Erectile Dysfunction

 What is Erectile Dysfunction (ED)?

Erectile dysfunction, or ED, is when a man can't get or keep an erection that is strong enough for sexual activity. Estimates show that 1 out of 10 men will have ED at some point in their lives. It is important to know that most of the time, ED is a sign of a bigger problem. ED is not normal at any age, and it may be linked to other problems that make it hard to have a sexual relationship, like a lack of desire or trouble getting orgasmic or ejaculating.

How common is trouble getting an erection?

About one out of every ten adult men will have ED for a long time.

Many men do sometimes have trouble getting an erection. This can happen for a number of reasons, like drinking too much alcohol, being stressed, having relationship problems, or being very tired.

If you can't get an erection less than 20% of the time, it's not unusual and usually doesn't mean you need to see a doctor. But if you can't get an erection more than 50% of the time, this is usually a sign that there is a problem that needs to be treated.

ED doesn't have to come with growing older. Even though some older men may need more stimulation to get an erection, they should still be able to get one and enjoy sexual activity.

What causes problems with getting an erection?

ED can be caused by several things, such as:

• Vascular disease: Vascular diseases like atherosclerosis can cause the blood supply to the penis to become blocked or narrowed (hardening of the arteries).
• Neurological diseases (like multiple sclerosis): A stroke, diabetes, or other conditions can damage the nerves that send signals to the penis.
• Psychological states include stress, depression, boredom in the brain, and performance anxiety.
• Trauma: An injury could contribute to ED symptoms.
• ED can also be caused by a long-term illness, some medications, or a condition called Peyronie's disease. Operations for prostate, bladder, and colon cancer may also be a factor.

What kinds of medicines could cause impotence or Erectile Dysfunction?

Erectile dysfunction (ED) is a common side effect of many prescription drugs. Even though these medicines are used to treat a disease or condition, they can affect a man's hormones, nerves, or blood flow. This can cause ED or make it more likely to happen.

If you have ED and think it might be because of a drug you are taking, don't stop taking the drug. If the problem keeps happening, talk to your doctor. He or she might be able to give you a different drug. Some common medicines may list ED as a possible side effect.

Diuretics (pills that cause increased urine flow).

Antihypertensives (high blood pressure drugs).

Antihistamines.

Antidepressants.

Parkinson's disease drugs.

Counterrhythmics (a drug for irregular heart action).

Tranquilizers.

Muscle relaxants.

Nonsteroidal anti-inflammatory drugs.

Antagonists for histamine H2-receptors.

Hormones.

Medications for chemotherapy.

Prostate cancer drugs.

Anti-seizure medications.

What other drugs or substances can lead to impotence?

These recreational and commonly abused drugs can also cause or lead to erectile dysfunction (ED):

Alcohol.

Amphetamines.

Barbiturates.

Cocaine.

Marijuana.

Methadone.

Nicotine.

Opiates.

Aside from the known problems that using or abusing these drugs can cause, ED is not often talked about. But using these drugs puts you at risk for ED. These drugs not only affect the central nervous system and often slow it down, but they can also cause serious damage to the blood vessels, which can lead to permanent ED.

What is the link between depression and erectile dysfunction?

For some men, erectile dysfunction might be accompanied by depression (ED). It is normal for males with ED to experience feelings of anger, frustration, sadness, self-doubt, and even diminished masculinity. Such emotions may result in low self-esteem and, in extreme circumstances, depression.

Depression associated with ED is treated. Being honest with yourself, your spouse, and your doctor is the first step in addressing your worries about ED-related depression. After depression has been exposed, it will be easier and less stressful to deal with it.

ED DIAGNOSIS AND TESTS

How do doctors detect erectile dysfunction (ED)?

As there is a range of causes for erectile dysfunction (ED), there are a number of tests that your doctor may use to diagnose the problem and identify its cause. Effective treatment of erectile dysfunction is not possible until the underlying cause has been identified.

Before ordering any tests, your doctor will evaluate your medical history and complete a thorough physical examination. In addition, the physician will "interview" you about your personal and sexual past. Some of these questions will be extremely intimate and may feel intrusive. It is essential, however, that you answer these questions truthfully. These may be among the questions asked:

• What medications or drugs do you presently take? This includes prescription medications, OTC drugs, herbs, nutritional supplements, and illegal substances.
• Have you ever had psychological issues like worry, stress, or depression?
• When did you first become aware of ED symptoms?
• What is the frequency, quality, and length of any erections you've experienced?
• What are the particular conditions that led to the onset of ED?
• Do you suffer erections at night or in the early morning?
• What sexual practices do you use?
• Exist any issues in your present relationship?

The doctor may also wish to interview your sexual partner, as your partner may be able to shed light on the underlying issues.

