Early Knowledge on Erectile Dysfunction

Erectile Dysfunction Definition, Causes, and Treatment

Erectile dysfunction has various causes, and it is essential to identify the underlying cause to address it properly.

In general, an erection occurs when blood flow to the penis increases due to sexual stimulation. The erection ends when the muscles in the blood vessels contract, and blood flows out through the veins of the penis.

However, some men may experience erectile dysfunction (impotence), which is the inability to get and maintain an erection strong enough for sexual intercourse. Find out the causes of erectile dysfunction and proper treatment methods here.

What Is Erectile Dysfunction?

Erectile dysfunction is a condition in which a man cannot get or maintain an erection strong enough for satisfactory sexual intercourse. Erectile dysfunction can be a short-term or long-term problem. There are three categories of erectile dysfunction:

  1. Occasional erectile dysfunction, not happening every time you want to have sexual intercourse.
  2. An erection does not last long enough for satisfying sexual intercourse.
  3. Inability to have an erection at all.

Medical professionals, such as general doctors and andrology specialists, can often treat erectile dysfunction. Andrology is a branch of medicine that focuses on male reproductive health issues such as sexual dysfunction and fertility disorders. Some male reproductive organ problems that can be addressed by an andrologist include:

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  1. Infertility
  2. Decreased libido (sex drive)
  3. Andropause
  4. Erectile dysfunction, including premature ejaculation, delayed ejaculation, and impotence
  5. Male sexual hormone disorders (hypogonadism)
  6. Prostate disorders

The prevalence of erectile dysfunction increases with age. The University of Wisconsin estimates that mild or moderate erectile dysfunction affects 10% more in older men. In fact, about 60% of men in their 60s may experience some form of erectile dysfunction.

However, erectile dysfunction can also occur in young men. A study in 2013 found that 1 in 4 men aged 40 sought treatment for erectile dysfunction.

Based on research, it was observed that smoking and the use of certain medications are more associated with erectile dysfunction than age-related factors. This suggests that lifestyle choices are essential in preventing erectile dysfunction.

Causes of Erectile Dysfunction

Erectile dysfunction can be caused by several factors, including:

  1. Vascular diseases: Blood supply to the penis can be obstructed or narrowed due to vascular diseases like atherosclerosis (hardening of the arteries).
  2. Neurological disorders (such as multiple sclerosis): Nerves sending impulses to the penis may be damaged due to stroke, diabetes, or other causes.
  3. Psychological conditions: Including stress, depression, lack of stimulation from the brain, and performance anxiety.
  4. Trauma: Injuries can contribute to erectile dysfunction. Chronic illnesses, the use of certain medications, and conditions such as Peyronie’s disease can also cause erectile dysfunction. Surgeries on the prostate, bladder, and colon may also be contributing factors.
  5. Medication effects on Erectile Dysfunction Erectile dysfunction can also be caused by the consumption of certain medications. If you are regularly taking medication and experiencing erectile dysfunction, do not stop the treatment, but consult with your doctor.

The doctor may prescribe alternative medications. Some common drugs that may cause erectile dysfunction are:

  • Diuretics (medications that increase urine flow).
  • Antihypertensive drugs (high blood pressure medications).
  • Antihistamines.
  • Antidepressants.
  • Parkinson’s medications.
  • Antiarrhythmic drugs (medications for heart rhythm disorders).
  • Anxiolytics (anti-anxiety drugs).
  • Nonsteroidal anti-inflammatory drugs.
  • H2 receptor antagonists.
  • Chemotherapy drugs.
  • Prostate cancer drugs.
  • Antiepileptic drugs.

Other substances or drugs that can cause or affect erectile dysfunction include commonly abused illegal drugs such as:

  • Amphetamines.
  • Barbiturates.
  • Cocaine.
  • Marijuana.
  • Methadone.
  • Nicotine.
  • Opiates.

These drugs not only affect and often suppress the central nervous system but can also cause serious damage to blood vessels, leading to permanent erectile dysfunction.

Diagnosis for Erectile Dysfunction

There are several examinations that doctors will perform to determine the cause of a man’s erectile dysfunction. Some of the examinations include:

  1. Physical examination: During a physical examination, the doctor will examine the penis and conduct a nerve examination to evaluate sensation.
  2. Blood tests: Your blood sample can be sent to a laboratory to check for signs of heart disease, diabetes, low testosterone levels, and other health conditions.
  3. Urinalysis: Like blood tests, urinalysis is used to look for signs of diabetes and other underlying health conditions.
  4. Ultrasound (USG): This test is usually performed by a specialist in a clinic. Using a device like a transducer, the doctor will scan the blood vessels that supply the penis to obtain a video image and evaluate blood flow.
  5. Blood, urine tests, and USG may be performed together with injections of drugs into the penis to stimulate blood flow and cause an erection.
  6. Psychological tests: During psychological examination, the doctor may ask questions to evaluate depression and other possible psychological causes of erectile dysfunction.

