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Erectile Dysfunction (ED): Causes, Symptoms, Treatment and Prevention.

Erectile dysfunction (ED) is the inability to get or maintain an erection long enough to have sexual intercourse. There are many different causes, which can include conditions affecting your blood vessels, neurological conditions, mental health conditions, and injuries. A healthcare provider can diagnose and treat erectile dysfunction. 

Table of content: 

1. Overview
2. Symptoms and Causes
3. Diagnosis and Tests
4. Management and Treatment
5. Prevention
6. Outlook / Prognosis
7. Living With
8. Additional Common Questions
9. Resources

Overview:

What is erectile dysfunction?

Erectile dysfunction (ED) is a type of penis disorder. This affects your ability to get and maintain an erection strong enough for intercourse.

Your emotions play a major role in getting and maintaining an erection. It is important to feel relaxed, confident and excited. But sometimes it is normal to have erection problems. Erection problems may occur if you feel nervous, anxious, depressed, or tired. Drinking alcohol and/or using substances can also have an impact. It may also be caused by other conditions or as a side effect of certain medications or cancer treatments.

If you are having difficulty getting or maintaining an erection, it is a good idea to make an appointment with a healthcare provider to discuss it further.
In many cases, ED may be the first symptom of another underlying problem, including heart disease. It is important to talk to a healthcare provider if you have trouble getting and maintaining an erection.

Other names for erectile dysfunction include:

• Impotence.

• Impotency.

What are the types of erectile dysfunction?

Healthcare providers separate ED into several categories:

• Vascular erectile dysfunction. Vascular ED includes causes that affect the blood vessels that send blood to the tissues in your penis that allow you to get and maintain an erection, or the valves in the penis that normally keep blood inside. Vascular ED is the most common type of ED.

• Neurogenic erectile dysfunction. Neurogenic ED occurs as a result of nerve problems, which prevent signals from traveling from your brain to your penis to produce an erection. This may be caused by trauma, pelvic surgery, radiation therapy, or neurological conditions such as stroke, spinal stenosis, and multiple sclerosis (MS).

• Hormonal erectile dysfunction. Hormonal ED refers to ED that results from testosterone deficiency or, in some cases, thyroid problems.

• Psychogenic erectile dysfunction. Psychogenic ED includes psychological conditions (conditions that affect your thoughts, feelings, or behavior) that can cause ED. 

How common is erectile dysfunction?

Erectile dysfunction is the most common sex-related condition that men and people who are male at birth (AMAB) report to healthcare providers, especially as they age and develop other health problems.

What is the normal age for erectile dysfunction?

Providers and medical researchers estimate that erectile dysfunction affects more than 50% of men who identify as male between the ages of 40 and 70. And these numbers may be higher – many people do not seek help for the condition because of embarrassment or shame.

Symptoms and causes:

What are the symptoms of erectile dysfunction?

Symptoms of erectile dysfunction include:

• Only sometimes being able to get an erection before intercourse.

• Being able to get an erection before intercourse but not being able to maintain it during intercourse.

• Complete inability to get an erection.

• Maintaining an erection requires a lot of stimulation.

What causes erectile dysfunction?

There are several possible causes of ED, including conditions that affect you:

• Circulatory Systems: Your circulatory system consists of blood vessels that carry blood throughout your body. Your penis needs adequate blood flow to become erect and maintain an erection. Your penis also relies on a series of valves to close when they fill with blood – in some cases, these valves stop working as they should.

• Nervous system: Your nervous system includes your brain, spinal cord, and nerves. They work together to send electrical impulses that help your body, including your penis, move and feel.

• Endocrine system: Your endocrine system includes glands that make and release hormones. Hormones help tell your body to do certain things. Testosterone can help your blood vessels open (vasodilate), which helps blood flow to your penis. 

