Erectile dysfunction (ED) is quite common, affecting men of all ages. There are many organic (physical) and psychogenic (psychological) causes of ED. Physical factors include medical conditions such as diabetes, obesity, heart disease, high blood pressure, low testosterone, while psychogenic factors include conditions such as depression, performance anxiety, stress or relationship issues. Cigarette smoking, excessive alcohol consumption, illicit drug use and side effects from some prescription medications can also adversely affect erectile function.
Symptoms of ED may include:
Diagnosing ED generally begins with a patient history and physical examination. Identifying common cardiovascular risk factors such as obesity, high blood pressure, high cholesterol, diabetes, smoking habits as well as identifying possible common psychological causes will be an important initial step in establishing a diagnosis and offering appropriate subsequent counseling.
Part of this diagnostic process may also include reviewing medication side effects, obtaining blood tests such as testosterone levels, evaluating penile blood flow with an Ultrasound and referring to a cardiologist for a consultation as well.
Healthy lifestyle changes can significantly improve not only your overall health but also your erectile function. Losing weight, quitting smoking, regularly exercising and adopting a heart healthy diet are all important in achieving a healthy lifestyle and improving your erectile function as well as your sex drive.
Lifestyle changes alone may not be sufficient to give you an erection you desire or the erection may be inadequate for sexual activity. Medications may therefore be considered. Common oral ED medications include Viagra (sildenafil), Cialis (tadalafil) and Levitra (vardenafil). Other treatments available include vacuum erection devices, vasodilating medications (these dilate blood vessels to allow more blood flow to the penis) that are either directly injected into the shaft of the penis or introduced into the urethra.
More invasive treatment options include surgical implantation of penile prosthetics.
Sometimes testosterone replacement therapy may be necessary for patients with low testosterone levels and decreased sex drive.
Finally, a referral to a sex therapist may be recommended as well especially if psychogenic causes are thought to be predominantly responsible for the ED.
Most people do not need surgery for their ED. There are many other options that are either not or are only very minimally invasive that can be tried first.
Reasons for ED in any one person are often many and my require a thorough evaluation to determine which ones might be the major contributors. Older men with chronic illnesses are more likely to have ED secondary to medical causes while younger and healthier individuals are more likely to experience ED secondary to psychological causes. It is also possible for some men to have both psychological and medical reasons for their ED.
Some medications are designed to be taken daily, while others are just taken as needed. Some men may require the medications for a short period of time and others may depend on them for a longer period of time.
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