Impotence (Erectile Dysfunction) : What are the treatment options ?

Erectile dysfunction refers to the inability to obtain and sustain an erection powerful enough for sexual activity (impotence).

The odd erection problem is not necessarily a cause for concern. However, if erectile dysfunction persisted, it may have a negative impact on your relationships, make you feel less confident, and stress you out. In addition to being a risk factor for heart disease, difficulties getting or keeping an erection can also be a sign of an underlying medical condition that needs to be treated.

Even if you feel ashamed, discuss your concerns with your doctor if you have erectile dysfunction. Sometimes treating the root cause of erectile dysfunction can suffice. Utilizing medications or other direct therapy may be essential in some circumstances.

Causes

During male sexual arousal, the brain, hormones, emotions, nerves, muscles, and blood vessels interact in a complex way. Any of these being impacted can cause issues that may result in erectile dysfunction. Similar to stress, mental health problems can cause or exacerbate erectile dysfunction.

Sometimes a combination of psychological and physical issues can lead to erectile dysfunction. For instance, a little physical condition that slows down your sexual reaction could cause you to worry about maintaining an erection. The concern may cause or make erectile dysfunction worse.

The reasons for erectile dysfunction are physical.

A physical issue frequently brings on erectile dysfunction. Typical reasons include:

• Heart condition
• Obstructed blood vessels (atherosclerosis)
• High triglycerides
• Elevated blood pressure
• Diabetes
• Obesity
• Increased blood pressure
• Elevated insulin levels and excess body fat 
• Obesity and elevated cholesterol
• Parkinson's condition
• Sclerosis
• Certain prescription drugs
• Nicotine usage
• The illness Peyronie's — the formation of scar tissue within the penis
• Alcoholism and other drug misuse are examples of this.
• Sleep problems
• Treatments for enlarged or cancerous prostate
• Injuries or operations that damage the spinal column or the pelvis
• Reduced testosterone

The reasons for erectile dysfunction can be psychological:

Beginning with sensations of sexual arousal, the brain is crucial in setting off the cascade of physical processes that lead to an erection. Erectile dysfunction can be caused by or made worse by a variety of variables, including sexual desire. These consist of:

• Anxiety, depression, or other mental health issues
• Relationship issues brought on by stress, poor communication, or other issues

How to check if you have Impotence?

Your family doctor is a wonderful place to start when you have erectile dysfunction. Consult a doctor if

• You worry about your erections or you are having other sexual issues, including early or late ejaculation.
• You have a condition that is known to be linked to erectile dysfunction, such as diabetes, heart disease, or another illness.
• Along with erectile dysfunction, you also have additional symptoms.

Risk Factors

As you become older, erections can not be as strong or take longer to occur. You might need more direct contact with your penis in order to get and keep an erection.

The following are risk factors for erectile dysfunction:

• Health issues, especially diabetes or heart issues
• As tobacco smoking decreases blood flow to veins and arteries, it can eventually lead to chronic health issues that include erectile dysfunction.
• Being obese, especially if you are overweight
• Some medical procedures, such as radiation therapy for cancer or prostate surgery
• Accidents, especially those that harm the arteries or nerves that govern erections
• Drugs for high blood pressure, pain, and prostate diseases, as well as antidepressants, antihistamines, and other prescription medications
• Mental illnesses like stress, worry, or depression
• Alcohol and drug use, especially if you have a history of frequent drinking or drug use.

Symptoms

Erectile dysfunction signs might still include:

• Having issues obtaining an erection
• Problems maintaining an erection
• Decreased sexual arousal

Prevention

Making good lifestyle decisions and managing any underlying health concerns are the best ways to prevent erectile dysfunction. For instance:

• Consult your doctor for the management of diabetes, heart disease, or other chronic medical conditions.
• For routine checkups and medical screening procedures, see your doctor.
• Do not use illicit substances, cut back on or avoid drinking alcohol, and stop smoking.
• Regular exercise
• Take action to lessen your stress.
• Get therapy if you are experiencing depression, anxiety, or other mental health problems.

Treatments

Your doctor will examine you to determine if you are receiving the right treatment for any conditions that might be causing or exacerbating your erectile dysfunction.

Depending on the underlying cause, the severity of your erectile dysfunction, and any underlying medical issues, you may have a range of therapeutic options. Your doctor will consider your wishes and may discuss the benefits and risks of each course of treatment.

Your treatment decisions may also be influenced by your partner's preferences.

