You Will Never Have Erection Again Chastity

Overview

Dr. Drogo Montague discusses treatment options for erectile dysfunction.

What is erectile dysfunction (ED)?

Erectile dysfunction (ED) is the inability to get and keep an erection firm enough for sexual intercourse. Estimates advise that i of every 10 men will suffer from ED at some point during his lifetime. It is important to understand that in most cases, ED is a symptom of some other, underlying problem. ED is non considered normal at any age, and may be associated with other problems that interfere with sexual intercourse, such equally lack of desire and bug with orgasm and ejaculation.

How mutual is erectile dysfunction?

Approximately one in ten developed males will endure from ED on a long-term basis.

Many men exercise experience occasional failure to achieve erection, which can occur for a variety of reasons, such as drinking as well much alcohol, stress, human relationship problems, or from existence extremely tired.

The failure to get an erection less than 20% of the time is non unusual and typically does not require treatment. However, the failure to achieve an erection more l% of the time generally means that there is a trouble and treatment is needed.

ED does non take to exist a part of getting older. While it is truthful that some older men may need more stimulation, they should still be able to reach an erection and enjoy intercourse.

Symptoms and Causes

What causes erectile dysfunction (ED)?

ED can be caused by a number of factors, including:

• Vascular disease: Blood supply to the penis can become blocked or narrowed as a outcome of vascular disease such equally atherosclerosis (hardening of the arteries).
• Neurological disorders (such equally multiple sclerosis): Fretfulness that ship impulses to the penis can become damaged from stroke, diabetes, or other causes.
• Psychological states: These include stress, depression, lack of stimulus from the brain and functioning anxiety.
• Trauma: An injury could contribute to symptoms of ED.

Chronic illness, certain medications, and a condition called Peyronie's disease tin can also crusade ED. Operations for the prostate, bladder, and colon cancer may besides be contributing factors.

What medications could cause erectile dysfunction (ED)?

Erectile dysfunction (ED) is a mutual side effect of a number of prescription drugs. While these medications may treat a disease or condition, in doing then they can impact a man'southward hormones, nerves or blood circulation, resulting in ED or increasing the take a chance of ED.

If you lot feel ED and think that it may be a event of the medication you are using, do non stop taking the medication. If the problem persists, contact your doctor and he or she may be able to prescribe a different medication. Common medications that may list ED every bit a potential side consequence include:

• Diuretics (pills that crusade increase urine menses).
• Antihypertensives (loftier blood force per unit area drugs).
• Antihistamines.
• Antidepressants.
• Parkinson's disease drugs.
• Antiarrhythmics (drug for irregular heart activeness).
• Tranquilizers.
• Muscle relaxants.
• Nonsteroidal anti-inflammatory drugs.
• Histamine H2-receptor antagonists.
• Hormones.
• Chemotherapy medications.
• Prostate cancer drugs.
• Anti-seizure medications.

Other substances or drugs that tin cause or lead to ED include these recreational and frequently abused drugs:

• Alcohol.
• Amphetamines.
• Barbiturates.
• Cocaine.
• Marijuana.
• Methadone.
• Nicotine.
• Opiates.

These drugs non but affect and often suppress the primal nervous arrangement, but can also cause serious impairment to the blood vessels, leading to permanent ED.

What prescription drugs may cause erectile dysfunction?

Erectile dysfunction (ED) is a mutual side effect of a number of prescription drugs. While these medications may care for a disease or condition, in doing so they can affect a man'due south hormones, nerves or blood apportionment. The result may be ED or an increment in the take a chance of ED.

If you have ED and call back that it may be a consequence of the medication you lot are using, do not end taking the medication. If the problem persists, contact your md and he or she may be able to prescribe a unlike medication. Mutual medications that may list ED as a potential side effect include:

• Diuretics (pills that cause an increase in urine catamenia).
• Antihypertensives (medication for high blood pressure).
• Antihistamines.
• Antidepressants.
• Parkinson'south disease drugs.
• Antiarrhythmics (medication for irregular eye action).
• Tranquilizers.
• Muscle relaxants.
• Non-steroidal anti-inflammatory drugs.
• Histamine H2-receptor antagonists.
• Hormones.
• Chemotherapy medications.
• Prostate cancer drugs.
• Anti-seizure medications.

