Erectile Dysfunction or impotence is the inability among men to get & keep an erection which is firm enough for sex. However, having trouble with penile erection from time to time is not necessarily any cause for concern. Only when erectile dysfunction is an ongoing issue can cause stress & affect self-confidence thereby contributing to problems with relationship. Quite often, problems getting and/or keeping erections is sign of some underlying health condition which is requiring treatment & a risk factor for developing heart disease in future. Patients concerned with erectile dysfunction should speak to doctors even if it were embarrassing. Many a times, treating underlying conditions can be good enough to reverse erectile dysfunction, while in most other cases medications and/or direct treatments are invariably required.
Persistent erectile dysfunction symptoms include the following.
Trouble getting erection
Trouble keeping erections
Reduction in sexual desire
Men should sensibly consult doctors in case they experience the following.
Having concerns about erection or experiencing other sexual problems like ejaculatory dysfunction including premature or delayed ejaculation.
Men having heart disease, Diabetes or other known health conditions which are linked to erectile dysfunction.
Men having other symptoms alongside erectile dysfunction.
Causes of Erectile Dysfunction
Sexual arousal among men is a complex process involving nerves, muscles, blood vessels, hormones, emotions & the brain. Erectile dysfunction therefore can result from problem with any of these factors. Stress & mental health concerns can also cause or worsen matters for erectile dysfunction. Quite often it is found that a combination of physical & psychological factors make up for erectile dysfunction. For example, minor physical conditions which slow down sexual response can cause anxiety & disturb maintaining erections. This resultant anxiety can subsequently lead to worsening of erectile dysfunction.
Physical Factors Influencing Erectile Dysfunction
Most cases of erectile dysfunction are caused by some physical condition. Common causes among these can include the following.
Brain plays a major role in triggering a series of physical events for erection to happen. Starting with feelings of sexual excitement, there are a number of factors which can interfere so as to cause or worsen erectile dysfunction. Some of these include the following.
Other Mental-Health Related Conditions
Relationship Problems due to Poor Communication and/or Other Concerns
Initial Consultation for Erectile Dysfunction
Since appointment with doctors can be brief, it is a good idea to be well prepared so as to make the best of available time. Following information will help erectile dysfunction patients get ready for initial consultation & know exactly what to expect from the doctor.
Take the following steps to prepare for initial consultation.
What Patients Need to do Ahead of Time – Be sure to ask the doctor if there is anything you will need to do in advance; like not eating anything before undergoing blood test.
Note Down Symptoms Experienced – This will also include any other symptom which may not seem directly related to erectile dysfunction.
Jot Down Key Personal Information – Including major causes for stress or recent changes in life.
Make a List of Medications – This list must also include supplements, herbal remedies & vitamins along with medications.
Take Along Your Partner – If possible since she can help remembering something which you have missed or forgotten during initial appointment.
List of Questions to Ask Doctors During Initial Consultation –
What is the most likely cause of my erectile dysfunction problem?
What can be other possible causes of my problem?
What type of tests will I need to undergo?
Is my erectile dysfunction problem temporary, or chronic?
What is the best treatment option in my case?
What alternatives do I have to the primary approach you are suggesting?
How best can I manage other health conditions along with my erectile dysfunction problem?
Will there be any restrictions I need to follow?
Will I need to consult a specialist for my ED problem?
Is there any generic alternative in case medication is prescribed?
Can you give me any printed material or brochures for more information?
Which websites would you recommend I refer to?
Additionally, do not hesitate to ask any number of questions you can think of during initial consultation.
Doctors are Likely to Ask Some of these Following Questions
What other chronic conditions or health concerns do you have?
Have you ever had any other sexual problem?
Have you ever noticed any changes in sexual desire?
Do you experience erections during masturbation or while sleeping?
Do you have any problems in relationship with your sexual partner?
Does your partner have any kind of sexual problem?
Are you depressed, anxious or under any kind of stress?
Have you been diagnosed with any mental health condition in the past? In case you did, what medications or psychological counseling (psychotherapy) are you currently undergoing?
When did you notice erectile dysfunction problems for the first time?
Your erectile dysfunction problem occurs sometimes, often or all of the time?
What medications are you presently taking, including supplements, vitamins & herbal remedies?
Do you consume alcohol & how much in case you do?
Do you use any illegal or recreational drugs?
What seems to you, if anything, improves erectile dysfunction symptoms?
What seems to you, if anything, worsens erectile dysfunction symptoms?