Drugs administered orally

Oral medications are a successful erectile dysfunction therapy for many men. They include:

• Sildenafil (Viagra) 
• Tadalafil (Adcirca, Cialis)
• Vardenafil (Levitra, Staxyn)
• Avanafil (Stendra)

All four medications improve the effects of nitric oxide, a chemical your body naturally produces and which relaxes penile muscles. This enables you to respond to sexual stimulation by getting an erection via increasing blood flow.

The presence of an erection after taking one of these medications is not guaranteed. Your penile nerves require sexual stimulation before nitric oxide can be produced. These drugs boost that signal, allowing some patients to have a normal penile function. Oral erectile dysfunction drugs are not aphrodisiacs, will not make you feel excited, and are not necessary for guys who get regular erections.

The dose, duration of action, and adverse effects of the drugs differ. Potential side effects include flushing, nasal congestion, headaches, blurred vision, backaches, and upset stomach.

Your doctor will take into account your specific condition when deciding which drug would be most effective. These medications may not immediately alleviate your erectile dysfunction. To determine the best drug and dose for you, you might need to consult your doctor.

Get your doctor's approval prior to using any erectile dysfunction medicine, including over-the-counter vitamins and herbal therapies. Not everyone responds to erectile dysfunction medications, and they may be less successful if you have diabetes or have undergone prostate surgery, for example. Some medicines might be harmful if you:

• Take nitrate medications, which are frequently recommended for angina (chest discomfort), including nitroglycerin (Nitro-Dur, Nitrostat, etc.), isosorbide mononitrate (Monoket), and isosorbide dinitrate.
• Possess a heart condition or heart failure
• Possess extremely low blood pressure (hypotension)
• Various drugs

These other drugs are used to treat erectile dysfunction:

• Self-injection of alprostadil. This procedure involves administering alprostadil into your penis' base or side. Drugs that are generally recommended for different disorders are occasionally injected into the penile area, either alone or in combination. Alprostadil and phentolamine are two examples. These combination drugs are sometimes referred to as bimix (if two medicines are present) or trimix (if three are included).

• Each dose has been designed to result in an erection that lasts no more than an hour. Due to the use of a very small needle, injection site discomfort is typically minimal.

• Mild injection-related bleeding, persistent erections (priapism), and, very infrequently, the development of fibrous tissue at the injection site are possible side effects.

• Urethral suppository with alprostadil. A small alprostadil suppository is inserted into the penile urethra during alprostadil (Muse) intraurethral treatment. 

• Penis pumps. A hollow tube with a hand- or battery-powered pump is a penis pump (vacuum erection gadget). The pump is used to remove the air from the tube once it has been positioned over your penis. A hoover is thus produced, drawing blood into your penis.

• You wrap a tension ring around the base of your penis in order to keep the blood within and maintain a firm erection. You then pull out the vacuum.

• The erection often lasts long enough for a couple to have intercourse. You remove the tension ring after sexual activity. Penis bruising is a potential adverse effect, and the band will prevent ejaculation. To the touch, your penis could feel chilly. You should consider getting a penile pump; your doctor may suggest or prescribe a certain model. By doing this, you may be certain that it meets your requirements and was produced by a reliable company.

• Penile prosthesis. Devices are surgically placed into the penis on both sides during this surgery. These implants are made using flexible (bendable) or inflated rods. You may manage when and how long you get an erection by using inflatable devices. The bendable rods keep your penis flexible and firm.

• Penile implants are often not advised before alternative options have been explored. Many people who have tried and failed more conservative therapy report high levels of satisfaction with implants. There is a danger of complications, such as infection, with any operation.

Surgery for a penile implant is not advised if you have an active urinary tract infection.

Exercise 

According to recent research, exercise, particularly aerobic activity that ranges from moderate to intense intensity, can help with erectile dysfunction.

Regular, even more, modest exercise may reduce the incidence of erectile dysfunction. Increasing your exercise level might help to further lower your risk.

With your doctor, go through an exercise regimen.

Psychological guidance

If your erectile dysfunction is brought on by stress, anxiety, or depression, or if the condition is generating stress, your doctor may suggest you consult a psychologist or counsellor.

Complications of Impotence

Among the complications brought on by erectile dysfunction are:

• Unsatisfactory sexual experience
• Worry or tension
• Embarrassed or lacking in self-worth
• Relationship difficulties
• The inability to successfully impregnate your partner

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