Physical causes of erectile dysfunction

In many cases, erectile dysfunction is caused by a physical cause. Common causes include:

• Heart disease

• Blocked blood vessels (atherosclerosis)

• High Cholesterol

• High Blood Pressure

• Diabetes

• Obesity

• Metabolic syndrome – a condition that includes increased blood pressure, high insulin levels, body fat around the waist, and high cholesterol

• Parkinson's disease

• Multiple sclerosis

• Certain prescription medications

• Tobacco use

• Peyronie's disease – development of scar tissue inside the penis

• Alcohol and other drug abuse

• Sleep disorders

• Treatment of prostate cancer or enlarged prostate

• Surgeries or injuries that affect the pelvic area or spinal cord

• Low testosterone

Psychological causes of erectile dysfunction

The brain plays a key role in initiating the chain of physiological events that begins with feelings of sexual arousal and leads to an erection. Many things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:

• Depression, anxiety or other mental health conditions

• Tension

• Relationship problems due to stress, poor communication, or other concerns 

Other substances

Substances that have the potential to cause addiction can cause ED, including:

• Liquor.

• Amphetamine.

• Barbiturates.

• Cocaine.

• Marijuana.

• Methadone.

• Nicotine.

• Opioids.

These substances can affect and depress your central nervous system. They can also cause serious damage to your blood vessels, leading to permanent erectile dysfunction. 

What is the primary cause of erectile dysfunction?

Conditions that affect your body's ability to deliver blood to your penis are the most common causes of ED.

Who does erectile dysfunction affect?

You may be at greater risk for ED if you:

• Are 40 or older.

• Have diabetes.

• Body mass index (BMI) is greater than 25.

• Have depression.

• Are physically inactive.

• Smoke. 

Diagnosis and Testing:

How is erectile dysfunction diagnosed?

A healthcare provider can diagnose ED and determine its cause. They will review your medical history and perform a physical examination. They will also ask you questions about your personal and sexual history. These questions may make you feel embarrassed or awkward. But it is important to be honest with the provider to find out the cause immediately. Questions may include:

• Are you currently taking any medications, including prescription drugs, over-the-counter drugs, herbal supplements, dietary supplements, and non-prescription drugs?
• Has a healthcare provider ever diagnosed you with depression or anxiety?
• Do you often feel stressed?
• Are you facing any problem in relationship?
• How often are you able to get an erection?
• How hard is your erection?
• How long are you able to maintain an erection?
• Do you lose your erection because you ejaculate sooner than you want?
• When did you first notice symptoms of erectile dysfunction?
• What exactly happened when you first had symptoms of erectile dysfunction?
• Did you experience erections at night or in the morning?
• What sexual positions do you regularly engage in?

The provider may also ask to talk to your sexual partner. Your partner may be able to provide additional information on possible causes.
The provider may order tests to confirm their diagnosis and determine the cause of your ED. 

What tests will be done to diagnose erectile dysfunction?

It depends on what your healthcare provider suspects is causing erectile dysfunction. Your provider may order:

• Blood test.
• Complete blood count (CBC).
• lipid panel.
• liver function tests.
• Kidney function test.
• Thyroid test.
• Testosterone test.
• Urinalysis (urine test).
• Penile Doppler ultrasound.
• Tests that measure whether the nerves in your penis respond to vibration (penile biothesiometry).
• Medicines that temporarily make your penis erect (vasoactive injections).
• Magnetic resonance angiogram (MRA).

Before the test, your provider will explain what the test involves and answer any questions you may have. If you don't feel comfortable, you can decide not to have the test at any time. 

Management and Treatment:

What is the best way to cure erectile dysfunction?

The first step in treating erectile dysfunction is to identify the underlying cause. A healthcare provider will help determine the best treatment for you. Treatment options may include:

• Cardiovascular exercise. Vigorous cardiovascular exercise for at least 45 minutes three times per week may help reverse some cases of mild ED. Cardiovascular exercises may include brisk walking, jogging, swimming, cycling, and jumping rope.

• Quit smoking. For men with mild ED, quitting smoking may lead to improvement after several months.

• Talking to a sex therapist.

• Oral medications that help increase blood flow to your penis, including sildenafil (Viagra®), vardenafil (Levitra®), tadalafil (Cialis®) or avanafil (Standra®). Oral medicines start working within an hour. 
  
  

• Penile low-intensity focused shockwave therapy (LiSWT). This non-invasive treatment improves blood flow using sound waves. It may take two months to see improvement.

• Medications that you inject directly into your penis to cause an erection include alprostadil (Caverject®), papaverine (Papacon®), phentolamine (Rezitine®), or a combination of several medications. The injected medicines start working within 10 minutes.

• Vacuum contraction device (penis pump). Penis pumps start working almost immediately.