After conducting a physical examination and discussing your condition, your doctor may recommend any of the following diagnostic procedures:

Complete blood count (CBC): This set of blood tests can, among other things, find out if someone has anemia. A low number of red blood cells is what causes anemia, and fatigue can lead to ED.

Liver and kidney function tests: These blood tests can help you find out if your ED is caused by your kidneys or liver not working right.

Lipid profile: This blood test checks how much cholesterol and other fats are in the body. High levels may be a sign of atherosclerosis, which is a hardening of the arteries that can affect the flow of blood to the penis.

Thyroid function test: One job of thyroid hormones is to control how much sex hormones are made, and a lack of these hormones may cause or contribute to ED.

Blood hormone studies: The levels of testosterone and/or prolactin in the blood can be checked to see if there are any problems with either of these sex hormones.

Urinalysis: Analysis of urine can tell a lot about a person, such as how much protein, sugar, and testosterone they have in their bodies. ED can be caused by diabetes, kidney disease, or a lack of testosterone, all of which can be shown by abnormal levels of these substances.

Duplex ultrasound: This is probably the best way to find out if someone has ED. An ultrasound takes "pictures" of the body's tissues by using high-frequency sound waves. People with ED may get an ultrasound to check their blood flow and look for signs of a vein leak, atherosclerosis (hardening of the arteries), or scarring of the tissue. This test is done both when the penis is straight (usually after a drug that causes erections is injected) and when it is soft.

Bulbocavernosus reflex: This test checks how sensitive the nerves are in the penis. During the test, your doctor will squeeze the top of your penis. This should make your anus contract right away. If nerve function isn't normal, it will take longer for people to react.

Nocturnal penile tumescence (NPT): This test checks a man's ability to get and keep an erection while he's sleeping. A man will usually get five or six erections while he is sleeping. If you don't get these erections, it could mean that your nerves aren't working right or that blood isn't getting to your penis. There are two ways to do the test: with a snap gauge and with a strain gauge. For the snap gauge method, three plastic bands of different strengths are wrapped around the penis. The man's ability to get and keep an erection is then based on which of the three bands breaks. In the strain gauge method, elastic bands are wrapped around the tip and base of the penis. If the penis stands up during the night, the bands will stretch and show how much the penile circumference has changed.

Penile biothesiometry: This test uses electromagnetic vibrations to find out how sensitive a person is and how well their nerves work. If you feel less of these vibrations, it could mean that your nerves are damaged.

Vasoactive injection: During this test, an erection is made by injecting special solutions that make the blood vessels widen, which lets blood flow into the penis.

Dynamic infusion cavernosometry: Men with ED who have a venous leak take this test. Fluid is pumped into the penis at a certain rate during this test. Doctors can figure out how bad a venous leak is by measuring the rate at which fluid must be pumped to get a firm erection.

Cavernosography: In this test, a dye is injected into the penis. This test is done along with the dynamic infusion cavernosometry. The vein leak can then be seen on an X-ray of the penis.

Arteriography: People who want to have vascular reconstructive surgery are given this test. The damaged artery is injected with a dye, and X-rays will be taken.

Before any of these tests, your doctor will talk to you about what will happen. Don't be afraid to ask your doctor if you have any questions. You can consult online too with an online sexologist. To know more about Erectile Dysfunction treatment options or dignosis.

What kinds of doctors treat erectile dysfunction?

ED is treated by a different type of doctor depending on what's causing it. Your doctor may treat you with oral medications (Viagra®, Levitra®, Cialis®) based on the health of your family as well as your own health and medical history.

If these don't work, you may be sent to a urologist who can help with other non-surgical options like a vacuum device, injections, or surgery. If you need it, your doctor may also suggest that you see a psychologist who specializes in sexual problems.

Treatment options for erectile dysfunction

There are many ways to treat ED, such as:

• Taken by mouth.
• Sex counseling.
• Injections in the penis.
• Vacuum devices.
• Medication is put into the urethra.
• Surgery (penile implant).
• The pros and cons of each type are different. Talk to your doctor about your options to figure out what the best treatment is for you.

To treat Erectile Dysfunction, the first step is to find out what's causing it. The right treatment can then start. A man can get back to normal sexual function in a number of ways, both with and without surgery.

What treatments for erectile dysfunction (ED) don't involve surgery?

Education and communication

A man may be able to get over his worries about sexual dysfunction if he learns more about sex, sexual behaviors, and sexual responses.

Talking openly with your partner about your needs and worries can also help you get past many things that are getting in the way of healthy sex life.

Medication

By bringing more blood to the penis, medicines like sildenafil (Viagra®), vardenafil (Levitra®), and tadalafil (Cialis®) may help men have better sexual function. Men who are taking nitrate-based drugs like nitroglycerine shouldn't take oral ED drugs. Low blood pressure can be caused by the combination of nitrates and these specific medications (hypotension).

Most of the time, these medicines cause an upset stomach, stuffy nose, flushing, headaches, or a temporary change in vision.