What other substances or drugs may cause erectile dysfunction?

Other substances or drugs that tin can cause or atomic number 82 to ED include these recreational and frequently driveling drugs:

• Alcohol.
• Amphetamines.
• Barbiturates.
• Cocaine.
• Marijuana.
• Methadone.
• Nicotine.
• Opiates.

Aside from the well-known complications that the use and abuse of these drugs can cause, ED is not oft mentioned. However, utilize of these drugs is a take chances factor for ED. These drugs not simply bear upon and often times deadening down the central nervous system, merely tin can also crusade serious harm to the claret vessels, leading to permanent ED.

How are low and erectile dysfunction related?

For some men, depression tin back-trail the condition of erectile dysfunction (ED). Information technology is common for men with ED to feel angry, frustrated, sad, unsure of themselves, or fifty-fifty less "manly." Such feelings may lead to a lack of self-esteem and, in astringent cases, to low.

Depression that accompanies ED is treatable. The first pace in addressing your concerns almost ED-related low is to exist honest with yourself, your partner, and your md. Later low has been brought out into the open, coping with it will exist easier and less stressful.

Diagnosis and Tests

How is erectile dysfunction (ED) diagnosed?

Considering there are a diverseness of causes for ED, there are several dissimilar tests your doctor may use to diagnose the condition and determine its cause. But after the cause of ED is determined tin information technology be effectively treated.

Before ordering any tests, your physician volition review your medical history and perform a thorough physical test. The dr. will besides "interview" you about your personal and sexual history. Some of these questions will be very personal and may feel intrusive. However, it is of import that you reply these questions honestly. The questions asked may include:

• What medications or drugs are yous currently using? This includes prescription drugs, over-the-counter drugs, herbals, dietary supplements and illegal drugs.
• Take yous had whatever psychological issues such as stress, feet and depression?
• When did you start notice symptoms of ED?
• What are the frequency, quality and duration of whatever erections you take had?
• What are the specifics of the circumstances under which ED get-go occurred?
• Do/did y'all experience erections at night or during the morning?
• What sexual techniques do you utilise?
• Are at that place problems in your electric current relationship?

The dr. may besides wish to interview your sexual partner since your partner may exist able to offer in sight about the underlying causes.

Later your physical examination and discussion, your doctor may then order any one of the post-obit tests to farther diagnose your condition:

• Complete claret count (CBC): This is a ready of blood tests that, among other things, tin detect the presence of anemia. Anemia is caused by a low cherry-red blood cell count and can cause fatigue, which in turn tin can crusade ED.
• Liver and kidney function tests: These claret tests may indicate whether ED may exist due to your kidneys or liver functioning improperly.
• Lipid contour: This blood test measures the level of lipids (fats), like cholesterol. Loftier levels may signal atherosclerosis (hardening of the arteries), which can touch on blood circulation in the penis.
• Thyroid function test: One of the thyroid hormones' functions is to regulate the production of sex hormones, and a deficiency in these hormones may contribute to or cause ED.
• Blood hormone studies: Testosterone and/or prolactin levels in the blood may exist measured to encounter if abnormalities in either of these sex hormones are present.
• Urinalysis: Analysis of urine can provide a wealth of data, including information on protein, carbohydrate and testosterone levels. Abnormal measurements of these substances can indicate diabetes, kidney affliction or a testosterone deficiency, all which can cause ED.
• Duplex ultrasound: This is perhaps the best test for evaluating ED. An ultrasound uses high-frequency audio waves to take "pictures" of the body's tissues. For people with ED, an ultrasound may be used to evaluate blood flow and check for signs of a venous leak, atherosclerosis (hardening of arteries) or tissue scarring. This examination is performed both while the penis is cock (usually induced by an injection of a drug that stimulates erection) and besides while it is soft.
• Bulbocavernosus reflex: This test evaluates nerve awareness in the penis. During the exam, your medico will squeeze the head of your penis, which should immediately cause your anus to contract. If nerve function is abnormal, there will exist a delay in response time.
• Nocturnal penile tumescence (NPT): This test measures a man'due south erectile function while he is sleeping. Unremarkably, a man will take five or six erections while asleep. A lack of these erections may indicate there is a problem with nerve function or circulation to the penis. The test uses two methods, the snap gauge method and the strain gauge method. The snap gauge method is performed by wrapping iii plastic bands of varying force effectually the penis. Erectile function is then measured based on which of the three bands breaks. The strain guess method works past placing elastic bands around the tip and base of operations of the penis. If the penis becomes erect during the night, the bands stretch, measuring the changes in penile circumference.
• Penile biothesiometry: This test involves the use of electromagnetic vibration to determine sensitivity and nervus function. A decreased sensitivity to these vibrations may indicate nervus damage.
• Vasoactive injection: During this test, an erection is produced by injecting special solutions that crusade the blood vessels to dilate (enlarge) allowing blood to enter the penis.
• Dynamic infusion cavernosometry: This exam is used for men with ED who have a venous leak. During this test, fluid is pumped into the penis at a predetermined rate. Past measuring the charge per unit at which fluid must be pumped to attain a rigid erection, doctors can make up one's mind the severity of the venous leak.
• Cavernosography: Used in conjunction with the dynamic infusion cavernosometry, this examination involves injecting a dye into the penis. The penis is then X-rayed so that the venous leak tin be seen.
• Arteriography: This exam is given to people who are candidates for vascular reconstructive surgery. A dye is injected into the artery believed to be damaged and X-rays volition be taken.

