Erectile dysfunction (ED) is a condition in which the man is unable to get or keep an erection firm enough for satisfactory sexual intercourse.
Though it’s not rare for a man to have some problems with erections from time to time, ED that is progressive or happens routinely with sex is not normal, and it should be treated.
Causes of Erectile Dysfunction:
Erectile dysfunction can happen:
• Most often when blood flow in the penis is limited or nerves are harmed
• With stress or emotional reasons
As an early warning of a more serious illness, like:
• Atherosclerosis (hardening or blocked arteries),
• Having high blood sugar (Diabetes)
• Having high blood pressure
• Having cardiovascular disease
• Having high cholesterol
• Using drugs or drinking too much alcohol
• Being obese
• Being over age 50
• Lacking exercise
Even though ED becomes more common as men age, growing old is not always going to cause ED. Some men stay sexually functional in their 80s. ED can be an early sign of a more serious health problem. Finding and treating the reason for ED is a vital first step.
Emotional Causes of Erectile Dysfunction
Normal sex needs the mind and body working together. Emotional or relationship problems can cause or worsen erectile dysfunction.
Some emotional issues that can cause ED are:
• Relationship conflicts
• Stress at home or work
• Stress from social, cultural or religious conflicts
• Worry about sex performance
Symptoms of ED include:
• Erections those are too soft for sex
• Erections that are don’t last long enough for sex
• An inability to get an erection at any time
Finding the cause of your erectile dysfunction will help direct your treatment options. Diagnosing ED starts with your health care provider asking questions about your heart and vascular health and your erection problem. Your provider may also give you a physical exam, order lab tests or refer you to a Urologist.
What Questions Will the Health Care Provider Ask?
Questions about your health:
• What medications, over-the-counter medications or supplements do you take?
• Do you use recreational drugs?
• Do you smoke?
• How much alcohol do you drink?
• Have you had surgery or radiation therapy in the pelvic area?
• Do you have any urinary problems?
• Do you have other health problems (treated or untreated)?
Questions about Erectile Dysfunction:
Knowing about your history of erectile dysfunction will help your health provider learn if your problems are because of your desire for sex, erection function, ejaculation, or orgasm. Some of these questions may seem private or even embarrassing. However, be assured that your doctor is a professional and your honest answers will help find the cause and best treatment for you.
Questions about your Erectile Dysfunction symptoms:
• How long have you had these symptoms? Did they start slowly or all at once?
• Do you wake up in the morning or during the night with an erection?
• If you do have erections, how firm are they? Is penetration difficult?
• Do your erections change at different times, like when going in a partner, during stimulation by mouth, or with masturbation?
• Do you have problems with sex drive or arousal?
• Do you have problems with ejaculation or orgasm (climax)?
• How is this problem changing the way you enjoy sex?
• Do you have pain with erections, feel a lump or bump in the penis or have penile curvature? These are signs of Peyronie’s Disease which can be treated but calls for an expert in urology to assess and manage.
Questions about Stress and Emotional Health
Your health care provider may ask you questions about depression or anxiety. He or she may ask about problems in your relationship with a partner. Some health care providers may also ask if they may talk to your sex partner.
• Are you often under a lot of stress, or has something recently upset you?
• Do you have any anxiety, depression or other mental health issues?
• Are you taking any drugs for your mental health?
• How satisfied are you with your sex life? Has there been any change lately?
• How is your relationship with your partner? Has there been any change lately?
A physical exam checks your total health. Examination focusing on your genitals (penis and testicles) is often done to check for ED. Based on your age and risk factors, the exam may also focus on your heart and blood system: heart, peripheral pulses, and blood pressure. Based on your age and family history your doctor may do a rectal exam to check the prostate. These tests are not painful. Most patients do not need a lot of testing before starting treatment.
Your health care provider may order blood tests and collect a urine sample to look for health problems that cause ED.
Advanced Erectile Function Tests
For some men with erectile dysfunction, specialized testing may be needed to guide treatment or re-assess you after treatment fails.
• Blood work to check Testosterone and other male hormones
• Blood work to measure blood sugar (Diabetes)
• Ultrasonography (penile Doppler) to check blood flow
• A shot into the penis with a vascular stimulant to cause an erection
• Pelvic x-rays like arteriography, MRI or CT scanning are rarely needed to check ED unless there is a history of trauma or cancer
• Nocturnal penile tumescence (NPT), an overnight test to check for sleep erection
Treatment of Erectile Dysfunction:
The treatment for Erectile Dysfunction starts with taking care of your heart and vascular health. Your doctor may point out ‘risk factors’ that can be changed or improved.
You may be asked to change certain food habits, stop smoking, increase workouts or stop using drugs or alcohol. You may be offered alternatives to the drugs you take. (Never stop or change prescription drugs without first talking to your health care provider.)
Non- invasive treatments are the first options. Most of the best-known treatments for ED work well and are safe.
• Oral drugs or pills
• Testosterone Therapy (when low testosterone is detected in blood testing)
• Penile Injections
• Intraurethral medication
• Vacuum Erection Devices – Vacuum devices for erectile dysfunction, also called pumps, offer an alternative to medication. You’ll place your penis inside a cylinder and use a pump to draw the air out. This creates a partial vacuum around your penis, which causes it to fill with blood and leads to an erection. You’ll wear an elastic band around the base of your penis to keep the erection while you have intercourse.
• Even when Erectile Dysfunction has a physical cause, psychotherapy can help. A therapist can teach the man and his partner techniques to reduce performance anxiety and improve intimacy. Therapy can also help couples adjust to the use of vacuum devices and implants.
Penile Implants & Surgery:
• For long-term Erectile Dysfunction, a penile implant could help to have intercourse again. An inflatable implant uses two cylinders you can pump full of pressurized fluid. A malleable implant uses rods that let you adjust the position of your penis.
• If Erectile Dysfunction comes from a blocked artery leading to the penis, surgery can restore blood flow. The procedure usually works best on men under 30. Doctors don’t recommend it for older men with widespread narrowing of the arteries.
Erectile Dysfunction: Lowering the Risk
Following simple steps can help lower the odds of Erectile Dysfunction:
• Exercise and maintain a healthy weight.
• Stop smoking.
• Avoid alcohol and substance abuse.
• Keep diabetes under control.
Urology Care Foundation
National Institute of Diabetes and Digestive and Kidney Diseases
Handbook of Andrology, second Edition
U.S National Library of Medicine
Harvard Medical School¬ – 5 natural ways to overcome erectile dysfunction
Endotext – Medical and Surgical Therapy of Erectile Dysfunction
Disclaimer: All contents on this site are for general information and in no circumstances information be substituted for professional advice from the relevant healthcare professional, Writer does not take responsibility of any damage done by the misuse or use of the information.