burdened with erectile dysfunction is staggering.
When erectile dysfunction is seen in older men with no previous history of the disease, the cause is most commonly of a physical nature, such as decreased blood flow to penile erectile tissue, the result of surgery, injury, or side effects of drugs. In fact, the incidence of erectile dysfunction increases with age. Less than 5 percent of men 21 or younger have erectile dysfunction, as opposed to nearly 25 percent of men 65 or older having erectile dysfunction.
The very good news is that we have entered an era where there is not a stigma associated with erectile dysfunction. With information being disseminated, classifying and exposing the real fact that erectile dysfunction is a bonafied medical condition, men no longer feel "less manly" about having ED, and seek treatment. With this new awareness has come an unprecedented number of effective options to treat erectile dysfunction. Within the text of this page, we will discuss the specific causes for erectile disfunction, detail various treatment options, and describe the most popular pharmaceutical agents used to effectively and safely treat erectile dysfunction.
Let us first begin by explaining what actually leads to an erection. The penis is comprised of two cavities, called the corpora cavernosa that run the length of the entire penis. Within these cavities is spongy tissue surrounded by a membrane called the tunica albuginea. Within the spongy tissue are blood vessels and smoth muscle.
When mental or or physical sexual stimulation occurs, blood is directed toward the spongy tissue and smooth muscle within the corpora cavernosa, and engorges the tissue. This rush of blood causes the tissue to increase in pressure and expand, leading to the formation of an erection. Once mental or physical stimulus is removed (or climax acheived), the smooth muscles relax, and the blood drains out of the spongy erectile tissue, causing a reversal of the erection.
With such a precise sequence of varous organ systems being responsible for the formation and maintenance of an erection, it is easy to see how easily the process can be disrupted. Compromise of any of the organ systems involved in the erection process (nervous systmem, cardiovascular system, endocrine system, and reproductive system) can lead to erectile dysfunction.
The most common causes for erectile dysfunction are primary physical diseases. The most common are diabetes, atherosclerosis (hardening of the arteries), primary neurological disease such as parkinson's disease or multiple sclerosis, and sustained alcohol or drug abuse.
Diagnosing erectile dysfunction is attained with a combination of complete history, physical examination, psychological examination. For example, from a historical perspective, a history of alcohol abuse would point to substance abuse related erectile dysfunction. From a physical perspective, the appearance of breast tissue in the pectoral regions could indicate a hormonal problem. Psychologically speaking, if the patient has no problem maintaining an erection while masturbating, but cannot sustain an erection during intercourse with a partner, then erectile dysfunction is not the problem at all, but performance anxiety is.
Routine laboratory blood tests that test for hormone imbalances, kidney dyfunction, diabetes, and other diseases are often helpful in diagnosing erectile dysfunction. Also, nocturnal penile tumescence, the monitoring of nighttime sleep erections, can also help to pinpoint the cause of erectile dysfunction. This test is based on the fact that healthy men have a certain number and duration of erections throughout the course of the night.
Treatment for erectile dysfunction varies, depending on severity and underlying causes. The general consensus among internal medical and urological specialists is that the proper procedure is to start with least invasive techniques and progress to more intensive treatments only as the case dictates.
In cases where there is no physical underlying cause, but the issue is performance anxiety, treatment is geared to psychological counseling for the patient, ideally together with the sexual partner when possible. In refractory cases, the patient can be placed on anti-depressant medication, such as Paxel or Prozac to help augment psychotherapy.
In cases where substance abuse is suspected to be the culprit, the erectile dysfunction treatment is geared toward treatment for the addiction, such as counseling or rehab. The stoppage of substance abuse will often lead to a return of erectile function.
When arterial blockages from clots, scar tissue from surgery or pelvic injury, or atherosclerosis impede the blood flow to the penis and lead to erectile dysfunction, then treatment is aimed toward surgical correction of the blockages. However, in older patients presenting with widespread blockages, surgery is unlikely to be successful.
The most popular mode of treatment for erectile dysfunction has become drug therapy. In the past, drugs had to be injected into the penis to work effectively. However, now, with the advent of oral medications, relief from erectile dysfunction can be as easy as swallowing a pill one hour before the act. The first drug of this kind was Viagra, followed shortly by Levitra and Cialis. These medications are part of a class of drugs called phosphodiesterase inhibitors, that increase blood flow to the penis.
Phosphodiesterase inhibitors have shown themselves to be highly effective and safe for treatment of erectile dysfunction. However, these drugs can be quite dangerous when taken in conjunction with other medications, or while affected by other diseases. Therefore, it is important to NEVER take any of these drugs without the full guidance of a physician.
When the severity of erectile dysfunction is beyond medical resolution, then the the next option would be to try a vaccume device. Mechanical vacuum devices cause erection by creating a vacuum, which draws blood into the penis, causing engorgement and expansion. The device has three components: a plastic cylinder, into which the penis is placed; a pump, which draws air out of the cylinder; and an elastic band, which is placed around the base of the penis to maintain the erection after the cylinder is removed and during intercourse by preventing blood from flowing back into the body. One variation of the vacuum device allows a semirigid rubber sheath that is placed on the penis and remains there after erection is attained and during intercourse.
Another option is surgical implantation of an erection pump. With this treatment option, erectile dysfunction is managed by surgical implanting inflatable implants into the corpora cavernosa. The implants can be manually inflated, expanding the penis for intercourse, by pressing a pump that is surgically implanted just under the skin of the scrotum.
Whatever the cause for erectile dysfunction, there are many treatment options available to treat it, with new ones emerging every day. Defeating erectile dysfunction can be as easy as picking up the telephone and making an appointment with your doctor.