Before you are given any of these tests, your doctor volition explicate what is involved. If you take any questions, do not hesitate to ask your doctor.

Management and Treatment

What doctors treat erectile dysfunction?

The type of medical specialist who treats ED will depend on the cause of the problem. Based on your family unit'southward medical history, as well equally your own medical history and current health, your doctor may care for you with oral medications (Viagra®, Levitra®, Cialis®).

If these options neglect, you may be referred to a urologist who can assist with other non-surgical options such as vacuum device or injections or surgical handling options. If needed, your doctor may also refer you to a psychologist specializing in sexual dysfunction.

How is erectile dysfunction treated?

ED can be treated in many ways, including:

• Oral medications.
• Sex therapy.
• Penile injections.
• Vacuum devices.
• Intraurethral medication.
• Surgery (penile implant).

Each type has its ain pros and cons. Talk over your options with your md to decide the best treatment for yous.

The commencement step to treating ED is to find the underlying cause. Then the appropriate treatment can begin. There are a number of not-surgical and surgical options that can help a man regain normal sexual role.

What non-surgical treatments are there for erectile dysfunction (ED)?

Education and communication

Education about sex, sexual behaviors, and sexual responses may aid a human overcome his anxieties most sexual dysfunction.

Talking honestly with your partner about your needs and concerns may too aid to overcome many barriers to a salubrious sex life.

Medication

Medications such equally sildenafil (Viagra®), vardenafil (Levitra®), or tadalafil (Cialis®) may assistance ameliorate sexual function in men by increasing blood period to the penis. Men who are on medicines that contain nitrates such as nitroglycerine should not take oral ED medications. The combination of nitrates and these specific medications tin can crusade depression blood pressure (hypotension).

The most mutual side effects of these medications are indigestion, nasal congestion, flushing, headaches and a temporary visual disturbance.

Mechanical aids

Aids such as vacuum devices and penile constriction rings serve as erectile aids for some men.

A vacuum constriction device (in a higher place) is a cylinder that is placed over the penis. The air is pumped out of the cylinder, which draws blood into the penis and causes an erection. The erection is maintained by slipping a ring off of the base of operations of the cylinder and onto the base of the penis. The ring tin can stay in place for up to thirty minutes. The vacuum device can exist safely used to care for nigh causes of erectile failure. Lack of spontaneity, discomfort, and cumbersomeness of the device seem to exist the biggest concerns of patients.

Penile injection therapy (intracavernosal injection therapy)

Men are taught how to inject medications direct into the erection chambers of the penis to create an erection. Injection therapy is effective in treating a wide variety of erection problems acquired by blood vessel, nerve and psychological conditions.

Using a tiny needle and syringe, the man injects a pocket-size amount of medicine into the side of his penis. The medicine relaxes the blood vessels, allowing blood to flow into the penis. This handling has been widely used and accustomed since the early 1980s. The three most mutual medicines are prostaglandin E1 (alprostadil), papaverine (Papacon®), and phentolamine (Regitine®).

