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About Erection Problems
Today experts estimate that, in most cases, Erectile Dysfunction (ED) has an underlying medical cause. This means that there are medical problems that may contribute to ED and can be treated effectively.
What are these underlying medical problems? Some of the physical causes of ED include:
- Heart disease
- Prostate surgery
ED also occurs frequently in men who have clinical depression or are taking antidepressant medications (however, you should continue to take these medications unless your doctor advises you otherwise). Lifestyle factors can also be important, as smoking and alcohol can all contribute to the problem.
ED is a common problem
The World Health Organisation has defined Erectile Dysfunction (ED) as “the consistent or recurrent inability of a man to attain and/or maintain a penile erection sufficient for sexual performance.” ED is one of the most common male sexual disorders. The good news is that it is treatable about 95 % of the time. Although the terms ED and impotence can be used to describe the same thing, ED is preferable because it is more precise.
Although psychology can play a role in sexual function and desire, most erection problems have an underlying physical cause. You can take our self-assessment quiz to help you identify issues. These should be discussed with your doctor.
ED is a common condition. It can be progressive.
The information contained here will help you understand ED and its causes.
How does ED affect men?
Men with ED can experience low self-esteem, performance anxiety, depressive states, stress, guilt and relationship conflicts, and sometimes these can make the problem worse.
ED are you at risk?
Most experts now agree that up to 80 % of all ED cases may be due to physical conditions. However, there are both physical and psychological reasons. Below are some of the risk factors or causes of ED.
Risk factors and causes of ED
Vascular Disease: Arteriosclerosis (hardening of the arteries caused by high cholesterol or high blood pressure), heart disease, stroke, and hypertension (high blood pressure) all affect blood flow in and out of the penis. Vascular disease is the most common physical cause of ED.
Diabetes: This chronic condition can cause nerve damage (neuropathy) and damage to the blood vessels that supply the penis. About 50% of men with diabetes can develop ED.
Nerve diseases: Neurological conditions include spinal cord injury, multiple sclerosis, and nerve damage due to diabetes or alcoholism.
Hormonal problems: Low levels of the male hormone can result in ED.
Surgery: Surgery for colon, rectal or prostate disease and even radiation therapy in the pelvic area can damage nerves and blood vessels, which may result in ED.
- Spinal cord injuries
- Pelvic fractures
Chronic medical conditions: If you have a chronic medical condition, ask your doctor or men’s sexual health professional whether it might be affecting your sexual health.
Side effects of medications: There is a long list of prescription medications and over-the-counter medications that have the potential side effect of ED. If you observe problems with your erection after starting a new medication, ask your doctor or men’s sexual health professional about possible side effects of the medication and possible alternatives and solutions. Do not stop or change the dosage of any medication without advice from your doctor.
Alcohol: Heavy drinking may immediately reduce your ability to have a strong erection. Long-term, excessive drinking can cause nerve and liver damage.
Sedentary lifestyle: Lack of exercise can lead to ED.
Smoking: Men who smoke have a greater chance of developing ED than men who don’t smoke.
These can occur alone or in combination with one or more of the physical causes of ED.
Performance anxiety: When a man is anxious about his sexual performance, his erectile function can be affected.
Stress: Stress can affect sexual performance.
Depression: Men with ED can have some degree of depression and men with depression can also have ED.
Relationship problems: Tensions with your sexual partner, whether related to sexual issues or other issues
Oral Medication for Erectile Dysfunction
There are a number of tablets available in this class, known as PDE5 inhibitors. Your doctor can explain the differences between these tablets.
These treatments are generally well tolerated, and work in the majority of men with mild to moderate ED. The tablets work by enhancing the normal sexual response, allowing greater blood flow to the penis.
A common misconception is that men will have a permanent erection while the medication is working – this is not the case. All tablets for ED require sexual stimulation to work.
You should always obtain these tablets on prescription from your doctor and purchase through your pharmacist (for personal use only) to ensure you are purchasing legitimate product.
Remember that you should always talk to a doctor before commencing medical treatment to assess your individual suitability for taking these tablets or other treatments.
Penile Injection Therapy
Medication that increases blood flow in the penis is injected by the patient injected into the penis shortly before sexual activity.
Men with ED at the more severe end of the spectrum tend to find injections into the penis a more effective treatment than the tablets. Injections have been used in Australia since the mid-90s. Injections are only available on prescription and are usually recommended if:
- The oral medication has not worked, or
- The individual is unable to use them for medical reasons
The injections work by directly opening up the penile blood vessels. It may take between 5 and 10 attempts to master the technique.
After injecting, the drug will usually work within 5 to 20 minutes (with or without sexual stimulation) and ideally will last for 30 minutes.
You should discuss any treatment involving injections with your doctor. A follow-up appointment is important to ensure you are correctly using the injection.
It is recommended to start injections at a lower dose, then work your way up to minimise the chance of a prolonged erection (called priapism), which can cause permanent damage. By working with your doctor, this risk can be minimised.
Some men will experience pain in the penis and sometimes scarring may occur.
The vacuum device is placed over the penis and, as air is pumped out of the cylinder, blood is drawn into the penis making it enlarge.
A ring is then placed around the base of the penis to maintain the erection.
It is recommended that its use is limited to 30 minutes. The ring must be removed when this time has elapsed or there is a risk of permanent damage to the penis (i.e. it’s important not to go to sleep with it on).
Your doctor will recommend where to purchase these devices.
A really good presentation is available at : http://www.readyanytime.com.au/pdfs/Standing_Tall.pdf
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