Tests & Diagnosis for Erectile Dysfunction
Physical examination & answering questions including medical history are all that is needed for diagnosing erectile dysfunction in many men. They may however require further testing & consultation with specialists in case doctors suspect involvement of underlying conditions or chronic health problems.
Tests for Erectile Dysfunction Related Underlying Conditions
Blood Tests – Sample of blood may be sent to a laboratory to check for signs of diabetes, heart disease, lower levels of testosterone or any other health condition.
Physical Examination – This includes careful examination of penis & testicles along with checking nerves for sensation.
Urine Analysis – Testing urine sample involves looking for signs of diabetes & any other underlying health condition.
Ultrasound – Usually performed by specialists, this test involves using transducer, which is a wand-like device held over blood vessels supplying blood to penis. This device creates video images that let doctors understand if there are problems with blood flow. Sometimes performed in combination with an injection of medications into penis so as to stimulate blood flow & produce erections.
Nocturnal Penile Erection Monitoring – Many men have erections during sleep without even remembering one. This specific test involves wrapping a special device around penis before patients go to bed. This device is designed to measure number & strength of erections that patients achieve overnight. It can therefore also help determine if erectile dysfunction is related to physical or psychological causes.
Psychological Examination – Doctors will often also ask questions to screen for underlying conditions like depression & other possible psychological reasons for erectile dysfunction.
Other Non-Invasive & Invasive Tests for Erectile Dysfunction
Penile Arteriography – Involves injecting dye so as to see blood flowing in arteries which carry blood to penis.
Color Duplex Doppler Ultrasonography.
MRI – Magnetic Resonance Imaging
Treatments for Erectile Dysfunction
At the start, doctors will like to make sure that patients get the right treatment for any health condition which is causing or worsening erectile dysfunction. They may recommend various treatment options based upon causes & severity of erectile dysfunction & underlying health conditions. They will also explain risks & benefits of every treatment while considering patient preferences. Preferences of patients’ partner will also play a decisive role in the choice of treatment.
Oral Medications for Erectile Dysfunction
This is a successful mode of treatment for many men suffering from erectile dysfunction.
Vardenafil (Staxyn, Levitra)
All of these 4 medications enhance effects of nitric oxide which is a natural chemical produced by the body & is helpful in relaxing muscles in penis. This will result in increasing blood flow & allowing patients get erections in response to sexual stimulation. However, these medications will not automatically produce an erection; it will require sexual stimulation at first so as to cause release of nitric oxide from penile nerves. Nevertheless, these medications will amplify signals & allow men to normally function. Since oral erectile dysfunction medications are not aphrodisiac in nature, they will eventually not cause any excitement & which is not required in men who can get normal erections. Varying in dosage will determine how long these medications work & the type of side effects they create. Common side effects of oral medications for erectile dysfunction include backache, visual changes, headache, nasal congestion, flushing & stomach upset. Doctors will always consider particular situations so as to determine which medication will best suit the patient. Quite often, these medications will not immediately fix erectile dysfunction & patients will therefore need to work with doctors in order to find the right medication & dosage for their problem.
Consult the Doctor before Taking Medications for Erectile Dysfunction
It would be sensible to check with the doctor before taking any medication for erectile dysfunction including over-the-counter supplements & herbal remedies. Many erectile dysfunction medications may not work in particular cases or may be dangerous for patients with the following conditions.
Patients taking nitrate drugs which are commonly prescribed for angina (chest pain).
Patients having hypotension or hypertension (very low blood pressure or uncontrolled high blood pressure).
Patients with severe liver disease.
Patients with kidney disease requiring dialysis.
Other Medications for Erectile Dysfunction
Alprostadil Self-Injection – This method uses a fine needle to inject alprostadil into base or side of penis. In quite a few cases, medications which are generally used for other conditions like papavering, phentolamine&alprostadil are also used for penile injections, either single or in combination. Every injection normally produces an erection which lasts for about 60 minutes. Pain from site of injection is usually minor as needles used for this purpose are very fine. Side effects of self-injection usually include prolonged erection (priapism), bleeding from injection site & formation of fibrous tissue.
Alprostadil Urethral Suppository – Also known as Muse or Alprostadil therapy, this procedure involves placing a tiny alprostadil suppository inside penis in urethra by using a special applicator for insertion. Erections usually start within 10 minutes & last between 30 – 60 minutes. Side effects of alprostadil urethral suppository include pain, minor bleeding within urethra & formation of fibrous tissue inside penis.
Testosterone Replacement – Erectile dysfunction in some men may have complicated by lower levels of testosterone hormone. Testosterone replacement therapy in such cases may be recommended as the first step of treatment.
