185 Male Erectile Disorder (302.72)
DSM-IV-TR criteria
- A. Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate erection.
- B. The disturbance causes marked distress or interpersonal difficulty.
- C. The erectile dysfunction is not better accounted for by another Axis I disorder (other than a Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition
- Specify if:
- Lifelong Type
- Acquired Type
- Specify if:
- Generalized Type
- Situational Type
- Specify:
- Due to Psychological Factors
- Due to Combined Factors
Associated Features
- It is normal for older men to need more stimulation to gain an erection, and they may require more time in between erections too. However, older men should still be able to achieve erection and enjoy sex. When a man of any age, younger or older, cannot achieve an erection or maintain one long enough for sexual satisfaction for both partners, it is considered Erectile Dysfunction (ED).
- Child vs. adult presentation
- Premature ejaculation one form of ED can occur at any age, and it is a common disorder. The occurrence of Premature Ejaculation in men aged 18-30 is common, it but may also occur in conjunction secondary to impotence in men aged 45-65. The inability to achieve an erection and ED, in general, is more commonly seen in older men, and sexual function drastically declines after one reaches the age of 50. This disorder only occurs in men.
Gender and cultural differences in presentation
There is no significant data that supports major differences in premature ejaculation between races, however, recent surveys suggest some racial variation. An analysis by Laumann et al (1999), found that premature ejaculation was more prevalent in African American men (34%) than white men (29%) or Hispanics (27%).
Epidemiology
Approximately 5-20% of men have moderate-to-severe ED.
Etiology
The majority of these cases with this disorder have an organic etiology, most commonly vascular disease that decreases blood flow into the penis. Diabetes, Hypertension, and Artherosclerosis are associated and linked to causal explanations for ED. If a person’s hormones are imbalanced, it can result in ED as well. A few physical causes of ED are: excessive alcohol and tobacco use, fatigue, brain and spinal-cord injuries, Hypogonadism, liver or kidney failure, Multiple Sclerosis, Parkinson’s Disease, radiation therapy to the testicles, stroke, or some types of prostate or bladder surgeries. Emotions or feelings which can lead to ED are similar to those associated with Male Orgasmic Disorder and include: nervousness due to previous bad sexual experiences or prior episodes of impotence, stress from external situations (ie. work, school, or family), depression, crowding insecurities, being preoccupied, and thinking the partner is displaying negative reactions. Values and conceptio