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Failure to achieve an erection less than 20% of the time is not unusual and treatment is rarely needed. Failure to achieve an erection more than 50% of the time, however, generally indicates there is a problem requiring treatment.
"Men can develop erectile dysfunction after sitting on a hard bicycle seat for many hours because they compress an area of the anatomy known as the perineum," explains Ken Taylor, MD, a former assistant clinical professor of family medicine at UCSD and a co-researcher in the 1999 cycling-impotence study. The perineum is the area between the anus and the scrotum.
Hormone shots (brand names: Depo-Provera, Lunelle) work much like the pill to prevent pregnancy. They may have some side effects, such as headaches and changes in your period, mood and weight. A Depo-Provera shot prevents pregnancy for 3 months. A Lunelle shot prevents pregnancy for 1 month.
These are generally ineffective when tested blind, but may be useful for their psychological (placebo) effect: if a good result is expected, any highly-praised, and often expensive, treatment can be effective. Reputable drugs can also benefit from the same effect.
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Other medical conditions linked to erectile dysfunction and impotence include depression, kidney disease, chronic alcoholism, hepatitis C, cancer, neurological diseases, and pelvic injuries.
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A significant number of men develop impotence from psychological causes that can be overcome. When a physiological cause is treated, subsequent self-esteem problems may continue to impair normal function and performance. Qualified therapists (e.g., sex counselors, psychotherapists) work with couples to reduce tension, improve sexual communication, and create realistic expectations for sex, all of which can improve erectile function.
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Ejaculation, the release of semen at climax, is triggered when the man reaches a critical level of excitement. Sexual stimulation causes nerves in the penis to send chemical messages or impulses to the spinal cord and into the brain. There, more chemical messages are sent back to the penis causing ejaculation.
A study in 2002 found that ED can also be associated with bicycling. The number of hours on a bike and/or the pressure on the penis from the saddle of an upright bicycle is directly related to erectile dysfunction.[19]
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The guideline is published in the Oct. 20 issue of the journal Annals of Internal Medicine.
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