Erectile dysfunction (ED) isn’t the inevitable result of aging. Yet mild, moderate or severe ED strikes more than 50% of American men between age 40 and 70. So if getting old is not the “cause” of ED, what is?
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Erectile dysfunction may be caused by numerous diseases and conditions including vascular disease, nerve disease (such as multiple sclerosis and diabetes mellitus), psychological conditions (such as stress, depression or performance anxiety) and injury to the penis. In addition, chronic illnesses, certain medications, as well as prostate, bladder and colon surgery can lead to ED.
However, it’s estimated that vascular disease such as atherosclerosis (or hardening of the arteries) and diabetes may be responsible for as much as 50 to 70% of ED cases. While ED treatments include lifestyle changes, prescription medications or outpatient procedures such as penile implants, Cleveland Clinic is offering a novel endovascular intervention for selected patients.
“Vascular disease was first identified as a cause of ED by a French surgeon, Rene Leriche, more than 100 years ago,” says interventional cardiologist Joseph Campbell, MD. “He determined that men who were heavy smokers had blockages of plaque (fatty deposits) build up in their aorta, the main artery that delivers blood to a complex network of artery branches throughout the abdomen and pelvis, including the male genitals.”
Build up of plaque in any of these arteries essentially blocks sufficient blood flow to the penis, preventing men from obtaining an erection.
“Patients who suffer from peripheral vascular disease (also known as peripheral arterial disease, or PAD), described as clogged arteries in the legs, neck or carotids, renals or aorta can be at higher risk for ED,” Dr. Campbell says. These individuals should be evaluated for possible arterial blockages that may be contributing to ED.
Treatment options depend on the underlying cause of ED. These may include:
However, a small subset of patients who have significant blockages in arteries that deliver blood to the penis may be candidates for a novel endovascular intervention. This type of minimally invasive procedure enables physicians to treat blocked arteries from inside the blood vessel using sophisticated medical equipment.
The physician gains access to the main artery in the patient’s leg by way of a small needle through which wires are passed. A catheter, a thin flexible tube, is then threaded up to the blocked artery. The catheter also carries a deflated balloon and a stent, or a tiny wire mesh tube. The physician inflates the balloon to open the artery and then installs stents, which push the blockage aside and keep the artery open, improving blood flow.
“This novel approach has been available for a little over a decade now,” explains Dr. Campbell.
Still considered an investigational, or “off-label” use of an FDA-approved technology, ideal candidates for this procedure are chosen according to strict criteria. Cleveland Clinic will be participating in clinical trials to determine how effective endovascular treatment is for treating ED.
Plan early — getting the right vaccines can help you stay healthy on your travels
Sizzling temperatures force your heart to work much harder
The numbness and tingling should wear off in about two hours
Rethinking your Mondays might make the ‘Sunday scaries’ a thing of the past
The emotional toll of loss and other strong emotions can have life-threatening physical effects
It’s 97% effective in preventing shingles in people between the ages of 50 and 69
Pick specific, measurable goals, but also be open to changing them if need be
From nausea, weight gain and eczema, stress can affect your immune system in many ways
Coffee won’t cure a hangover and you definitely shouldn’t mix your cocktail with an energy drink
Focus on the philosophy — replenishing and respecting your skin — not necessarily the steps
This social media sleep hack with tart cherry juice and magnesium could be worth a try
