All the facts you need about erectile dysfunction

Erectile dysfunction: A photo of a man in doctor's office

Erectile dysfunction is a condition many men deal with, but it is something few are willing to discuss. However, men should rest assured that help is available to them, and all it takes is a willingness to discuss it with your loved one and your doctor.

What is erectile dysfunction?

Commonly called impotence, erectile dysfunction is “the inability to achieve an erection, and/or dissatisfaction with the size, rigidity, and/or duration of erections,” according to an entry in the Banner Health library. This entry also notes that erectile dysfunction affects about 30 million men.

Who gets erectile dysfunction?

Well, clearly that is going to be men, but I wanted to know if there were specific things that could cause erectile dysfunction. I asked James Wolach, MD, from the Banner Health Clinic specializing in Urology, what some of the risk factors are for erectile dysfunction.

“It can occur at any age but is more common as you get older,” says Dr. Wolach.

Dr. Wolach notes other risk factors include:

  • Cardiovascular disease, such as hypertension (high blood pressure), atherosclerosis (the build-up of fats, cholesterol and other materials in the arteries) and hyperlipidemia (high lipid levels)
  • Diabetes
  • Endocrinopathies (diseases of the endocrine system – the system that produces hormones)
  • Neurologic diseases
  • Depression
  • Psychosexual relationship problems
  • Alcoholism
  • Some prescription medications and recreational drugs
  • Smoking
  • Pelvic trauma
  • Obesity

To figure out if a person has erectile dysfunction, Dr. Wolach says a patient will undergo a routine physical examination and may have some lab work done. Additionally, the doctor will review the patient’s history.

What treatments are available for erectile dysfunction?

“In younger patients, we need to rule out comorbidities, or the presence of multiple chronic conditions and treat and evaluate for low testosterone,” says Dr. Wolach.

Three lines of treatment are available to patients, says Dr. Wolach. The first line is probably easy to guess only because of the numerous commercials that play during televised sporting events: Oral medications. There are several options available, and your doctor will find the right one for you.

The next line of treatment is divided into three options, Dr. Wolach notes. The first option is called intra-urethral alprostadil, which involves inserting a small capsule through the opening on the penis and into the urethra – the tube that goes to the bladder to allow urine to pass. Once the capsule dissolves, the body absorbs the medication, and an erection occurs.

Another option is intra-cavernous vasoactive medications – injections you can give to yourself at the base of the penis. There are also vacuum devices, which work by creating negative pressure to draw blood into the penis.

The final line of treatment is penile prosthesis or penile implant, says Dr. Wolach. A surgical procedure is performed to insert inflatable cylinders into the erection chambers of the penis. When an erection is needed, it’s a matter of pumping fluids with a small bulb into the cylinders.

“Psychosexual therapy may be useful in combination with the treatments,” adds Dr. Wolach.

What is the first step a guy should take?

A guy might be very embarrassed to talk about not being able to perform, but he has to remember that it won’t get better without help. The good news is that things can get working again.

The first step is to have the discussion with the spouse or significant other, recommends Dr. Wolach.

“It is also important to know that this is a common problem and there are good treatments.”

Also read: What is Your Snot Telling You?

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