Difficulty achieving or maintaining a hard erection, which prevents sexual intercourse. It is more common in older men due to ageing, which affects the blood supply and innervation of the penis.
There are many triggers: smoking, alcohol, obesity, high blood pressure, diabetes, arteriosclerosis, multiple sclerosis, spinal injuries, medication (antihypertensives, antihistamines, antidepressants, tranquillisers), hormonal changes and psychological factors (anxiety, low self-esteem, stress).
The diagnosis is made clinically by interview and physical examination. Blood tests may be needed to rule out certain diseases.
Treatment aims to eliminate the cause, if known. Cardiovascular risk factors should be eliminated (stop smoking, reduce alcohol) and regular exercise should be taken. The use of phosphodiesterase inhibitors (Viagra, Cialis, Levitra) or the injection of vasodilators into the erectile tissue may be considered, always under medical supervision.
- Glenn R Cunningham, Raymond C Rosen. Overview of male sexual dysfunction. UpToDate. May11, 2016.
- Glenn R Cunningham, Mohit Khera. Evaluation of male sexual dysfunction. UpToDate. Dec 16, 2015.
- Glenn R Cunningham, Mohit Khera. Treatment of male sexual dysfunction. UpToDate. Jul 31, 2016.
- McVary KT. Disfunción sexual. Harrison. Principios de Medicina Interna. Volumen 1. 19º Edición: 326-330.
- Otero A. Ballús C. Trastornos psicosexuales. Farreras Rozman. Medicina Interna. Volumen 2. 12º edición: 1537-1538.
