Erectile Dysfunction Treatment

Erectile Dysfunction

"Erectile Dysfunction affects at least 12 million men in the United States"

I am pretty sure you would have probably seen this statement on erectile dysfunction somewhere..

But did you know that India of all countries is currently the…

Impotence capital of the world

Surprised!. I am not…

In this article I am going to tell you everything you need about erectile dysfunction (ed)

Erectile Dysfunction affects at least 50% of men above 40 years of age….

…..Another interesting fact is that ed affects 100% of men at least once in a lifetime.

Erectile Dysfunction definition

Erectile Dysfunction is defined as the inability to achieve a state of erection or to maintain a state of erection that is sufficient enough for a satisfying sexual performance or to complete the sexual act in a way sex is enjoyed mutually by both partners. As one would commonly expect the frequency and incidence of Erectile dysfunction increases as a man ages.

Erectile Dysfunction Test

How do I test for ed?…..

…… Simple go to a Sexologist!

Just Kidding…jokes apart there is a really easy way to assess whether you suffer from erectile dysfunction and really require medical intervention.

Although the questionnaire mentioned below may not replace a professional sexologist opinion it is the closest we have to assess ed as objectively as possible

You can download these pdf’s below from the links on our site.

Answer the questions as honestly as possible and resubmit it to us and we can help you with your issue….if required.

Here is another questionnaire you can fill and answer if you think or feel you suffer from erectile dysfunction….

Table :

Impotence is frequently defined as not being able to get and keep an erection that is rigid enough for satisfactory sexual activity.

How would you describe yourself from a sexual view point?

  1. Not impotent: always able to get and keep an erection good enough for sexual intercourse.
  2. Minimally impotent: usually able to get and keep an erection good enough for sexual intercourse.
  3. Moderately impotent: sometimes able to get and keep an erection good enough for sexual intercourse.
  4. Completely impotent: never able to get and keep an erection good enough for sexual intercourse

 

Erectile Dysfunction Causes

Erectile dysfunction is caused by numerous conditions some directly being a cause and some be an associated medical finding. I have listed over 20 odd common conditions that could lead to erectile dysfunction. Look at the table below.

What would be interesting for you to know is that …

the causes of erectile dysfunction is broadly divided into two categories. Erectile dysfunction caused due to an organic problem and ed caused due to a psychogenic problem..

Erectile Dysfunction Causes (Organic)

Clinical Work up – what is done?

Heart Disease

History /exam/cardiac evaluation

Diabetes

History/ exam/sugar tests

Hypogonadism (deficient sex and reproductive hormones

Hormonal evaluation/history/exam and semen analysis

Hyperprolactinemia (Increased Prolactin levels from a pituitary tumour)

Hormonal evaluation/history/exam and CT scan brain

Thyroid problems

History /exam/thyroid hormone evaluation

Increased Blood Cholesterol

History /exam/BMI/Blood lipid estimation/cardiac assessment

Genital Pain

History /exam

Obesity

History /exam/BMI/Blood lipid estimation/waist measurement

Hypertension

History /exam

Neurological conditions

History /exam

Multiple sclerosis

History /exam

Parkinson’s disease

History /exam/CT scan brain

Spinal Cord Injury

History /exam/CT scan spine

Stroke

History /exam/ CT scan brain/cardiac assessment

Peyronie’s disease

History /exam/Penile doppler

Prostate surgeries

History /exam

Cancer therapies

History /exam

Radiation therapies

History /exam

Erectile Dysfunction (Psychological)

Clinical Work up – what is done?

Anxiety

History /exam/Anxiety assessment questionnaire

Depression

History /exam/Mental health assessment

Guilt

History /exam

Extramarital affairs

History

Childhood sexual abuse

History

Traumatic sexual events

History

Domestic violence

History

Masturbation addiction

History

I am sure you are convinced of one thing…erectile dysfunction in the context of other diseases requires an expert trained to treat the condition…

….in the RIGHT WAY.

Do not pop a pill called VIAGRA!, without a prescription. The implications of unsupervised self medications can be severe…

Next …

Medications or substances that cause erectile dysfunction

Numerous of the following medications or substances mentioned in the table below commonly prescribed for other medical disease states can lead to erectile dysfunction.

