What Is Erectile Dysfunction?
Erectile dysfunction or ED is the inability to achieve or sustain an erection suitable for sexual intercourse and is also known as impotence. Problems with erections may stem from medications, chronic illnesses, poor blood flow to the penis, drinking too much alcohol, or being too tired. Lifestyle changes, medications, and other treatments are often used to treat ED.
Erectile dysfunction (impotence) also comprises "soft erections" where the inability to get and keep an erection firm enough to enjoy sex is impacting a man. Having erection trouble or softer erections from time to time isn't necessarily a cause for concern. But if erectile dysfunction is an ongoing problem, it may be due to an androgen deficiency or medical problem and can cause stress, relationship problems, depression or affect a man's self-confidence.
Even though it may seem awkward to talk with your doctor about erectile dysfunction, it is best for a man who is experiencing erectile dysfunction for a period of time go in for a medical evaluation. Problems getting or keeping an erection over the long term can be a sign of a health condition that needs medical treatment such as heart disease or diabetes. Treating an underlying health problem may be enough to reverse your erectile dysfunction. A low testosterone test can help determine if low testosterone may be the cause of ED.
If treating an underlying health condition doesn't help with erectile dysfunction, prescription medications or other direct treatments may work. The first thing you need to do is to make sure you're getting the correct treatment for any male health problems that could be causing or worsening your erectile dysfunction.
A variety of options exist for treating erectile dysfunction. The cause and severity of your condition, medical history and underlying health problems are important factors in your doctor's recommending the best treatment or treatments for you. Your doctor can explain the risks and benefits of each treatment, and will consider your preferences. Your partner's preferences also may play a role in treatment choices.
Oral Prescription Medications
Oral medications are a successful erectile dysfunction treatment for many men. They include:
- Sildenafil (Viagra)
- Tadalafil (Cialis)
- Vardenafil (Levitra)
All three medications work in much the same way but rely on your body having sufficient levels of testosterone. These drugs enhance the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation. These medications vary in dosage, how long they work and their side effects. Your doctor will take into account your particular situation to determine which medication may work best. Don't expect these medications to fix your erectile dysfunction immediately. You may need to work with your doctor to find the right medication and dose for you.
Before taking any prescription erectile dysfunction medication (including over-the-counter supplements or herbal remedies), get your doctor's approval. Although these medications can help many people, not all men should take them to treat erectile dysfunction. Because of prior or current health conditions, these medications may not work or may be dangerous for you if you:
- Take nitrate drugs for angina, such as nitroglycerin (Nitro-Bid, others), isosorbide mononitrate (Imdur) and isosorbide dinitrate (Isordil)
- Take a blood-thinning (anticoagulant) medication, alpha blockers for enlarged prostate (benign prostatic hyperplasia) or high blood pressure medications
- Have heart disease or heart failure
- Have had a stroke
- Have very low blood pressure (hypotension) or uncontrolled high blood pressure (hypertension)
- Have uncontrolled diabetes
Other medications
Other medications for erectile dysfunction include:
- Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Alprostadil, Caverject Impulse, Edex) into the base or side of your penis. In some cases, medications generally used for other conditions are used for penile injections on their own or in combination. Examples include papaverine, alprostadil and phentolamine. Each injection generally produces an erection in five to 20 minutes that lasts about an hour. Because the needle used is very fine, pain from the injection site is usually minor. Side effects can include bleeding from the injection, prolonged erection and formation of fibrous tissue at the injection site.
- Alprostadil penis suppository. Alprostadil intraurethral (MUSE) therapy involves placing a tiny alprostadil suppository inside your penis. You use a special applicator to insert the suppository about two inches down into your penis. Side effects can include pain, minor bleeding in the urethra, dizziness and formation of fibrous tissue inside your penis.
- Testosterone hormone replacement. Some men's erectile dysfunction is caused by low levels of the hormone testosterone, and may need testosterone replacement therapy in the form of testosterone injections, testosterone creams, gels or pellets.
Penis pumps, surgery and implants
Medications may not work or may not be a good choice for you. If this is the case, your doctor may recommend a different treatment. Other treatments include:
- Penis pumps. A penis pump (vacuum constriction device) is a hollow tube with a hand-powered or battery-powered pump. The tube is placed over your penis, and then the pump is used to suck out the air inside the tube. This creates a vacuum that pulls blood into your penis. Once you get an erection, you slip a tension ring around the base of your penis to hold in the blood and keep it firm. You then remove the vacuum device. The erection typically lasts long enough for a couple to have sex. You remove the tension ring after intercourse.
- Penile implants. This treatment involves surgically placing devices into the two sides of the penis. These implants consist of either inflatable or semirigid rods made from silicone or polyurethane. The inflatable devices allow you to control when and how long you have an erection. The semirigid rods keep the penis firm but bendable. This treatment can be expensive and is usually not recommended until other methods have been tried first. As with any surgery, there is a risk of complications such as infection.
- Blood vessel surgery. In rare cases, a leaking blood vessel can cause erectile dysfunction and surgery is necessary to repair it.
Psychological counseling
If your erectile dysfunction is caused by stress, anxiety or depression, your doctor may suggest that you, or you and your partner, visit a psychologist or counselor. Even if it is caused by something physical, erectile dysfunction can create stress and relationship tension.
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Testosterone Treatment Info - Testosterone Treatment for Men with ED - Erectile Dysfunction