Treatment of Erectile Dysfunction

Depending on the cause and severity of your erectile dysfunction, as well as the underlying health conditions, several treatment options are available. The doctor can explain the risks and benefits of each treatment and consider your preferences. Your partner’s preferences may also influence the treatment options you choose.

Here are some treatment options for erectile dysfunction:

  1. Oral Medications Some oral medications that doctors usually prescribe for the treatment of erectile dysfunction are:
    • Sildenafil (Viagra)
    • Tadalafil (Adcirca, Cialis)
    • Vardenafil (Levitra, Staxyn)
    • Avanafil (Stendra)

    These four drugs can enhance the effect of nitric oxide, a natural chemical produced by the body to relax the muscles in the penis. This increases blood flow and allows men to achieve an erection in response to sexual stimulation.

    Taking one of these medications will not automatically give you an erection. Sexual stimulation is required first to cause the release of nitric oxide from the nerves of your penis.

    Each medication may have different dosages, duration of effect, and side effects. Possible side effects include nasal congestion, headaches, visual changes, back pain, and stomach upset. The doctor will consider your condition to determine which drug is suitable for you.

    Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal treatments, consult with your doctor first. Erectile dysfunction drugs do not work for everyone and may be less effective in certain conditions, such as after prostate surgery or if you have diabetes.

  2. Alprostadil Injections Alprostadil injections involve using a fine needle to inject alprostadil (Caverject, Edex) into the base or side of the penis. Each injection is given in a dose to create an erection that lasts no longer than one hour.Because the needle used is very fine, the pain from the injection site is usually mild. Side effects may include slight bleeding from the injection, prolonged erection (priapism), and, rarely, the formation of fibrous tissue at the injection site.
  3. Alprostadil Urethral Suppositories Alprostadil urethral suppositories are an intraurethral Alprostadil therapy (Muse), where you insert a small alprostadil suppository into the penis through the urethra using a special applicator to place the suppository in the urethra.An erection usually begins within 10 minutes and, if effective, lasts between 30 to 60 minutes. Side effects may include a burning sensation in the penis, slight bleeding in the urethra, and the formation of fibrous tissue inside the penis.
  4. Testosterone Replacement Testosterone replacement may be recommended as a first step or may be given in conjunction with other therapies if a person is experiencing erectile dysfunction that may be related to low testosterone levels.If medications are not effective or not suitable for you, the doctor may recommend alternative treatments such as:
  5. Penis Pump A vacuum erection device that consists of a hollow tube and a hand or battery-operated pump. The tube is placed over the penis, and then the pump is used to create a vacuum that draws blood into the penis.After an erection occurs, a tension ring is placed at the base of the penis to keep the blood inside. The pump is then removed after sexual intercourse. Side effects include bruising on the penis and limited ejaculation.
  6. Penis Implants A surgical procedure involving the placement of a device on both sides of the penis. The implant can be an inflatable rod (can be pumped to create an erection) or a malleable rod (maintains rigidity but can be bent). Penis implants are usually recommended after other methods have failed.High levels of satisfaction have been reported by those who have tried other therapies without success. Penis implant surgery carries risks of complications such as infection and is not recommended if you have a urinary tract infection.
  7. Exercise Recent research indicates that exercise, especially moderate to vigorous aerobic activity, can improve erectile dysfunction. It doesn’t have to be overly intense exercise; regular physical activity can reduce the risk of erectile dysfunction. Increasing your level of physical activity can also reduce this risk.
  8. Consultation with a Psychologist If erectile dysfunction is caused by stress, anxiety, or depression, or if the condition causes stress and tension in the relationship, the doctor may suggest you and your partner seek counseling from a psychologist or counselor.

In essence, the right treatment options will be tailored to your condition and needs, as well as considering the advice of the doctor. Therefore, if you experience erectile dysfunction, try to consult with a doctor to get the proper treatment.

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Sources:

  • National Institute of Diabetes and Digestive and Kidney Diseases. Accessed 2023. Definition & Facts for Erectile Dysfunction https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts
  • Mayo Clinic. Accessed 2023. Erectile Dysfunction https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776
  • Healthline. Accessed 2023. Erectile Dysfunction (ED): Symptoms, Causes, Diagnosis, and Treatment https://www.healthline.com/health/erectile-dysfunction
  • Cleveland Clinic. Accessed 2023. Erectile Dysfunction https://my.clevelandclinic.org/health/diseases/10035-erectile-dysfunction
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