that this higher estimate is still too low.

Who is included? Any man who has a recurring problem with his erections, such as:

Men whose erections are not hard enough to permit them to complete sexual intercourse in a way that they and their partners find satisfactory;

Men whose erections don't last long enough for them to have satisfactory intercourse with their partners,

• Men who are sometimes unable to get erections, even though they are sexually stimulated; and

• Men who for one reason or another are unable to get erections at all.

Who is not included? Men who have one or two episodes of erectile failures, but are otherwise capable of getting good erections and having fulfilling sexual encounters. In other words, if your erections don't fail frequently and regularly, you are not defined as suffering from ED.

Who Has ED and Why?

As men age, they are more likely to have erectile dysfunction. But the condition is not caused directly by the aging process.

In the past, people assumed that as men grew older; their sexual function would automatically slow down and finally fail. But in the past few years, a great deal has been learned about how a man's body works. We now know that the inability to function sexually has very little to do with age.

If a man remains active and healthy, he can continue to have sex well into old age, even into his nineties. Of course, be will not perform the same way he did when he was much younger, but he can still complete intercourse to his satisfaction.

Studies also show a correlation between a man's frequency of sex in his younger years and how sexually active he is later on. If a man has enjoyed a lively sex life through middle age, he is more likely to remain sexually potent into old age. It lends truth to the old saying "Use it or lose it."

But problems can intervene. With age, come many health problems that can directly affect a man's sexual abilities. They include cardiovascular disease, diabetes, depression, prostate surgery, the use of many prescription medications, smoking, and alcohol abuse.

According to the 1994 Massachusetts Male Aging Study, more than half of all men between the ages of forty and seventy have erectile problems. This survey included more than 1,700 men, the largest study of erectile dysfunction since the famous Kinsey report in the 1940s. The study also found complete impotence (no erections at all) in about 5 percent of men at the age of forty and 15 percent of men at the age of seventy. Other studies involving younger men indicate that about 10 percent of men in their twenties and thirties also suffer from some degree of erectile dysfunction.

Until about twenty five years ago, it was thought that psychological problems were the main reason for these difficulties. "It's all in your head" was a common diagnosis. But now, the tables are completely turned and we know that about 80 percent of male erectile dysfunction has a physical cause, and only about 20 percent is psychological in origin.

What does it all boll down to? Impaired blood flow to the genitals. Simply put, erectile dysfunction is essentially a vascular disease.