01 October, 2005  20:41 GMT
 Erection problems that have one or more major physical causes also often have psychological factors that make the problem worse and treatment more complicated.
Commonly referred to as ED, erectile dysfunction is the inability to achieve and sustain an erection.
Studies have shown up to 50 percent of adult males suffer from ED at some time during their lives. Failure to achieve an erection less than 20 percent of the time is not unusual and treatment may or may not be indicated. Failure to achieve an erection more than 50 percent of the time, however, generally indicates there is a problem requiring treatment.
Common causes of ED include organic diseases that affect blood flow, nerve diseases or hormonal imbalances. Psychological factors, such as stress, depression and performance anxiety, can also play a role in ED. Chronic illness certain medications and a condition called Peyronies disease can also be responsible for ED.
If you suspect you may have erectile dysfunction, see your doctor. He or she can perform tests to identify what is causing your problem and refer you to a urologist.
Least Invasive Treatments First
Once the cause is identified, there are several treatments to consider, including oral medications, sex therapy, penile injections and surgery. Each type of treatment has advantages and disadvantages.
Treatment for ED depends on the cause of the problem, which may be physical, psychological or a combination of both. Erection problems that have one or more major physical causes also often have psychological factors that make the problem worse and treatment more complicated.
Many urologists take a stepwise approach to treating erection problems, using the least invasive treatments first. These steps include discovering and eliminating medications, if possible, that may be causing your condition. In some cases, a different medication can be tried. Your specialist may recommend that you try an oral medication.
Other treatments might include trying a vacuum erection device, medications that are injected or inserted into the penis, penile implant surgery or an external penile splint. Counseling or behavioral therapy may be appropriate in cases of psychogenic ED.
Common Functional Disorder
Because ED is a functional disorder and not a cosmetic condition, insurance plans will often provide coverage for this condition particularly when associated with medical conditions.
Insurance coverage of ED depends upon the type of treatment prescribed. If there is a documented medical condition that is shown to be causing ED, insurance will usually provide some coverage.
If you suffer from ED, do not assume that you have an untreatable condition. Do not be embarrassed to seek help. Take the first step and talk to your healthcare provider about treatment for this common functional disorder.
David Thompson, PA-C, is with Piedmont Urological Associates, a Cornerstone Health Care Practice.
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