Erectile dysfunction often known as impotence is the consistent inability to achieve and maintain an erection for satisfactory sexual performance.
Erectile dysfunction gets more common as a man gets older, and varies in severity, but this is not to say that sexual dysfunction is a natural part of ageing. Some men experience a total inability to achieve erection while others can sustain only brief erections.
A lot of men with this problem are reluctant to talk with their doctors because they are embarrassed and so the condition remains under-diagnosed. However, experts have estimated that about 30 million men in the U.S have this problem. According to Massachusetts male ageing study, complete impotence increases 5% among men 40 years of age, 15% in men 70 years and older. By 45 years most men have experienced erectile dysfunction at one time or the other.
What causes erectile dysfunction?
A variety of diseases, medications, drug use, and psychological problems can cause erectile dysfunction. Common causes includes
- High blood pressure
- Cholesterol clots
- Pyeronies disease
- Surgeries involving the pelvic region
- Spinal cord injury
- Hormonal disorders
- Performance anxiety
- Sexual aversion
- Drug use.
Diagnosis is made by the doctor after close interaction and interviews with the patient.
A diagnosis is made in men having repeated inability to achieve and maintain an erection for satisfactory sexual performance for at least 3 months.
Physical examinations can also be helpful in diagnosis. In cases where the men have small testicles, or enlarged breasts (gynecomastia), these physical features points to a hormonal imbalance like hypogonadism and low testosterone levels.
The diagnosis for erectile dysfunction has no formal test, but various assays can be carried out to check if the dysfunction is due to the presence of an underlying condition, to know if itís due to a hormonal imbalance or if itís due to psychological problems.
Liver function tests - Liver diseases can lead to hormonal imbalance and low testosterone levels.
Tests to check for luteinizing hormone (LH), Prolactin, and Thyroid hormone levels.
Lipid profile - To check cholesterol level.
To check for Diabetes Mellitus Ė Blood glucose levels, urinalysis.
PSA Test: To exclude prostate cancer before starting testosterone treatment.
After physical examination and the laboratory tests listed above, three specific tests used to find the cause of erection problems are:
- Nocturnal penile tumescence (NPT) test
- Intracavernosal injection test
- Doppler ultrasound.
If there is an underlying condition, for example Diabetes Mellitus, then the disease is treated first, thereafter treatment for erectile dysfunction commences.
Life style: A change in lifestyle would also be helpful in cases of:
Weight loss if the patient is overweight
Moderate alcohol intake
Psychological counseling: If erectile dysfunction is caused by stress, you need counseling.
Drugs: Before taking any drugs for erectile dysfunction, it should be prescribed by a doctor, because these drugs have their individual side effects and interaction with other drugs which the patient may be on.
- Sildenafil (Viagra)
- Tadalafil (Cialis)
- Vardenafil (Levitra)
These drugs enhance the effects of nitric oxide, a natural chemical produced by the body that relaxes the muscles in the penis, increasing blood flow and producing an erection in response to sexual stimulation.
Some side effects of these drugs include:
- Headaches and Migraine
- Muscle pain
- Vision disturbances
Surgery: As a last resort if other treatments have failed, prosthetic implants are done which involves the insertion of artificial rods into the penis.
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