Penis Pumps for Erectile Dysfunction
Vacuum erection device or penis pump is a hollow tube with hand-powered or battery-powered pump attachment. While the tube is placed over penis, the pump is used to suck out air inside the tube so as to create vacuum which will pull blood into penis. Once an erection is obtained, a tension ring is slipped around the base of penis so as to hold in blood & keep penis firm. The vacuum device is subsequently removed. Erections through this method typically last long enough for couples to perform sexual intercourse. Tension ring is removed only after completion of intercourse. Possible side effects of penis pumps include bruising while ejaculation will be restricted by band & penis may feel cold to touch. In case penis pump is an ideal choice for treatment for erectile dysfunction, doctors may prescribe a specific model which is most suitable for the patient. Beware, as penis pumps available through magazines & sex ads may not be safe & effective for treating erectile dysfunction.
Surgery & Penile Implants for Erectile Dysfunction
Blood Vessel Surgery – Although rare, obstructed or leaking blood vessels can also cause erectile dysfunction. Surgical repair in such cases like a bypass procedure or vascular stenting may be required to fix erectile dysfunction in men.
Penile Implants – This treatment procedure involves surgically placing implant cylinders into both sides of penis consisting of inflatable or semi-rigid rods. While inflatable devices allow control over how long patients can have erections, semi-rigid rods keep penis firm but bendable at all times. Penile implants are however not recommended until all other methods have been tried & failed to yield results. Nevertheless, penile implants have a high degree of satisfaction among men & their partners despite the fact that there are risks of complications as with any other surgical intervention.
Psychological Counseling for Erectile Dysfunction
In case erectile dysfunction is caused by depression, anxiety or stress, or conditions creating stress & tension in relationships, doctors may often suggest such patients & their partners to visit psychologists or counselors so as to overcome problems.
Erectile Dysfunction Risk Factors & Complications
Erections among men may take longer to develop & may not be as firm as they grow older. Moreover, they may also need direct touch to penis in order to get & keep erections. This could indicate underlying health conditions or may be a result of taking certain medications. Some risk factors contributing to erectile dysfunction may include the following.
Medical Conditions – These include diabetes & heart conditions in particular.
Overweight Men –Especially when erectile dysfunction patients are obese.
Tobacco Consumption – Nicotine restricts blood flow to arteries & veins. Over time this can cause chronic health conditions leading to erectile dysfunction.
Certain Medical Treatments – This includes prostrate surgery or radiation treatments for cancer patients.
Medications – Particular types of medications include antihistamines, antidepressants & those required to treat pain, High blood pressure or conditions of prostate.
Injuries – Particularly when injuries damage arteries or nerves which control erections.
Psychological Conditions – These include conditions like depression, anxiety & stress.
Drug & Alcohol Consumption – Particularly so when erectile dysfunction patients are heavy drinkers or long-term drug users.
Prolonged Periods of Bicycling – Act of cycling can compress nerves & affect blood flow to penis which may eventually lead to temporary or permanent erectile dysfunction.
Complications Resulting from Erectile Dysfunction
Unsatisfactory sex life
Anxiety or stress
Low self-esteem due to embarrassment
Problems in relationships
Inability to provide pregnancy to partners
Preventive Measures for Erectile Dysfunction
One of the most effective ways to prevent erectile dysfunction is to maintain a healthy lifestyle & well manage existing health conditions. For this purpose, men should undertake the following steps.
Work with doctors so as to manage heart disease, diabetes and/or other chronic health conditions.
Visit doctors regularly for checkups & various medical screening tests.
Stop smoking or tobacco use.
Limit or avoid alcohol consumption.
Stop using illegal or recreational drugs.
Take necessary steps so as to reduce stress.
Seek help for depression, anxiety and/or other mental health concerns.
Erectile Dysfunction Treatments in India
Experts estimate that at least 18 – 30 million men are affected by erectile dysfunction in United States alone. While erectile dysfunction can occur at any age, it is however uncommon among young men & quite common among the elderly. Most men by age 45 would have experienced erectile dysfunction at least for some time. India is currently a leading medical tourism destination providing a wide array of affordable healthcare solutions including Andrology & Urology treatments for vasectomy & erectile dysfunction. IndianMedTrip is one of the fastest growing healthcare tourism companies in South Asia offering a wide spectrum of high-quality yet low-cost medical solutions for international patients. Consultants associated with IndianMedTrip would also be glad to combine an exotic recuperation vacation at reasonable costs to go along with your medical travel.