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Overview of Erectile Dysfunction

Erectile dysfunction (ED) is a condition where a man cannot sustain an erection firm enough for sexual intercourse. Also called impotence, erectile dysfunction causes psychological distress and affects self-confidence. ED affects men of advancing age most often, but can occur at any phase of life.

Overview of Erectile Dysfunction

Erectile Dysfunction

Sexual arousal in men involves hormones, emotions, the brain, nerves, muscles, and blood vessels. The brain is responsible for triggering a series of physical events that produce an erection. Any problem that occurs with any of these structures can cause erectile dysfunction. Also, mental health issues and stress can worsen or cause impotence.

Causes of Erectile Dysfunction

Physical Causes:

  • Low levels of testosterone
  • Heart disease
  • High cholesterol
  • High blood pressure
  • Obesity
  • Diabetes
  • Atherosclerosis
  • Low testosterone
  • Multiple sclerosis
  • Parkinson's disease
  • Metabolic syndrome
  • Prostate treatments
  • Alcohol and tobacco use/abuse
  • Certain prescription medications
  • Pelvic or spinal cord surgeries and injuries

Psychological Causes:

  • Depression
  • Anxiety
  • Stress
  • Relationship problems

Risk Factors for Erectile Dysfunction

As a man ages, erections can take longer to develop and not be as firm. This can result from many factors, such as taking medications or vascular problems. Other risk factors include:

Medical conditions : Includes diabetes and heart disease.

Tobacco use : Restricts blood flow to the penis.

Excess weight : Being overweight or obese.

Certain medical treatments : Includes radiation therapy and prostate surgery.

Injuries : Any damage to the nerves that innervate the penis.

Psychological conditions : Such as depression and anxiety.

Substance use/abuse : Includes narcotics, benzodiazepines, and alcohol.

Prolonged bicycling : Can compress nerves and alter blood flow to the penis.

Diagnosis Erectile Dysfunction

When a man has recurrent difficulty getting or keeping an erection and/or a decreased desire for sexual activity, he should consult a doctor. Also, any man with heart disease, high blood pressure, or diabetes should discuss erectile difficulties with their family physician. ED is diagnosed based on a man's subjective symptoms and complaints. The doctor will take a detailed history and conduct a comprehensive physical examination.

Treatment Erectile Dysfunction

There are numerous treatment options available for erectile dysfunction. The treatment depends on the cause, the severity of the condition, and underlying health problems that exists. It is important for a man to discuss these therapies with the doctor and partner. Treatment options include:

Oral medications : These enhance the effects of a natural chemical (nitric oxide) that the body produces to relax the penis muscles. Erectile Dysfunction pills include Viagra, Cialis, and Levitra.

Penile injections : The alprostadil (Caverject) self-injection is often used in combination with other medications or alone. The man injects the solution into the base or side of the penis, which will produce an erection that lasts an hour.

Penile suppositories : Alprostadil (Muse) intraurethral therapy is a tiny suppository placed inside the penile urethra. An erection occurs within 10 minutes of use, and it can last for up to an hour.

Testosterone replacement : For men with low testosterone levels (also called Low T), the doctor can prescribe testosterone replacement. Typically, the hormone is given by injection, but topical and oral therapies can also be prescribed.

Penis pumps : Also called a vacuum erection device, a penis pump is a hollow tube that has a battery-powered pump. The tube goes over the penis, and the pump places air inside the tube. As this occurs, the vacuum pulls blood into the penis, giving the man an erection.

Penile implants : A penile implant is a surgically positioned device that goes into the two sides of the penis. The rods can be inflatable, which allows the man to control when and how long to have an erection, or they can be semi-rigid, leaving the penis firm but flexible.

Blood vessel surgery : This is done only when a man has obstructed or leaking blood vessels to the penis.

Psychological counseling : If the ED is caused by a mental health disorder, psychological counseling can help. 

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