ERECTILE DYSFUNCTION - Watsons Health

ERECTILE DYSFUNCTION

Erectile dysfunction, commonly referred to as ED, is the inability to achieve and sustain an erection suitable for sexual intercourse.

Having erection trouble from time to time isn’t necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems.

In most cases, erectile dysfunction is caused by something physical. Common causes include:

  • Heart disease
  • Clogged blood vessels (atherosclerosis)
  • High cholesterol
  • High blood pressure
  • Diabetes
  • Obesity
  • Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
  • Parkinson’s disease
  • Multiple sclerosis
  • Peyronie’s disease — development of scar tissue inside the penis
  • Certain prescription medications
  • Tobacco use
  • Alcoholism and other forms of substance abuse
  • Sleep disorders
  • Treatments for prostate cancer or enlarged prostate
  • Surgeries or injuries that affect the pelvic area or spinal cord

The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:

  • Depression, anxiety or other mental health conditions
  • Stress
  • Relationship problems due to stress, poor communication or other concerns

Erectile dysfunction symptoms might include persistent:

  • Trouble getting an erection
  • Trouble keeping an erection
  • Reduced sexual desire

DIAGNOSIS

For many men, a physical exam and answering questions (medical history) are all that’s needed for a doctor to diagnose erectile dysfunction and recommend a treatment. If you have chronic health conditions or your doctor suspects that an underlying condition might be involved, you might need further tests or a consultation with a specialist.

Tests for underlying conditions might include:

  • Physical exam. This might include careful examination of your penis and testicles and checking your nerves for sensation.
  • Blood tests. A sample of your blood might be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health conditions.
  • Urine tests (urinalysis). Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions.
  • Ultrasound. This test is usually performed by a specialist in an office. It involves using a wandlike device (transducer) held over the blood vessels that supply the penis. It creates a video image to let your doctor see if you have blood flow problems.
This test is sometimes done in combination with an injection of medications into the penis to stimulate blood flow and produce an erection.
  • Overnight erection test. Most men have erections during sleep without remembering them. This simple test involves wrapping a special device around your penis before you go to bed.
This device measures the number and strength of erections that are achieved overnight. It can help to determine if your erectile dysfunction is related to psychological or physical causes.
  • Psychological exam. Your doctor might ask questions to screen for depression and other possible psychological causes of erectile dysfunction.

 

RECOMMENDED MEDICATIONS

The most common medical treatments for erectile dysfunction include medications. Several drugs may be used:

  • Tadalafil(Cialis), vardenafil (Levitra, Staxyn), avanafil (Stendra), and sildenafil (Viagra) are effective in about seven out of 10 men who use them. A pill is taken one hour before intercourse on an empty stomach and, when effective, allows a normal erection with stimulation. These drugs are not to be used by men who take any kind of nitroglycerin or nitrate drugs because the combination can result in dangerously low blood pressure.
  • Self-injected medications can produce an erection. The drug is injected before sex into the side of the penis; these drugs may also improve long-term potency and penile blood flow.
  • Prostaglandin suppositories can be inserted into the urethra to produce erections.
  • Testosterone replacement therapy may help men with low testosterone levels, but no specific level of the hormone guarantees potency. Treatment comes in many forms, including shots, patches, gels, and oral tablets, for example.

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