Erectile Dysfunction Treatment
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Erectile dysfunction, or ED, is when it is hard to get or keep an erection that’s firm enough for sex.
ED can happen when health problems limit blood flow or damage nerves in the penis. ED can be an early warning of a more serious illness.
How Erections Work
During sexual arousal, nerve messages release chemicals that increase blood flow into the penis. The pressure of the blood in the chambers makes the penis firm, giving you an erection. After you have an orgasm, the blood flows out of the chambers and the erection goes away.
What Causes ED?
Physical Causes of ED
- Age Over 50
- High Blood Sugar (diabetes)
- High Blood Pressure
- High Cholesterol
- Cardiovascular Disease
- Drug or Alcohol Abuse
- Lack of Exercise
Emotional Causes of ED
- Relationship conflicts
- Stress at home or work
- Worry about sexual performance
How is ED Diagnosed?
Health and ED History
Certain medicines may cause your ED. Also, smoking or alcohol use can affect erections. Your physician will ask you pertinent questions regarding any health problems you have, specific questions regarding ED and also about your stress/emotional health.
A physical exam checks overall health. This may involve checking your blood pressure, penis, testicles and prostate.
To test for diseases that cause ED, your physician may order blood tests and collect a urine sample.
A duplex ultrasound checks for blood flow, vein leaks, scars on erectile tissue and some signs of clogged arteries. If you take this test, you may be given an injection into your penis to cause an erection. The technician can then see how the blood flow and pressure changes in your penis, as well as how it expands.
How is ED Treated?
Drugs known as PDE-5 inhibitors (Viagra, Cialis) relax muscle cells in the penis and increase blood flow. Men with ED take these pills before having sex. The side effects of PDE-5 inhibitors are mild (headaches, flushing) and often last just a short time. Do NOT take these medicines if you are taking NITRATES!
Penile Injection Therapy
The drug is injected into the side of penis with a very fine needle. The success rate for getting an erection firm enough to have sex is as high as 85%.
A 3-part inflatable penile implant has paired cylinders, a scrotal pump, and a fluid reservoir in the belly. Penile implants are usually placed under anesthesia, during a 1-hour surgery. Usually 1 small surgical cut is made either above the penis where it joins the abdomen or under the penis where it joins the scrotum. Men can often be taught how to use the prosthesis for sex 1 month after surgery.
Vacuum Erection Device, MUSE intraurethral suppository
Dietary supplements (often called “herbal remedies”) for ED are popular but may not be safe or even work. Unlike prescription drugs, they do not have to be proven to work to be sold.
Frequently Asked Questions
How do I know my ED is not in my head?
Most men have an underlying physical cause of ED, but often both physical and psychological factors will affect ED.
If I worry about being able to get an erection, can I make a bad condition worse?
Nothing happens in the body without the brain. Worrying about your ability to get an erection can make it difficult to get one. This is called performance anxiety and can be overcome with education and treatment.
Can I combine treatment options?
This is often done. But because erections can last too long with drug therapy, combining treatment should only be done after talking with your physician.