What are erectile dysfunction Treatment Possibilities?
Erectile dysfunction (ED) is a common type of male sexual dysfunction. It is when a man has trouble getting or keeping an erection. Erectile Dysfunction Treatment is possible, ED becomes more common as you get older. But it’s not a natural part of aging. Some people have trouble speaking with their doctors about sex. But if you have ED, you should tell your doctor. ED can be a sign of health problems. It may mean your blood vessels are clogged. It may mean you have nerve damage from diabetes. If you don’t see your doctor, these problems will go untreated. Your doctor can offer several new treatments for ED. For many men, the answer is as simple as taking a pill. Getting more exercise, losing weight, or stopping smoking may also help.
Erectile Dysfunction Treatment
What Is an Erection Self-Test?
An erection self-test is a procedure a man can do by himself to determine if the cause of his erectile dysfunction is physical or psychological. It’s also known as the nocturnal penile tumescence (NPT)
How is Erectile Dysfunction Diagnosed and Treated?
Following questions will be answered by the doctor during patient interviews.
The physical causes of ED can be determined with physical examination. There can be problem in nervous system causing ED if penis is unable to respond to touching. There can be hormonal problems like hypogonadism in case of lack of facial hair, small testicles and enlarged breasts. You can find reduced blood flow due to atherosclerosis by finding reduced arterial pulses or listening for bruits with stethoscope. There can be ED with unusual penis characteristics like bending of penis with erection causing pain.
Ed can be evaluated with the help of following laboratory tests.
* blood counts
* there can be sign of kidney damage and diabetic mellitus with abnormal urinalysis tests.
* There can be atherosclerosis with high LDL cholesterol levels found in the Lipid Profile test.
* There can be sign of diabetic mellitus high glucose levels in the blood found in Blood Glucose levels.
* Blood Hemoglobin A 1c test to find diabetic mellitus.
* Serum Creatinine test to diabetic damage to the kidney.
* Liver function and liver enzyme tests to find gonad dysfunction and hormonal imbalance.
* Total testosterone level tests
* Hormone level tests
* PSA level tests
* Other blood tests
The bony abnormalities can be found with X-rays. The testicular size and structure can be found with the help of ultrasound penis and testicles. You can have additional information of blood flow in the penis with the help of ultrasound with Doppler imaging. Angiogram can also be used in case of vascular surgery.
The penile blood flow can be determined with the help of prostaglandin E1 which is directly injected into covernosa with the help of which blood vessels dilation can be determined. It can also promote the blood flow in the penis. There can be normal or adequate blood flow in the penis with normal erection. You can be able to find the physical or psychological causes of the erectile dysfunction with the help of monitoring erection usually in the sleep. The penile nerve function can be determined with the help of direct vibrational stimulation.
Causes of Erectile Dysfunction
Erectile dysfunction (ED) occurs when a man has consistent and repeated problems sustaining an erection. Without treatment, ED can make sexual intercourse difficult. The problem is reported by 1 in 5 men and that number increases with age.
ED vs. Poor Libido
There are several forms of male sexual dysfunction, including poor libido and problems with ejaculation. But ED refers specifically to problems achieving or maintaining an erection. Men with ED often have a healthy libido, yet the body fails to respond. In most cases, there is a physical basis for the problem.
Symptoms of ED
Symptoms of ED include:
Men who cannot get or maintain an erection that lasts long enough or is rigid enough to complete sexual intercourse is considered to have erectile dysfunction.
Sexual dysfunction and ED become more common as men age. The percentage of complete ED increases from 5% to 15% as age increases from 40 to 70 years. But this does not mean growing older is the end of your sex life. ED can be treated at any age. Also, ED may be more common in Hispanic men and in those with a history of diabetes, obesity, smoking, and hypertension. Research shows that African-American men sought medical care for ED twice the rate of other racial groups.
The Mechanics of ED
An erection occurs when blood fills two chambers known as the corpora cavernosa. This causes the penis to expand and stiffen, much like a balloon as it is filled with air. The process is triggered by impulses from the brain and genital nerves. Anything that blocks these impulses or restricts blood flow to the penis can result in ED.
The link between chronic disease and ED is most striking for diabetes. Men who have diabetes are two to three times more likely to have erectile dysfunction than men who do not have diabetes. Among men with erectile dysfunction, those with diabetes may experience the problem as much as 10 to 15 years earlier than men without diabetes. Yet evidence shows that good blood sugar control can minimize this risk. Other conditions that may cause ED include cardiovascular disease, atherosclerosis (hardening of the arteries), kidney disease, and multiple sclerosis. These illnesses can impair blood flow or nerve impulses throughout the body.
Causes of ED: Lifestyle
Lifestyle choices that impair blood circulation can contribute to ED. Smoking, excessive drinking, and drug abuse may damage the blood vessels and reduce blood flow to the penis. Smoking makes men with atherosclerosis particularly vulnerable to ED. Being overweight and getting too little exercise also contribute to ED. Studies indicate that men who exercise regularly have a lower risk of ED.
