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Breaking the Silence on Erectile Dysfunction: Insights into Causes, Diagnosis, and Treatment

Published on: June 5, 2023
Updated on: November 5, 2023
Written by Dr. Abhishek Agarwal
AUM - Advanced Urology Mumbai | Erectile Dysfunction

Erectile dysfunction (ED) is a common and widespread condition that affects numerous men across the globe. It entails the inability to attain or sustain an erection suitable for satisfactory sexual performance. The impact of erectile dysfunction extends beyond physical aspects, encompassing a man’s self-esteem, relationships, and overall well-being.

Causes of Erectile dysfunction (ED)

Erectile dysfunction (ED) can stem from a range of factors, both physical and psychological. Physical causes encompass conditions such as cardiovascular disease, diabetes, hormonal imbalances, obesity, certain medications, or neurological disorders. Psychological factors may involve stress, anxiety, depression, or relationship issues. Additionally, lifestyle choices, including smoking, excessive alcohol consumption, and sedentary habits, can also contribute to the development of erectile dysfunction.

Diagnosis of Erectile dysfunction (ED)

When diagnosing Erectile dysfunction, we at AUM undertake a thorough process that includes assessing the patient’s complete medical history, conducting a physical examination, and ordering relevant laboratory tests. During this assessment, urologists may enquire about symptoms, lifestyle factors, and any underlying medical conditions. Blood tests are often performed to evaluate hormone levels, cholesterol, and blood sugar. In certain cases, additional tests such as ultrasound doppler or nocturnal penile tumescence testing might be recommended to assess blood flow and pinpoint the cause of Erectile dysfunction.

Treatment of Erectile dysfunction (ED)

The treatment of Erectile dysfunction (ED) depends on its underlying cause and the preferences of the individual. Treatment options may include:

1. Lifestyle modifications:

Making positive changes such as adopting a healthy diet, regular exercise, weight management, smoking cessation, and moderating alcohol consumption can improve overall health and contribute to alleviating of Erectile dysfunction.

2. Medications:

Oral medications such as phosphodiesterase type 5 inhibitors (e.g., sildenafil, tadalafil, vardenafil, avanafil) are commonly prescribed to enhance blood flow to the penis and facilitate erections. These medications are effective for many individuals and are usually taken before sexual activity. The medications vary in dosage, duration of action and side effects. Possible side effects include flushing, nasal congestion, headache, visual changes, backache and stomach upset. These medications are not recommended for patients taking nitrate drugs — commonly prescribed for chest pain (angina) — such as nitroglycerin, isosorbide mononitrate and isosorbide dinitrate, have heart disease or heart failure.

3. Alprostadil self-injection:

A fine needle is used to inject alprostadil into the base or side of the penis. The medications may be used in combination as well which is known as bimix (if two medications are included) or trimix (if three are included). Side effects can include mild bleeding from the injection, prolonged erection (priapism) and, rarely, formation of fibrous tissue at the injection site.

4. Alprostadil urethral suppository:

Alprostadil intraurethral therapy involves placing a tiny suppository in the penile urethra using a special applicator. The erection usually starts within 10 minutes and, when effective, lasts between 30 and 60 minutes. Side effects can include a burning feeling in the penis, minor bleeding in the urethra and formation of fibrous tissue inside your penis.

5. Psychotherapy:

For individuals with psychological factors contributing to Erectile dysfunction (ED), psychotherapy or counselling may be recommended to address underlying stress, anxiety, or relationship issues.

6. Hormone therapy:

In cases where hormonal imbalances are a contributing factor, hormone replacement therapy or medications to regulate hormone levels may be prescribed.

7. Vacuum erection devices or penile implants:

These devices provide mechanical support for achieving and maintaining an erection. These are usually recommended when other measures have failed. Penile implants are of inflatable type which can be self controlled or malleable rod type which keeps the penis firm but bendable.

It is crucial to recognize that Erectile dysfunction is a treatable condition, and seeking professional assistance is of utmost importance. By identifying the root causes and choosing suitable treatment options, individuals experiencing Erectile dysfunction can regain confidence, enhance their sexual function, and improve their overall well-being. Open communication with urologists and partners is essential for successful diagnosis, treatment, and the restoration of a fulfilling sexual life.