An alternative medication can be prescribed if you are suffering from erectile dysfunction and are taking any of the following medications on a long term basis

Medication routinely prescribed leading to erectile dysfunction

Substances when abused that can lead to erectile dysfunction

Anticonvulsant medications (seizure disorder)

Alcohol consumption

Anti histamines (taken for allergies and common cold)

Analgesic (pain killer) abuse

Antidepressants  (taken for depression)

Cocaine abuse

Antihypertensive medications (taken for high blood pressure)

Marijuana abuse

Antipsychotics (taken for Parkinson’s, Alzheimer’s and host of other conditions

Tobacco abuse (smoking)

Cardiac medications (for heart problems)

Amphetamine abuse

Diuretics (drugs for cardiac/renal problems)

 

Cytotoxic agents (taken for cancer treatments)

 

Hormonal medications and injections

 

Erectile Dysfunction and Diabetes

There is a very strong link between diabetes and erectile dysfunction. An estimated 1 in 10 men who have diabetes will have erection problems.

The reason?…

Diabetes goes hand in hand with increased body weight, so what happens is that the body fat converts the male sex hormone testosterone to the female sex hormone oestrogen…

The reduced levels of testosterone directly affect the quality of a man’s erection!.

What’s also been proved by studies is that the chance of getting problems with erection significantly increases with higher values of fasting blood sugar, obesity and associated cardiovascular disease. These three conditions are intimately linked…as below…

What’s also been proven beyond doubt is that the longer the duration of Diabetes the higher the risk or chance of developing Erection problems

Erectile Dysfunction and Heart Disease

Recent research also suggests that if erectile dysfunction in itself can be an independent risk factor for developing cardiac disease at a later stage in life.

Not only cardiac issues, but erection problems seem to go closely associated with the risk of developing hypertension, angina, stroke and other high mortality conditions.

If a patient is diagnosed with erectile dysfunction a complete cardiovascular check up is an absolute must. Never ignore erectile dysfunction!

Furthermore numerous studies have clearly found out that erection problems is usually the first sign that a man can get heart disease especially more so when his age is between 40 to 49 years.

Erectile Dysfunction Treatment

Treatment of erectile dysfunction proceeds as below

Step 1 – First the sexologist has to assess whether the patient has erectile dysfunction using the IIEF questionnaire (International Index of Erectile Function Questionnaire)

Step 2 – Next a complete sexual history, psychological history, medical and surgical history is taken followed by a physical exam to check for normal secondary sex character development

Step 3 – Assessment of BMI, Waist circumference and blood pressure is done

Step 4 – Laboratory blood tests are ordered as relevant.

Cardiac stress testing is done if a cardiovascular disease risk is suspected

Life style modification

Specialized Kegel’s exercise

Erection friendly diet

Stage 1 plus the use of

Sildenafil or Tadalafil or Vardenafil (PDE-F inhibitors). The dosages are always individualized based on patient profile.

Patients who are not responsive to stage 1 and stage 2 treatments can be taken up for stage 3 treatments which include

Penile vacuum devices and/or intra-urethral or penile injectable Alprostadil. The risks of injections include the fear of pricking a needle in the penis. Furthermore there is also a small risk of developing fibrosis in the penis while using these injections. Where possible penile vacuum devices are better.

The last line of managing erectile dysfunction is by usage of penile prosthesis. This is a major surgical approach and there is always a risk of penis shortening, penis being semi erect or infection with the usage of these prosthesis. A surgical approach is taken only when all other conservative management strategies fail.

Well I hope this article gave you adequate info about ed and all its associated nuances. Please feel free to contact us for more info!

FAQ's on Erectile Dysfunction

To put it in simple words the main cause of erectile dysfunction is psychological, atleast 80% of the time. The other well known causes include diabetes, high cholesterol, hypertension and use of certain medications

Of course it is a disease. No two ways about that!. Erectile dysfunction precedes many diseases that can affect your health if left untreated. Most patients who have erectile dysfunction will at somet point into the future develop heart problems and diabetes.

Numerous studies have clearly pointed out that simple life style changes like walking daily and eating healthy food in itself can reverse erectile dysfunction.

  1. Eat a diet rich in green leafy vegetables
  2. Walk at least 5 times a week with each walking session lasting for atleast 30 minutes
  3. Do pelvic strengthening exercises

Meet Dr. Shah at the Male Infertility & Sexual health Clinic

Dr. Shah is Consultant Andrologist and Sexologist in Chennai. His passion for helping men facing infertility issues stems from the fact that “Men never ever get the care they deserve as far as fertility treatments is concerned”

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