HealthCentral Talks to Dr. Knowles About ED

David Knowles, M.D. Health Pro
  • Is ED a natural part of getting older?
    Although you are more likely to have ED if you are older, it should not be considered a natural part of getting older. According to the Massachusetts Male Aging Study, the overall probability of complete erectile dysfunction increases dramatically as men get older. Forty percent of men in their 40’s have some problems with erections while over 70 percent of men in their 70’s report having problems with erectile function. Complete erectile dysfunction triples as 5 percent of men in their 40’s and 15 percent of men in their 70’s have complete ED. Because some men in their 90’s still maintain normal erectile function, age does not necessarily mean that you will develop ED. Many experts believe that it isn’t aging that causes erectile dysfunction but the accumulation of risk factors over an extended period of time that causes erectile dysfunction with increasing age. Therefore, it is not a natural part of getting older, but getting older with known diseases which cause erectile dysfunction that leads to erectile dysfunction.
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    Normal erectile function is mainly a product of vascular and neural health. We know that health problems like diabetes and high blood pressure can cause damage to the neural and vascular systems. If given enough time, i.e. older age, they can cause enough problems that may affect erectile function. So if you are healthy, you should be able to maintain your erectile function and continue a happy and healthy sex life regardless of your age.

    It is also important to understand that no matter what age you may be, it is not natural to live with erectile dysfunction. Today, we have many safe and effective ways to treat ED. Even if you were to live to 120, if you want to return to a normal and happy sex life, you should seek treatment to restore your erectile function. There is no natural age which someone should no longer enjoy a happy, healthy sex life. Anyone interested in treatment should seek the help of their health care provider.

    How does diabetes cause ED?
    Diabetes causes ED through two main mechanisms. Diabetes causes damage to the vascular and neural systems which are necessary for normal erectile function. The blood flow into the penis is decreased due to narrowing of the blood vessels caused by diabetes. Diabetes causes vascular damage in many other organ systems such as the heart, brain and eye. Diabetic vascular damage to these organs causes heart attacks, strokes and blindness. Without the proper amount of blood flowing into the penis, the penis can not become erect.

    Diabetes also causes damage to the nerves responsible for erection. In normal erectile function, the cavernous nerves that run next to the prostate send messages to the tissues and blood vessels in the penis to increase blood flow. The blood is then trapped inside the penis and the penis becomes erect. Without this original neural signal to the penis, the normal cascade of events that cause erection can not occur. The oral medications for erectile dysfunction work by increasing the neural signals, so that an erection can occur. By increasing the neural signal you can often overcome some of the vascular damage done as well. This is why up to 80 percent of patients with diabetes can be helped with oral erectile dysfunction drugs. Because these medications work by amplifying the neural signal, if there is absolutely no neural input into the penis, the oral medications will not work and other methods of treatment may be required.
Published On: June 05, 2006