Erectile Dysfunction diagnosis

Dear Ask The Doctor: Hi, I am 27 years old and I've been suffering from occasional erectile dysfunction for a couple years. I can get an erection, but I need to be very turned on or constant stimulation to keep it. I've recently had a physical and my cholesterol level came back very low. The doctor didn't mention any concern with very low cholesterol, but I did some research on my own and discovered that cholesterol was used in the production of adrenal steroid hormones and sex hormones. Is there a chance that the low cholesterol is related to the ED? If so, are there medicines/health diet suggestions to raise my cholesterol. Some extra information: I eat a very healthy, fairly low fat diet and exercise regularly. My cholesterol results: Cholesterol, Total - 97 Triglycerides - 54 HDL Cholesterol - 58 VLDL Cholesterol Calc - 11 LDL Cholesterol Calc - 28

Dear Joe: Impotence, also referred to as erectile dysfunction (ED), is the term used to describe men who cannot acquire or maintain an erection during 75% of attempts to have sexual intercourse.

There are several causes of ED and these can be broadly grouped into four categories including: reduced blood flow to the penis; reduced nervous supply to the penis; medication side-effects; and psychological factors.

Anything that limits blood flow to the penis can cause impotence. The most common conditions that limit blood flow include cigarette smoking, diabetes, high blood pressure, alcoholism, drug abuse, normal aging, and depression.

Many commonly prescribed medications can interfere with male sexual function - the most common being anti depressant medications.

Clinical depression, performance anxiety, and lack of focus are common causes of psychogenic impotence.

Your cholesterol levels are low, with a HDL level of 58 which is close to the recommended >60mg/dL, which provides some protective benefit against cardiovascular disease. I think it is highly unlikely that your low cholesterol levels are contributing to occasional ED or are responsible for low androgen levels (sex hormones).

I would advise attending your family doctor for a detailed sexual history and clinical examination. He may perform some routine blood tests to check hormone levels including testosterone, prolactin and thyroid hormones, to determine the cause of ED in your case.  If all tests are normal, your doctor may prescribe medications to help with erectile difficulties.