The virtually common side furnishings are hurting and penile scarring (fibrosis). In extremely rare cases, patients with cognitive and vascular disease or severe cardiovascular diseases might non be able to tolerate the dizziness and high claret pressure occasionally caused by injection therapy.

A painful erection that lasts longer than 2 to three hours is chosen priapism and may occur with injection therapy. This tin can be lessened with proper dosing and by post-obit the treatment guidelines.

Psychology and sex activity therapies

Psychological causes may contribute to erectile failure even when there is a clear organic cause.

Therapy with a trained advisor can aid a person address feelings of anxiety, fear or guilt that may accept an impact on sexual dysfunction.

Sexual activity therapy tin can be beneficial to most men when counseling is provided by a skilled sexual practice therapist. Sexual practice therapy besides helps a homo's partner accept and cope with the problems.

A patient whose ED has a clear psychological crusade should receive sex therapy counseling earlier any invasive treatments are pursued.

Hormone

Low hormone levels may play a role in ED. Hormone replacement in the form of topical gels, creams, patches, injections and pellets are but used subsequently physician evaluation.

What are surgical treatment options for erectile dysfunction (ED)?

Penile prosthesis surgery

Inflatable penile prostheses are implanted during outpatient surgery. Once they are part of a man's torso, they enable him to have an erection whenever he desires. The use of a prosthesis preserves penile sensation, orgasm and ejaculation for most men.

The most commonly used penile implant consists of a pair of inflatable cylinders that are surgically implanted in the erection chambers of the penis. The cylinders are connected through tubing to a reservoir of fluid under the lower abdominal muscles, and to a pump inside the scrotal sac.

To inflate the penile prosthesis, the man compresses the pump a number of times to transfer fluid from the reservoir to the cylinders. This causes the penis to go erect. When inflated, the prosthesis makes the penis strong and thick, which is very similar to a natural erection.

A penile prosthesis does not change the awareness on the skin of the penis or a man's ability to reach orgasm or ejaculate. Pressing on a deflation valve fastened to the pump returns the fluid to the reservoir, which returns the penis to a flaccid country.

The surgical procedure is performed through 1 or two small incisions that are generally well subconscious. Other people will exist unable to tell that a human has an inflatable penile prosthesis. Complications following surgery are non common, only primarily include infection and mechanical device failure.

Approximately 95% of penile implant surgeries are successful in producing erections that enable men to have sexual intercourse. Moreover, patient satisfaction questionnaires show that up to 90% of men who have undergone penile implants say they would cull the surgery again, and overall satisfaction ratings are higher than those reported by men using oral medication or penile injection therapy.

Prevention

Tin can erectile dysfunction (ED) be prevented?

For people who are at take chances of developing ED due to personal behavior, steps may be taken to try to prevent its occurrence. Withal, other causes may not be preventable.

A number of studies now suggest a link between ED and obesity, high cholesterol, hypertension, diabetes and heart illness.

The following recommendations may help prevent ED or improve the problem if information technology is already present:

• Eat a healthy diet. A nutrition that limits saturated fat intake and includes several portions of fruits, vegetables and whole grains tin benefit men with ED.
• Reduce cholesterol. Loftier cholesterol tin harden, narrow or cake the arteries (atherosclerosis) leading to the penis. Men can lower cholesterol through diet, practice and medication.
• Maintain a healthy weight.
• Exercise regularly. Regular do may reduce the risk of ED. Cull exercises that you enjoy and will make a regular part of your day. In addition to reducing the risk of ED, exercise also tin aid you lot manage stress. Bank check with your md before starting any exercise program.

Living With

What should I practice if I am having problems achieving/keeping an erection?

If yous suspect you have erectile dysfunction, please meet your master care medico or a urologist. He or she can perform tests to discover out what is causing your problem and refer you to a specialist if needed. In one case the cause is identified, in that location are several handling options to choose from.

Does insurance cover erectile dysfunction (ED) treatment?

Insurance coverage for ED depends on the type of handling prescribed and whether your insurance covers sexual dysfunction at all. Speak with your insurance provider to make up one's mind if the option you are because will exist covered.

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Source: https://my.clevelandclinic.org/health/diseases/10035-erectile-dysfunction

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