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Understanding Erectile Dysfunction -- Diagnosis and Treatment

What Are the Treatments for Erectile Dysfunction?

If you are troubled by occasional erectile dysfunction, remember that arousal takes longer as you get older and that satisfaction should not be equated with performance. If dysfunction is severe and persistent, you should seek medical help. The number of treatment options has increased in recent years.

Many doctors will recommend changes in lifestyle as a first step in treatment. Suggestions may include the following:

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  • Cut back on alcohol. 
  • Stop any tobacco or illegal drug use.
  • Talk to your doctor about your prescription medications. Some drugs may not only interfere with achieving erection but also decrease your interest in sex and the ability to reach orgasm.
  • Reduce stress.
  • Eat a healthy diet.
  • Exercise regularly.
  • Lose weight if you're overweight or obese.

 

Medications for Erectile Dysfunction

The most common medical treatments for erectile dysfunction include medications. Several drugs may be used:

  • Tadalafil(Cialis), vardenafil (Levitra), avanafil (Stendra), vardenafil (Staxyn), and sildenafil (Viagra) are effective in about seven out of 10 men who use them. A pill is taken one hour before intercourse on an empty stomach and, when effective, allows a normal erection with stimulation. These drugs are not to be used by men who take any kind of nitroglycerin or nitrate drugs because the combination can result in dangerously low blood pressure.
  • Self-injected medications can produce an erection. The drug is injected before sex into the side of the penis; these drugs may also improve long-term potency and penile blood flow.
  • Prostaglandin suppositories can be inserted into the urethra to produce erections.
  • Testosterone replacement therapy may help men with low testosterone levels, but no specific level of the hormone guarantees potency. Treatment comes in many forms, including shots, patches, gels, and oral tablets, for example.

Devices to Aid Erection

Another option for the treatment of erectile dysfunction is a vacuum inflation device. This instrument draws blood into the penis by creating negative pressure around it; a rubber ring is then slipped over the base of the penis to maintain the erection. The ring should be removed after 30 minutes to restore circulation and prevent damage to the penile tissues.

Surgery to Aid Erections

For certain blood-vessel problems, vascular surgery to open arteries leading to the penis may be of benefit. The effectiveness of such surgery can be quite variable and for the most part is not a main treatment option. It may be attempted for men with a traumatic injury to arteries that supply blood to the penis.

Penile Implants

When none of these therapies work, some men choose a penile implant. The simplest is a semirigid type that produces a permanent erection. More sophisticated and expensive implants are inflated by a pump mechanism placed beneath the skin of the scrotum. These can be very effective, with very high patient and partner satisfaction. There is, however, a risk of infection or that the device will fail over time.

Treating Psychological Causes

If the cause of erectile dysfunction is judged to be psychological, it is crucial to review your relationship with your partner and examine other possible sources of stress or tension in your life. A trained therapist can aid in these matters and may help unearth problems such as unreasonable guilt, performance anxiety, or inhibiting attitudes toward sex that are preventing a healthy sex life.

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