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Erectile Dysfunction (ED) - Causes, Symptoms and Treatment Options

If you're experiencing problems with erectile dysfunction, read on to learn more about the condition and how it can be treated.

Erectile Dysfunction

Erectile dysfunction (ED) is a sexual disorder characterized by the inability to develop or maintain an erection of the penis during sexual activity in humans. It can have psychological consequences as it can be tied to relationship difficulties and self-image. A number of effective treatments are available.

Causes

The most common organic causes are cardiovascular disease and diabetes, neurological problems (for example, trauma from prostatectomy surgery), hormonal insufficiencies (hypogonadism) and drug side effects. Alcoholism and other substance abuse are also common causes.

Symptoms

The primary symptom is the inability to develop or maintain an erection during sexual activity. Secondary symptoms may include:
  • Reduced sexual desire
  • Trouble getting an erection
  • Trouble keeping an erection

Diagnosis

The diagnosis of erectile dysfunction may involve:
  • Medical and sexual history
  • Physical examination
  • Lab tests, such as nocturnal penile tumescence testing
  • Ultrasound
  • Psychosocial assessment

Treatment

Medical therapies The most common treatment for erectile dysfunction is drugs known as phosphodiesterase-5 (PDE-5) inhibitors. These include tadalafil (Cialis), vardenafil (Levitra), and sildenafil citrate (Viagra). These are effective for about 75% of men with erectile dysfunction. They are tablets that are taken around an hour before sex, and last between 4 and 36 hours. Sexual stimulation is required before an erection will occur. The PDE-5 inhibitors cause dilation of blood vessels in the penis to allow erection to occur, and help it to stay rigid. Men using nitrate medication (e.g. GTN spray or sublingual tablets for angina) should not take PDE-5 inhibitors. Vacuum devices A vacuum device consists of a plastic cylinder, a pump, a set of soft silicone rubber rings, and a water-soluble lubricant. The cylinder is placed over the flaccid penis and held tight against the pelvis. The pump is used to create a vacuum within the cylinder, drawing blood into the penis. As the penis fills with blood, it becomes erect. The rubber rings are then used to keep the blood within the penis. The lubricant is used to prevent irritation of the skin by the cylinder and pump. Psychological therapies Psychological therapies such as sex therapy (which is couple-based), cognitive-behavioral therapy, and counseling can be effective for some men. These therapies can help men and their partners to cope with the psychological aspects of erectile dysfunction, and can help to restore sexual confidence. Surgery In some cases, surgery is used to treat erectile dysfunction. This may be done to repair damage to the blood vessels, nerves, or tissues of the penis. Surgery can also be used to treat other conditions that cause erectile dysfunction, such as penile cancer.
Dr. Natalya Lopushnyan from Greater Boston Urology discusses erectile dysfunction (ED), including causes, diagnostics, and treatment.

If you’re dealing with ED, you’re not alone—and there ARE treatment options available. Don’t suffer in silence. Make the call and talk to a urologist soon.

Watch the rest of our #urologists talk about other #urology conditions here: greaterbostonurology.com/videos/

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Video transcription:

High conductance a little push in on dr. hill, as most of my patients call me, I’m a board-certified urologist and I treat most of the urologic conditions, but my special interest is in men’s health and eating. So let’s talk about it today when I see a person with erectile dysfunction or Edie, as most patients call it I first want to find out what is the reason for the erectile dysfunction, so we’ll talk about it today. Unfortunately, the main reason for most men is age. There are three times as many patients at the age of 60, with Edie, as there are at the age of 40 and its basic wear and tear of the penis. The longer you live, the worse it gets. Second reason is anything that will affect your blood vessels, because what is erection correction is increased blood flow to your penis. That makes it expand and become harder, so anything that will affect your blood vessels will affect your erection function, so things like diabetes, smoking, high cholesterol, heart disease, high blood pressure will all be important in assessing your edie. Third reason that I always ask about is prostate cancer. If you had prostate cancer and you underwent treatment such as radiation or surgery, that will be very important because those treatments tend to make men’s erections course. Another reason is testosterone. When testosterone is it’s a male hormone, that’s very important in men’s libido, sex drive and erections. So if your levels are very low below normal, that could be a reason for your erectile dysfunction as well and last but not least, is something like stress and depression, and not only the condition of depression, but also the medications that are given to treat that. So, when you see your urologist or your primary care doctor, please talk to them about your erections and they will assess you for all those reasons and make sure that your treatment is tailored specifically to you.

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