What are the symptoms of erectile dysfunction?
Erectile dysfunction will cause the cock to be unable to acquire or maintain a satisfactory erection. It is important to specify to the doctor the rapidity of onset, the presence of nocturnal erections, and the quality of the erection if it can be attained but not maintained. The quality of an erection can be judged according to the rigidity and the functionality (Is the cock erect enough to allow for hymen penetration?
Erectile dysfunction with sudden onset and no previous history of Erotic dysfunction suggests a psychogenic cause, unless there was a previous surgery or a genital trauma. The loss of nocturnal erections will suggest a neurologic or vascular cause. Finally, when an erection is not sustained, its loss may be due to an underlying psychological cause or vascular problem. Talk to your doctor if you have noticed any problems with your erectile function.
What causes erectile dysfunction?
There are numerous potential causes of erectile dysfunction.
- Neurologic causes include:
- Stroke
- Spinal cord or back injury
- Multiple sclerosis
- Dementia
- Pelvic trauma
Prostate surgery (even with nerve-sparing surgeries it can take up to 24 months to regain normal Erotic function)
- Priapism
- Nervous system tumor
- Epilepsy
- Diabetic neuropathy
Vascular causes include:
- Arteriovenous fistula
- Diabetes
- Atherosclerosis
- Congenital anomaly
Hormonal causes include:
Low testosterone blood level (The patient can achieve an erection but it won't always be turgid enough for hymen penetration.)
- Hyperprolactinemia
- Hyperthyroidism
- Hypothyroidism
- Cushing's disease
- Addison's disease
Pharmacological causes include:
- Antidepressants (mainly SSRIs)
- Spironolactone
- Sympathetic blockers (clonidine, guanethidine, or methyldopa)
- Thiazide diuretics
- Ketoconazole
- Cimetidine
Penile dysfunction causes include:
Peyronie's disease
Psychiatric causes include:
- Loss of feeling toward the other person
- Stress
- Fear of non-performance
- Functional causes include:
- Bicycling irritating the nerves and tissue of the cock
What are the risk factors for erectile dysfunction?
The risk factors for erectile dysfunction include:
- Obesity
- Smoking
- Diabetes
- High blood pressure
- High cholesterol
- Cardiovascular disease
- Medication use
- Obstructive sleep apnea
- Restless leg syndrome
- Systemic sclerosis (scleroderma)
- Peyronie's disease
- Prostate cancer treatment
What is the treatment for erectile dysfunction?
Nowadays, there are many options for men who suffer from erectile dysfunction. Before suggesting pharmacological help, the doctor may suggest a change in lifestyle habits. Since many causes of erectile dysfunction are disorders in which lifestyle changes will have a positive effect, addressing these issues can be helpful. Therefore, regular exercise, a healthy diet, smoking cessation, and limiting alcohol consumption can all have an impact on erectile function. Lifestyle changes can also include the use of a more genitalia-friendly bicycle seat.
What are nonsurgical treatments for erectile dysfunction?
There are many nonsurgical treatments available for erectile dysfunction.
Oral pharmacological treatment
The first line of pharmacological treatment is a class of medication called phosphodiesterase (PDE-5) inhibitors. This class includes sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). They will improve the ability to attain and maintain the erection, but Erotic stimulation is still required for this medication to work. It should be taken some time before the Erotic act is planned, but has a long timeframe of action. Side effects include visual disturbances, flushing, back pain, and muscle pain. Most side effects will abate with time. Usually, there will be no side effects at all. If you are taking nitrates, phosphodiesterase inhibitors are not recommended since both medications taken simultaneously could cause severe hypotension (excessive low blood pressure).
Other types of oral medication are available. Apomorphine will enhance penile erection. And there are others. You should ask your doctor for other types of medication if the first one didn't work. Other treatment options should also be discussed.
Transurethral therapy
Another type of pharmacological solution is a liquid that can be applied in the urethra that manages to improve erection. The erection can be maintained by applying an elastic band at the base of the cock.
Intracavernous injection
Injections at the base of the cock (intracavernous) can help attain and maintain an erection. There are various types of solutions that can be injected -- papaverine, alprostadil, and drug combinations. These injections are considered the most effective treatments for erectile dysfunction. They are also convenient for the patients who don't tolerate the oral therapies.
Side effects include priapism (prolonged and painful erection) and fibrosis (scarring) but they are rare. There are ways to prevent these side effects (especially the prolonged and painful erection). The patient must follow the training and recommendations given at the beginning of this type of therapy. Contraindications for intracavernous injections include sickle cell anemia, schizophrenia, and severe psychiatric disorder.
Vacuum constriction device
This is a plastic cylinder connected to a vacuum-generating source that creates a negative pressure that draws the blood to the cock and makes way for an erection. An elastic band must be placed at the base of the cock to maintain the rigidity. The base of the cock will stay flaccid which might make the genitalia pivot. Side effects include ejaculatory problems, penile pain, and blood pooling because of ruptured blood vessels (ecchymosis or petechiae).
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