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Erectile Dysfunction

  • What is Erectile Dysfunction?

    Erectile dysfunction (ED) refers to the inability of a man to achieve or maintain an erection enough for sexual intercourse. An erection is driven by brain impulses that stimulate the inflow of blood through the blood vessels and the relaxation of the muscles in the penis. ED is a problem not a disease, and most men experience this at some point in their lives, most often by the age of 40.

  • ED can be caused by physical and psychological factors.

    The physical factors include:

    • Certain prescription drugs like blood pressure drugs and antidepressants
    • Chronic illnesses like diabetes, cardiovascular (heart-related) diseases, hypertension (high blood pressure), nerve damage and multiple sclerosis (an autoimmune disease affecting the nerves). These illnesses can affect the nerves and the blood flow to the penis, and lead to ED.
    • Low levels of testosterone, and injured or damaged nerves and arteries near the penis (eg. due to pelvic surgery)
    • Poor lifestyle, which includes smoking, drinking too much alcohol, drug abuse, lack of physical activity, and being overweight.

    The psychological factors include:

    • Fear of sexual failure
    • Guilt
    • Low self esteem
    • Previous traumatic sexual experiences
    • Stress, anxiety, and/or depression

    The prevalence of ED increases with age, from 5% in men aged 45 years to 50% in men aged over 75 years.

  • There are different treatment options available for ED. Your doctor will evaluate your condition and suggest the appropriate treatment for you, depending on the cause of your ED and your general health. Treatments include:

    • Oral medication – usually the first line of treatment and effective in about 80% of patients (brand names include Viagra, Levitra, or Cialis). However these may not be suitable for everybody as they can interact with some prescription medications you may be taking.
    • Injection therapy – the second line of treatment if oral medications are unsuccessful. The patient can self-inject a drug (prostaglandin E1) into the shaft of the penis to achieve an erection.
    • External suction devices – used to pull blood into the penis to achieve and maintain an erection for intercourse
    • Penile prosthesis (implants) – surgically fitted for some patients to artificially create an erection
  • ED could be a sign of various underlying diseases including:

    • Early diabetes
    • Heart diseases
    • Neurovascular diseases

    Heart attacks or strokes can develop after taking medications to treat ED.

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