Erectile Dysfunction

Erectile Dysfunction Treatments – When Do I Need It?

Erectile Dysfunction (ED), colloquially known as impotence, is common as men progress with age. Men with ED number over 30 million men in the United States.

Although Erectile Dysfunction is not a life-threatening condition, many men often find it difficult to breach this topic with partners or their doctor(s). Erectile dysfunction can lead to unsatisfactory sex life, complicated with a loss of intimacy shared between you and your partner, and inability to impregnate your partner.

Other factors that are attributed to causing ED in men can be emotional, such as anxiety, depression and low self-esteem. Many men with ED find the emotional aspect further compounded with the onset of the condition. The resulting inability to provide satisfactory sexual function leads to a vicious cycle of distress and unhappiness with themselves. Hence, it is important to seek Erectile Dysfunction treatments ASAP.

Symptoms Of Erectile Dysfunction (Ed)

Erectile Dysfunction is a form of sexual dysfunction when men are unable to get or sustain an erection sufficient for satisfactory sexual intercourse and other sexual functions.

Symptoms include:

  • Able to achieve an erection at times, but not every time when you want to have sex
  • Able to achieve an erection, but unable to sustain long enough for sex
  • Unable to achieve an erection at any point

Causes Of Erectile Dysfunction (Ed)

If Erectile Dysfunction keeps happening, this can be a sign of underlying health conditions.

Erectile Dysfunction can be caused by physical or psychological problems.

Physical causes:

  • Hypertension
  • Diabetes
  • Heart disease
  • Low testosterone hormone
  • Medication (such as blood pressure medication, prostate cancer medication, antidepressants, appetite suppressants, mood medications and sedatives)
  • Neurological conditions (such as multiple sclerosis, injury to spinal cord and nerve supply to penis, prostate, bladder, pelvis)
  • Blood vessels conditions (cavernosal insufficiency)
  • Structural impairment (Peyronie’s disease, prostate disease

Psychological causes:

  • Anxiety
  • Stress
  • Depression

Lifestyle and behaviours that can be associated with Erectile Dysfunction:

  • Smoking
  • Obesity
  • Sedentary lifestyle
  • Excessive alcohol drinking
  • Use of recreational drugs

What Do I Expect When I Consult My Doctor For Erectile Dysfunction (Ed) Treatment?

Your doctor will take a thorough medical history including questions on your lifestyle and relationship. Advice may be given to make lifestyle changes that may help improve ED, or to better manage ED symptoms. The physical examination will include blood pressure measurement, genital blood flow, prostate, and rectal examination.

Depending on individuals, your doctor may offer you blood tests to screen for any diabetes, cholesterol, hormonal issues. Doppler Ultrasound may be offered to evaluate the blood flow to your penis in an outpatient setting.

Other tests

Nocturnal erection test: It is a test to measure the number and length of erections at night. Men undergoing this test are advised to wear a plastic ring-like device around the penis while asleep. In normal men, each night during sleep, one would experience 3-5 erections. If you do have erections during this test, the likely cause of Erectile Dysfunction is due to psychological or emotional causes.

Injection test: This is a test performed by your doctor by injection of a medicine into your penis to induce erection. The clinician will then measure the fullness of the penis and how long the erection can last.

What Are Some Erectile Dysfunction (Ed) Treatments?

Healthy Lifestyle Changes

  • Quit smoking
  • Healthy eating
  • Increase physical activity, maintain healthy body weight
  • De-stress and manage your anxiety
  • Avoid excessive alcohol consumption (drink < 14 units per week)
  • Stop any illegal drug usage

Behavioural therapy and Counselling

Psychotherapy, behavioural challenges, and appropriate sexual therapy may be beneficial for psychological causes of Erectile Dysfunction. Many men with ED find that with the appropriate lifestyle changes in place, bettered health may help improve ED symptoms, increase performance and sexual function.

Oral medication (PDE5 inhibitors- Phosphodiesterase-5 inhibitors)

Medication treatment works by relaxing the smooth muscle and increasing blood flow into the penis during sexual stimulation. You should not take these medications together with nitrates which are commonly used to treat heart diseases. Nitrates can relax the blood vessel. Combination use of both medications can lead to unwanted side effects such as sudden drops in blood pressure, leading to fainting spells, dizziness, falls, and other injuries.

Common side effects men experience with PDE5 inhibitors include headache, nose congestions, feeling of flushed, muscle pain. Rarely, oral medication can be associated with vision and colour loss, please consult your doctor if you develop this rare side effect.

Other Oral medications

This will depend on the underlying cause of Erectile Dysfunction. Options include:

  • Hormone replacement –testosterone replacement
  • Alpha-blockers in cases of prostate enlargement

Other Erectile Dysfunction (Ed) Treatments

Injectable medicine and suppositories

A self-injecting medicine called alprostadil can be administered into the penis, leading to increased blood flow and causing a rapid sustainable erection. Your doctor will demonstrate the use of the injections.

Alprostadil can also be given in a pellet form and self-administered through insertion into the urethra. Do discuss with your doctor on treatment options and methods that you are comfortable with.

Vacuum Device

Vacuum devices can induce an erection by pulling blood into the penis. The use of a vacuum device may need some practice. This can be an option when oral medication is not suitable.

Extracorporeal Shockwave Therapy

This is a repeated session of treatments of delivering low level of shock waves into the penis to aid new blood vessels forming around the penis, hence achieving erections.

Surgery

Surgery is usually the final option when all else fails. This will be guided by a urologist. Surgery for erectile dysfunction involves –

  • Implanting a device to make the penis erect
  • Rebuilding the blood vessels to increase blood flow to the penis

 

*important Side Effects Of Erectile Dysfunction (Ed) Medicine

Pertaining to medicine that you take through your mouth, injection, or suppositories to your urethra, there is a risk of prolonged painful erection known as priapism. If your erection last > 4 hours, please speak to your doctor.

 

Living With Erectile Dysfunction (Ed)

It is important to understand there are treatment options for Erectile Dysfunction and other sexual health problems and you are not alone. Healthy sex life can improve one’s quality of life and overall wellbeing, so never be afraid to talk to your doctor about this.

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