Erectile Dysfunction is the persistent inability to achieve and maintain an erection suitable for penetrative sex.
Not sure if you have ED? Take the online SHIM Test, a simple 5-question form used by doctors to categorize erectile dysfunction.
Primary Causes of Erectile Dysfunction
There are many possible causes for erectile dysfunction. Erectile dysfunction is often a good indicator of overall health.
The most common cause of erectile dysfunction, especially among older men, is a vascular or circulatory problem. Other causes include neurological or nerve damage, Diabetes, Parkinson’s Disease, side effects of prescription medications, hormonal or vitamin deficiencies, and psychological issues such as anxiety, stress, or depression.
Sometimes ED is a symptom of a serious underlying problem, such as heart disease, so if you’re experiencing ED, it’s important to see a doctor.
Primary Treatments for Erectile Dysfunction
Oral medications, called PDE-5 inhibitors (Viagra, Cialis, Levitra, or the generic equivalents) are the most common treatment for erectile dysfunction. These medications don’t cure ED, but they allow most men to achieve an erection. They are effective for 60-65% of men. Doctors usually prescribe these pills as the first-line treatment for erectile dysfunction.
Lifestyle changes can reduce the effects of ED. This includes eating a heart-healthy diet, getting plenty of aerobic exercise, establishing a regular sleep schedule, quitting smoking, and reducing their alcohol consumption. Men can also do Kegel exercises to strengthen their pelvic floor muscles, which some studies have shown to reduce ED.
If PDE-5 inhibitors and lifestyle changes don’t improve your erectile dysfunction, there are several other treatment options available:
Vacuum pumps, also called penis pumps, can be used to achieve an erection prior to sex. A plastic tube is placed over the penis, and a small pump is used to create a vacuum, causing the penis to fill with blood. Pumps can be cumbersome and uncomfortable, and most men find them to be a real “mood killer.” However, pumps improve blood flow in the penis, and long-term daily use may improve erectile dysfunction.
Intracavernous penile injections are a good alternative for men who don’t respond well to PDE-5 inhibitors; they are effective for 80-85% of men. Medication is injected directly into the side of the penis prior to sex, using a very small needle. Just like a PDE-5 inhibitor, it allows a man to achieve a normal erection.
Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT), commonly called shockwave therapy, is used to treat ED caused by vascular problems. A series of treatments, administered in a clinic or by using a home device, improve blood flow in the penis and may restore the ability to achieve an erection.
Penile implants are seen by most men as a last resort treatment, because they require surgery, and the procedure cannot be reversed. Inflatable chambers are surgically implanted in the penis, and a small pump is placed in the scrotum. Implants have the highest rate of patient satisfaction among men and their partners of any ED treatment; over 90%!
Psychogenic Erectile Dysfunction
ED can also be caused by psychological or interpersonal issues, such as stress, anxiety, depression, or relationship problems. Psychological factors can add to the problems for men who have ED due to physical causes.
Sometimes psychogenic ED responds to the treatments described above, by giving men a “confidence boost” that may overcome anxiety. In many cases, however, men need help from a therapist, coach, or counselor who specializes in sexual dysfunction.
The Emotional Impact of Erectile Dysfunction
Studies show that erectile dysfunction can have a tremendous negative impact on the emotional and mental health of men and their partners. It can cause feelings of inadequacy, loss of self-worth, depression, and anxiety. It can contribute to a breakdown in intimacy and communication, and can even destroy relationships.
Overcoming the emotional impact and maintaining intimacy in your relationship often requires help. This can be a big hurdle, because most men are not comfortable talking about erectile dysfunction. Sometimes books or online resources can open up discussions between men and their partners. There are also a number of online discussion forums, as well as sex counselors who offer remote sessions.
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