Causes of ED: Surgery
Surgery, including treatments for prostate cancer, bladder cancer, or BPH can sometimes damage nerves and blood vessels near the penis. In some cases, the nerve damage is permanent, and the patient will require treatment to achieve an erection. In others, surgery causes temporary ED that improves on its own after 6 to 18 months.
Causes of ED: Medication
ED may be a side effect of medication, including certain blood pressure drugs, antidepressants, and tranquilizers. Men should talk with their doctor if they suspect a prescription or over-the-counter drug may be causing erectile problems. Never stop any medicine without first consulting your doctor.
Causes of ED: Psychological
ED usually has something physical behind it, particularly in older men. But psychological factors can be a factor in many cases of ED. Experts say stress, depression, poor self-esteem, and performance anxiety can short-circuit the process that leads to an erection. These factors can also make the problem worse in men whose ED stems from something physical.
ED and Bicycling
Research suggests avid cyclists suffer more ED than other athletes. The trouble lies in the shape of some bicycle seats that put pressure on the perineum. This area between the anus and scrotum contains arteries and nerves vital to sexual arousal. Cyclists who ride for many hours each week may benefit from seats designed to protect the perineum.
To diagnose ED, your doctor will ask you questions about your symptoms and medical history. The doctor will conduct a complete physical exam to uncover signs such as poor circulation or nerve trouble. And your physician will look for abnormalities of the genital area that could cause problems with erections.
Diagnosing ED: Lab Tests
Several lab tests can help diagnose male sexual problems. Measuring testosterone levels can determine whether there is a hormonal imbalance, which is often linked to decreased desire. Blood cell counts, blood sugar levels, cholesterol levels, and liver function tests can reveal medical conditions that may account for ED.
ED: A Sign of Heart Disease?
In some cases, ED can be a warning sign of more serious disease. One study suggests ED is a strong predictor of heart attack, stroke, and death from cardiovascular disease. The researchers say all men diagnosed with ED should be evaluated for cardiovascular disease. This does not mean every man with ED will develop heart disease, or that every man with heart disease has ED, but patients should be aware of the link.
Treating ED: Lifestyle Changes
Many men with ED are able to improve sexual function by making a few lifestyle changes. Giving up smoking, losing weight, and exercising more often can help by improving blood flow. If you suspect a medication could be contributing to ED, talk to your doctor about adjusting the dosage or switching to another drug.
Treating ED: Oral Medications
You’ve probably heard of Viagra, but it’s not the only pill for ED. This class of drugs also includes Cialis, Levitra, Staxyn, and Stendra. All work by improving blood flow to the penis during arousal. They’re generally taken 30-60 minutes before sexual activity and should not be used more than once a day. All require an OK from your doctor first for safety.
Treating ED: Injections
While pills for ED are convenient, some men sustain stronger erections by injecting medication directly into the penis. Drugs approved for this purpose work by widening the blood vessels, causing the penis to become engorged with blood. Another option is inserting a medicated pellet into the urethra. The pellet can trigger an erection within 10 minutes.
Treating ED: Vacuum Devices (Pumps)
Vacuum devices for ED, also called pumps, offer an alternative to medication. The penis is placed inside a cylinder. A pump draws air out of the cylinder, creating a partial vacuum around the penis. This causes it to fill with blood, leading to an erection. An elastic band worn around the base of the penis maintains the erection during intercourse.
Treating ED: Surgery
If ED is caused by a blockage in an artery leading to the penis, surgery can often restore blood flow. Good candidates are typically younger men whose blockage stems from an injury to the crotch or pelvis. The procedure is not recommended for older men with widespread narrowing of the arteries.
Treating ED: Implants
In men with persistent ED, a penile implant can restore sexual function. An inflatable implant uses two cylinders that are surgically placed inside the penis. When an erection is desired, the man uses a pump to fill the cylinders with pressurized fluid. Another option is a malleable implant, which bolsters erections with surgically implanted rods.
Treating ED: Psychotherapy
Even when ED has a known physical cause, psychotherapy can be beneficial. 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.
Treating ED: Alternative Therapies
Talk with your doctor before trying supplements for ED. They can contain 10 or more ingredients and may complicate other health conditions. Asian ginseng and ginkgo biloba (seen here) are popular, but there isn’t a lot of good research on their effectiveness. Some men find that taking a DHEA supplement improves their ability to have an erection. Unfortunately, the long-term safety of DHEA supplements is unknown. Most doctors do not recommend using it.
A quick web search will reveal dozens of “dietary supplements” that claim to treat ED. But the FDA warns that many of these are not what they seem. An investigation discovered the pills often contain prescription drugs not listed on the label, including the active ingredient in Viagra. This puts the man at risk for dangerous drug interactions.
Some tips to reduce the risk of ED include:
It’s natural to feel angry or embarrassed when dealing with ED. But don’t forget that your partner is also affected. Talking openly about ED will help your partner understand the diagnosis and treatment options. This can reassure a partner that you haven’t lost interest.
Author: Dr. Aslam Naveed
Publisher: Javed Ali