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What is erectile dysfunction?

Erectile dysfunction is a disorder in which a man has a tough time keeping an erection firm enough during a sexual intercourse. Erectile dysfunction (ED) is a medical problem but sometimes the problem can be psychological too. It may be due to the blood vessels or nerves supplying the penis is affecting an erection sufficient to sex.

During an erection, the spongy tissues in two chambers of the penis trap the blood flow, and the penis becomes erect. After the intercourse, the muscular tissue in the penis contract and blood is released and the penis gets soft and limp.

What are the Symptoms?

Common signs & symptoms of Erectile Dysfunction

  • Trouble in getting and keeping an erection
  • Premature ejaculation
  • Reduced desire for sex
  • Embarrassment, shame, anxiety, and low self-confidence
  • Cardiovascular disease

What are the Causes & Risk Factors?

Erectile dysfunction can be caused by a medical, emotional or physical reasons. Keeping and maintaining erection involves the vascular system, nervous system, hormones, brain, muscles, blood vessels, endocrine system, and general emotional wellbeing.

Physical causes

  • Cardiovascular disease, narrowing of blood vessels, and hardened arteries don't allow enough blood flow in the penis.
  • Diabetes causes small vessel disease or nerve damage to the penis
  • High blood pressure and high cholesterol
  • Injury or surgery in the pelvic area harms nerves in the penis and nerve signals don't reach the penis from the brain or spinal cord.
  • Obesity and metabolic syndrome
  • Hormone imbalances and low testosterone level because of thyroid condition
  • Anatomical disorders of the penis
  • Injury to the penis, spinal cord, prostate, and pelvic area
  • Parkinson's disease and multiple sclerosis
  • Peyronie's disease and the development of fibrous scar tissue inside the penis that causes curved and painful erections.
  • Cancer treatment and radiation therapy on the lower abdomen and pelvic region
  • Certain prescription medicines for antiandrogens, antidepressant, and tranquilizers create blood flow problem

Psychological cause

  • Depression, anxiety, and strees
  • Relationship conflicts
  • Guilt and low self-confidence about sexual performance

There are various health-related factors that contribute to erectile dysfunction:

  • Smoking tobacco restricts blood flow to veins and arteries
  • Diabetes and other heart conditions
  • Prostate surgery, pelvic surgery, and radiation therapy for cancer
  • Specific medication such as antidepressants, antihistamines, antiandrogens, and tranquilizers may create side effects.
  • Fear, anxiety, and depression
  • Overweight
  • Drinking too much alcohol

How is it diagnosed?

The primary test included a physical examination, mental health questioning, and checking of sexual history. Addition tests are as follows:

  • Blood test and Urine test is done to check diabetes, heart disease, thyroid issues, and low levels of testosterone.
  • Ultrasound examines the blood flows to the penis.
  • Nocturnal penile tumescence (NPT) test checks for sleep erection
  • Injection test is done to stimulate erection in the penis for evaluating the firmness of the erection.
  • X-rays, MRI, or CT scan to check the history of trauma or cancer. Though, it is rarely used.

How is it treated?

The treatment option is dependent on the patient's overall health condition, cause & severity of erectile dysfunction. There are various treatment options are available including:

Oral medication

Oral drug such as PDE5 inhibitors increases blood flow in the penis that relaxes muscles in the penis. These are Sildenafil (Viagra), Tadalafil (Adcirca, Cialis), Vardenafil (Levitra, Staxyn), and Avanafil (Stendra) and can be taken with a doctor's prescription only. It has to be taken 30 to 60 minutes before the sex. However, these medications may have some side effects such as nausea, headache, muscle aches & indigestion

Alprostadil self-injection can be injected into the base or side of your penis. It creates an hour-long erection. Mild bleeding and pain at the injection side are its side effects.

Testosterone replacement therapy fixes normal erections with the combination of ED drugs. It works well when you have low levels of testosterone hormones.

Vacuum erection device

A vacuum erection device is placed over your penis and sealed around it. A pump makes a low-pressure vacuum around the erectile tissue. The pump sucks the air inside the tube and holds blood for 30 minutes longer. After the erection, you can slip an elastic ring onto the base of the penis and remove the tension ring.

Surgical treatment

This is the generally considered as a last resort when other treatments have failed. Insertion of a penile implant involves placing devices into both sides of the penis. Penile implant surgery carries a risk of infection. However, it gives a higher degree of sexual satisfaction than other erection treatments.

Are there any lifestyle measures that help?

  • Pelvic floor muscles exercises
  • Aerobic exercises increase blood flow.
  • Yoga relaxes your mind & body and lowers stress levels.
  • Healthy eating and a healthy lifestyle maintain blood flow in the body and relieve mental stress.

Kokilaben Dhirubhai Ambani Hospital

Address: Rao Saheb, Achutrao Patwardhan Marg, Four Bungalows, Andheri West, Mumbai, Maharashtra 400053

Phone: +91-98 88 66 22 00

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