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What is Erectile Dysfunction and How to Treat It?

Erectile dysfunction (ED), also known as impotence, is the inability to get and maintain an erection. Erectile dysfunction is a very common condition, particularly in older men. It is estimated that half of all men between the ages of 40 and 70 will have it to some degree.

It’s important to see a doctor if you have erectile dysfunction for more than a few weeks. They will assess your general state of health because the condition can be the first sign of more serious health conditions, such as heart disease (when the heart’s blood supply is blocked or interrupted).

Why does erectile dysfunction happen?

Erectile dysfunction can have a range of causes, both physical and psychological.

Physical causes include:

  • narrowing of the blood vessels going to the penis – commonly associated with high blood pressure (hypertension), high cholesterol, or diabetes;
  • hormonal problems;
  • surgery or injury.

Psychological causes of ED include:

  • anxiety;
  • depression;
  • relationship problems.

Sometimes erectile dysfunction only occurs in certain situations. For example, you may be able to get an erection during masturbation, or you may find that you sometimes wake up with an erection but you are unable to get an erection with your sexual partner.

If this is the case, it is likely the underlying cause of erectile dysfunction is psychological (stress-related). If you are unable to get an erection under any circumstances, it is likely that the underlying cause is physical.

Erectile dysfunction can also be a side-effect of using certain medicines.

Diagnosis

Although you may be embarrassed, it’s important to get a diagnosis so that the cause can be identified.

A doctor can usually diagnose erectile dysfunction. This will involve answering questions about your symptoms, as well as a physical examination and some simple tests.

Tests to determine the cause of ED include:

  1. Physical Exam – an examination of the testicles and penis while also checking nerves for sensation.
  2. Blood Tests – Can help to identify signs of heart disease, diabetes, low testosterone, and other health issues.
  3. Urine Tests – Similar to a blood test, a urine test can help identify diabetes or other potential causes.
  4. UltraSound – This test is usually conducted by a specialist to determine if there is a lack of blood flow that is preventing you from getting an erection.

How is erectile dysfunction treated?

Erectile dysfunction is primarily treated by tackling the cause of the problem, whether this is physical or psychological.

The narrowing of the arteries (called atherosclerosis) is one of the most common causes of ED. In these cases, a doctor may suggest lifestyle changes, such as losing weight, to try to reduce your risk of cardiovascular disease. This may help to relieve your symptoms as well as improving your general health.

Overall, treatments for erectile dysfunction have improved significantly in recent years. Most men are eventually able to have sex again.

Lifestyle Changes

The same healthy lifestyle tips a doctor has been recommending for years may also help treat your ED:

  • quitting smoking;
  • reducing alcohol consumption;
  • losing weight;
  • exercising regularly;
  • reducing stress.

These steps aren’t an instant fix, but they may improve your blood flow and nerve functioning. If you’re having trouble sticking to these goals, ask your spouse or partner to join you. Getting healthy together and trying new things as a couple can be a great bonding experience and can strengthen your relationship.

Drug Therapy and Injections

When lifestyle changes alone don’t work, drug therapy is normally the next step. Most of these medications work similarly to enhance a natural chemical in your body that relaxes the muscles in your penis. The goal of this medication is to increase your response to sexual stimulation by increasing the blood flow in your penis allowing you to get an erection.

In addition to pills, injections can be used to treat ED. Erections usually occur within 5-20 minutes, but there is the risk of an erection lasting longer than 4 hours and often has poor long-term tolerability.

PRP for ED

PRP therapy is used in recovery from muscle and joint injuries and explored for treating chronic health conditions.

PRP 9or platelet-rich-plasma) has been used as an alternative treatment in cases including:

  • erectile dysfunction (ED);
  • lichen sclerosis;
  • Peyronie’s disease, a condition in which scar tissue makes the penis curve when it’s erect;
  • penis enhancement;
  • general sexual function, performance, and orgasm enhancement.

Acoustic Waves for ED

Acoustic Wave therapy is administered with a wand-like device placed near different areas of the penis. A healthcare provider moves the device along parts of your penis for about 15 minutes while it emits gentle pulses. No anesthesia is needed.

The pulses trigger improved blood flow and tissue remodeling in the penis. Both of these changes can lead to erections sufficient for sex.

A 2019 review and meta-analysis of clinical trials found that the most common treatment plan was twice weekly for 3 weeks, followed by 3 weeks without treatments, and another 3-weeks of twice-weekly treatments.

The analysis found that the effects of Acoustic Wave therapy lasted about a year.

Trimix for ED

Trimix is indicated in the treatment of males with erectile dysfunction. This injectable medication is for patients unsuitable for oral medication prostaglandin E1.

3 medications are combined to form this sterile injection

  1. Papaverine. This is a vasodilator that helps to expand the blood vessels. When injected into the penile tissue, this medication causes the smooth muscles to relax. In turn, this allows blood to flow through the cavernous tissue resulting in an erection.
  2. Alprostadil. Also known as prostaglandin E1 (PGE1), Alprostadil is a naturally occurring prostaglandin used as a medication. It is also used to help open the blood vessels by relaxing the smooth muscles within the penis.
  3. Phentolamine. This medication is a reversible non-selective-adrenergic antagonist. Its primary action is vasodilatation. Because it is a nonselective a-blocker, this medication also increases cardiac output.

Trimix injection is a medication that is very customizable to the patient’s needs. Increasing the dosage little by little will help reach the individual patient’s goal and receive the most effective results.

ED Drugs

The pills to treat ED are as follows:

  • avanafil (Stendra);
  • sildenafil (Viagra);
  • tadalafil (Cialis);
  • vardenafil (Levitra, Staxyn).

Caution: Do not use these ED medications if you take nitrates, such as nitroglycerin or a similar medicine, for chest pain. The combination can cause dangerously low blood pressure.

These medications all work similarly to each other. However, there are subtle differences in how long they stay effective and how quickly they begin to work.

If you’d like to ask any questions concerning the ED treatment from our medical experts, please contact us here.

4 January 2021 Sexual Health
About Dr. Nil Hoppins

Dr. Nil Hoppins is a consultant dermatologist and professor of medical dermatology specializing in the diagnosis and treatment of skin disorders, treatment of severe scarring, and photodermatology. He has a strong background in translational research, and expertise in genetic skin disorders.

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