• Testosterone replacement therapy, which is available in the form of gel, injection, patch, and pellets. Testosterone replacement therapy starts working within four weeks.

• Penile implant procedure. Penile implant is a procedure in which a surgeon inserts a device into your penis to make it harder. This device does not affect sensation, urination or sexual arousal. 

Read more to know: 

How to Use Viagra for Best Results: A Comprehensive Guide 

Viagra vs. Sildenafil: Understanding the Difference 

Will ED go away on its own?

ED will not go away on its own without changes in your lifestyle or some type of treatment. 

Prevention:

Can ED be prevented?

Some lifestyle changes may help reduce the risk of developing erectile dysfunction, including:

• Lowering your cholesterol.

• Being more physically active, especially doing cardiovascular exercise like running, jogging or cycling.

• Maintaining a healthy weight for you.

• Getting high quality sleep.

• Eating healthy foods low in saturated fat, such as fruits, vegetables and whole grains.

• Stopping smoking.

• Reduce or stop drinking alcohol.

Outlook/Forecast: 

What can I expect if I have erectile dysfunction?

The outlook for ED is good and it is a very treatable condition. Although there is no cure for some causes of ED, several treatment options can help you get and maintain an erection strong enough for intercourse.

Living With: 

When should I see a healthcare provider?

If you suspect you have erectile dysfunction, talk to a primary care doctor or urologist. They can help diagnose ED, identify its cause, and recommend the best treatment options for you. A urologist is a healthcare provider who specializes in diagnosing and treating conditions that affect your reproductive system and urinary system.

When should I go to the ER?

If you are taking medication for erectile dysfunction and erection pain lasts more than two to four hours, go to your nearest emergency room. This could be a sign of priapism, which can cause permanent damage to your penis without treatment.

What questions should I ask the healthcare provider?

• Is it normal to have erectile dysfunction?

• How do you know if I have erectile dysfunction?

• What is causing my erectile dysfunction?

• Which ED treatment option do you recommend?

• Can erectile dysfunction cause other conditions that affect my sexual health?

• Can I still have orgasms if I have ED?

• Can you recommend a sex therapist?

• Can you recommend a support group for people suffering from erectile dysfunction?

• Am I a candidate for a penis implant procedure? 

Additional Commen Question:

How does it feel when you can't get an erection?

You may feel a variety of emotions due to erectile dysfunction. You may feel embarrassed, disappointed, guilty, ashamed, angry, or "less than." This can lead to more serious long-term feelings like anxiety and depression. But you don't have to live with these feelings. ED is common, and it does not reflect your value as a person. Health care providers are available to assist.

What can I do if my partner has erectile dysfunction?

Erectile dysfunction is a sensitive topic for many people. The following tips may help you if your partner has erectile dysfunction:

• Encourage open communication. Let your partner know that you care about their feelings and well-being. Take appropriate time to talk to your partner so that he or she does not feel insecure.

• Remind your partner that they are not alone. ED is common, and treatment is available. Therapists and support groups can help your partner understand their feelings.

• Encourage healthy habits. Focus on the benefits of regular exercise, healthy eating, and reducing substances that cause ED.

• Get informed. Your partner will feel supported if you have accurate, up-to-date information on erectile dysfunction and its treatment options.

• Offer to accompany your partner to their appointments. You can help your partner ask questions, take notes, and give the healthcare provider information that can help them make a diagnosis. Respect their privacy if they prefer to see a provider alone.

• Express your feelings in other ways. Sex is not the only way to increase intimacy between partners. You can show your partner that you care through physical contact such as holding hands or rubbing the back, spending time with them, kissing, writing notes, being patient, and being a good listener.   

Read more:

Top 10 Questions/Answers About Viagra 

is viagra safe for take dialy? what are the benefits?

Resources:

• Erectile Dysfunction medicines 

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A Note from MOD Pharmacy

Erectile dysfunction (ED) is common, especially as we age. This can lead to embarrassment, low self-esteem, and other serious psychological conditions. But you shouldn't feel ashamed or embarrassed about having ED. This may be your body's way of telling you that something is not right. It's important to have an open conversation with a healthcare provider about your symptoms and how they affect your quality of life. They can diagnose ED, determine its cause, and recommend the most appropriate treatment for you.