DEAR DR. DONOHUE: I have not seen you address the causes of erectile dysfunction. I have seen more than enough ads for drugs to overcome the problem, but I have seen little about its causes. What, if anything, can be done to prevent or overcome them? – P.M.

ANSWER: Successful erectile function depends on the interplay of the brain, nerves, arteries and hormones. It’s quite complicated.

Arteriosclerosis – artery hardening – is one of the major causes of ED. If the arteries to the penis are clogged with buildup, blood cannot get into it to cause an erection. You have been lectured to death on the ways to prevent arteriosclerosis – don’t smoke, cut back on fat and cholesterol, exercise, maintain normal blood pressure, keep blood sugar controlled and strive for normal body weight.

Diabetes, which is so prevalent today, has two effects that lead to ED. One is artery clogging. The other is damage to nerves that open up the arteries that flood the penis with blood. Control of blood sugar is the best way to avoid these two complications of diabetes.

Medicines are a third important cause of ED. If a man has the problem, he should show his doctor a complete list of all the medicines he’s taking. One of them could be the cause.

Although much talked-about, testosterone deficiency is not one of the leading causes of ED. Since testosterone production wanes with age, and since this hormone stimulates libido, a very low level of the hormone could be implicated as a cause, but it’s not a common one.

Alcoholism, spinal cord injuries and depression are other factors that must be considered when trying to discover the reason for ED.

DEAR DR. DONOHUE: What can I take for headaches? Once I took Anacin, and within half an hour, I threw up. I tried Bufferin, and I had to urinate every five minutes. The only medicine I take is a thyroid pill. I will be 68 soon. Can you advise me? – L.H.

ANSWER: How often do you have headaches? If it’s often, you must see your doctor so that a medicine specific for the kind of headache you have is prescribed for you. In other words, medicines for a tension headache don’t work as well for migraine headaches as migraine medicines do.

My second question is, Which kind of Anacin did you use? Anacin has acetaminophen (Tylenol), aspirin and caffeine in it. Anacin Aspirin Free has only acetaminophen. Bufferin is aspirin along with the acid neutralizers calcium carbonate, magnesium oxide and magnesium carbonate. If you took Anacin, it might be the aspirin in it that upset you. It’s the ingredient common to both Anacin and Bufferin.

Have you tried plain Tylenol? Or how about the anti-inflammatory, pain-relieving drugs like ibuprofen (Advil, Motrin) and naproxen (Aleve)? They can be obtained without a prescription.

I have to say that the reactions you had to those medicines are quite unusual, especially urinating frequently after taking Bufferin. See your doctor and tell him or her what happened.

DEAR DR. DONOHUE: Does wearing earplugs every night cause any medical concern? Between the snoring of my husband and the dog, it’s the only way I can get any sleep. I wear soft, foam earplugs. – L.M.

ANSWER: The plugs don’t cause pain, do they? If they don’t, then they shouldn’t cause any damage to your ear canal. People with hearing aids wear devices that fit into the canal for the whole waking day.

I didn’t know dogs snored.

DEAR DR. DONOHUE: I am a 78-year-old male with osteoporosis and severe back pain. I visited my daughter, who brought out a chair for me to sit in. When I sat, the leg of the chair broke, and I fell about two feet. Since then, the pain has stopped. My daughter says it’s a miracle. I call it Irish luck. What do you think? – D.C.

ANSWER: I say it has to be a miracle or Irish luck.

DEAR DR. DONOHUE: My 40-year-old brother was just told that he has gout. We find it strange that in this day and age there would still be a diagnosis of gout. On my mother’s side of the family, three of four siblings, including her, all had kidney stones. Is that where my brother’s gout might come from? What advice can you give us? – M.B.

ANSWER: Why would you think gout has left the world? It’s very much here. More than 5 million Americans face it and continue to face it throughout their lives. You might not hear as much about it as you once did, since there are such effective gout medicines now.

Gout comes from a rise in blood uric acid, which, in turn, comes from the daily turnover of body cells. Uric acid seeps into joints and causes them to turn red, become hot and swell – a gout attack. Uric-acid levels rise because the kidneys aren’t getting rid of it as they should or because the body is producing too much of it. Ninety percent of the time the reason lies in the kidneys’ not filtering it properly.

Kidney stones don’t cause gout, but 10 percent to 15 percent of gout patients will come down with a uric-acid kidney stone. If your mother and her siblings never had a gout attack, it is unlikely that their kidney stones were uric-acid stones. They most likely never had gout.

Your brother can keep his uric acid controlled by losing weight (if he needs to) and taking the medicine prescribed to him. He should be cautious about drinking alcohol. It can precipitate an attack – beer more often than wine or liquor.

The gout booklet explains this illness in detail. Readers can obtain a copy by writing: Dr. Donohue – No. 302, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.