Mechanical aids

Some men use vacuum devices and penile constriction rings to help them get and keep an erection.

A vacuum constriction device (pictured above) is a cylinder that goes over the penis. When the air is pumped out of the cylinder, it draws blood into the penis and causes an erection. To keep the erection going, you slide a band off the bottom of the cylinder and onto the bottom of your penis. The band can stay in one place for up to 30 minutes. Most causes of erectile dysfunction can be treated safely with a vacuum device. Patients seem to be most worried about the lack of spontaneity, discomfort, and bulkiness of the device.

Penile injection therapy (intracavernosal injection therapy)

Men are taught how to directly inject drugs into the chambers of the penis that cause erections. Injection therapy works for a wide range of erection problems caused by problems with blood vessels, nerves, or mental health.

The man puts a small amount of medicine into the side of his penis with a tiny needle and syringe. Blood can flow into the penis because the medicine makes the blood vessels relax. Since the early 1980s, many people have used and agreed on this treatment. Prostaglandin E1 (alprostadil), papaverine (Papacon®), and phentolamine (Regitine®) are the three most common medicines.

Most people experience pain and scarring in the penile area (fibrosis). In very rare cases, people with brain and blood vessel diseases or severe heart problems might not be able to handle the dizziness and high blood pressure that can sometimes happen when they get injection therapy.

A painful erection that lasts longer than two to three hours is called priapism, and it can happen after injection therapy. This can be lessened by giving the right dose and following the directions for treatment.

Psychology and sex therapies

Even when there is a clear physical cause, erectile dysfunction can be caused or made worse by psychological factors.

With the help of a trained counselor, a person can deal with feelings of anxiety, fear, or guilt that may be causing sexual dysfunction.

When counseling is done by a skilled sex therapist, most men can benefit from sex therapy. Sex therapy also helps the man's partner understand and deal with the problems.

Before more invasive treatments are tried on a person with ED who has a clear psychological cause, sex therapy counseling should be tried first.

Hormone

ED may be caused by a lack of hormones. After a doctor checks you out, you can use gels, creams, patches, injections, or pellets to replace hormones.

What kinds of surgery can be used to treat erectile dysfunction (ED)?

Surgery for a penile prosthesis

During outpatient surgery, prosthetic penises that can be inflated are put in. Once they are in a man's body, they give him the ability to get an erection whenever he wants. Most men can still feel sensation, have an orgasm, and ejaculate when they use a prosthesis.

Most penile implants are made up of two inflatable cylinders that are surgically placed in the penis' erection chambers. The cylinders are linked by tubes to a reservoir of fluid under the lower abdominal muscles and to a pump inside the scrotal sac.

The man squeezes the pump a few times to move fluid from the reservoir to the cylinders. This makes the penile prosthesis bigger. This makes the penis stand straight up. When the prosthesis is inflated, it makes the penis stiff and thick, just like a natural erection.

A penile prosthesis doesn't change how a man's penis feels or his ability to have an orgasm or ejaculate. When you press a deflation valve on the pump, the fluid goes back into the reservoir, which makes the penis lose again.

The surgery is done through one or two small cuts that are usually not very noticeable. People won't be able to tell that a man has a penile prosthesis that is inflated. Infections and broken mechanical devices are the most common problems that can happen after surgery.

About 95% of penile implant surgeries are successful at giving men erections that let them have sexual relationships. Also, patient satisfaction surveys show that up to 90% of men who have had penile implants say they would do it again, and their overall satisfaction is higher than that of men who use oral medications or penile injection therapy.

Can erectile dysfunction (ED) be avoided?

People who are more likely to get erection problems because of how they act can take steps to try to stop it from happening. But some causes may not be able to be stopped.

ED has been linked to obesity, high cholesterol, high blood pressure, diabetes, and heart disease by a number of studies.

The following suggestions might help stop ED or make it better if it already happens:

Eating well is important. Men with ED can benefit from a diet that limits the amount of saturated fat they eat and has a lot of fruits, vegetables, and whole grains.

Cut down on cholesterol. High cholesterol can cause atherosclerosis, which can harden, narrow, or block the arteries that lead to the penis. Men can lower their cholesterol by eating right, working out, and taking medicine.

Keep your weight in a good range.

Exercise regularly. ED may be less likely to happen if you work out regularly. Choose exercises that you will do every day because you enjoy them. Aside from lowering your risk of ED, exercise can also help you deal with stress. Before you start an exercise program, talk to your doctor or book a sex doctor online consultation.

Conclusion:

We hope this information will help you to make your body sexual dysfunction free. If you are looking for a better understanding of Erections problems during Sex. Find an erectile dysfunction doctor who follows the patient-centric approach “The needs of the patients come first”.  He will suggest you proper erectile dysfunction treatment after finding the root cause of ed.