Treatment of erectile dysfunction
Medically Reviewed by Dr Sravya, MBBS, MS
Introduction
Erectile dysfunction, previously termed impotence, is the condition where men fail to achieve or maintain a rigid penile erection needed for
satisfactory sexual intercourse. It is a very common condition in men aged over 40 years.
It has generally been observed that erectile dysfunction is closely related to conditions such as cardiovascular disease, diabetes mellitus,
hyperlipidemia, and hypertension. The majority of patients, particularly younger men with ED have organic disease and a primary psychological
issue related to marital and relationship issues, cultural norms, loss of self- admiration, shame, anxiety, and depression.
For the treatment of erectile dysfunction, it is important to know that the
causes of erectile dysfunction are often multifactorial. It is very important
to distinguish early whether the condition has an underlying psychological cause or an organic disease.
It is very difficult to find accurate values for the true prevalence or
treatment of erectile dysfunction because many patients are reluctant to get medical attention and many physicians also fail to ask patients about theirsexual health.
Diagnostic evaluation
Erectile dysfunction is associated with many risk factors. Doctors should have a thorough knowledge of the medical condition of the patient. The physical examination of patients may give results of neurological or cardiovascular disease and intrinsic penile pathology.
Lab tests can be ordered by health care providers, such as blood tests and urine samples, to look for health problems that cause ED. Other ways also can be followed, such as questionnaires, which are often used by health experts. They rate your ability to initiate and keep erections, determine your satisfaction with sex, and help to identify if there are any problems with orgasm.
In some cases with ED, best ed treatment may be needed or re-assess patients after a treatment fails. Hence, some advanced function tests are
performed, such as,
- Testosterone and other male hormones test
- Ultrasonography to check blood flow (penile Doppler).
- A vascular stimulant shot into the penis to cause an erection
- Nocturnal penile tumescence (NPT) can be done to check sleep erection
- Pelvic X-rays like arteriography, MRI, or CT scanning can also be done if needed, and it is rare unless there is a history of cancer.
Best erectile dysfunction treatment
The following are the best ed treatment options:
1. Medication
- Non-invasive treatments are often prescribed first because they are the best ed treatment options that work well and are safe.
- Oral drugs or pills are prescribed, such as phosphodiesterase, which are type-5 inhibitors.
- When low testosterone is detected in blood tests, testosterone therapy is given. In those rare cases where low blood levels of testosterone are the reason for ED, testosterone therapy can be the best ed treatment to fix normal erections when combined with ED drugs.
2. Surgical treatment
- ICI, intracavernosal Alprostadil, and such penile injections are available. When the oral drugs do not show the required effect, the drug Alprostadil has been approved for use in men having ed. This drug is available in two forms, based on the type of administration that is intracavernosal injection or through the urethra.
- Penile implants are also helpful in the treatment of erectile dysfunction. The main surgical ed treatment option involves the insertion of a penile implant, also called a penile prosthesis. Penile vascular surgery is recommended only in young men, and it is not for older men with hardened arteries.
- Surgery to bypass penile artery damage is consulted in some younger men who have a history of severe pelvic trauma.
3. Vacuum devices
- A vacuum erection device is a plastic tube that slides over the penis and makes a seal with the skin. A pump present at the other end of the tube builds a low-pressure vacuum around the erectile tissue, which causes the erection. At the base of the penis elastic ring is then slipped, which holds the blood in the penis for about 30 minutes.
- Vacuum devices can be susceptible to mechanical faults which may affect efficacy, such as poor seals.
- Many people with ED find other treatments convenient and preferable to these vacuum devices.
4. Lifestyle changes
- The ed treatment option starts with taking care of heart and vascular health. A doctor may point out all the risk factors that can be changed or improved.
- Patients may be asked to change their certain food habits, stop smoking, increase exercise, or stop using drugs and alcohol, or may also suggest treating emotional problems. Doctors may suggest working on relationship conflicts, stress management, depression, or anxiety from coming from past problems with ED (performance anxiety.
Why is counselling needed?
Patients may think, why is counselling needed, or does this therapy work? So, counselling can be a very helpful part of treatment for erectile
dysfunction as it will allow the physician to understand the underlying cause of the condition. Counselling can develop coping mechanisms for
dealing with ED and also can improve communication with a partner about it.
During the counselling session, the doctor will give the patient activities to do at home, which may include reading books regarding sexuality and
improving sexual communication.
Though the physical examination and blood test are normal in patients having ED, counselling can help with improving this condition as the reason behind the condition can be financial worries, relationship conflicts, stress, and poor communication with a partner.
A counselor can help you to find out and challenge negative thoughts about your body and your ability to perform sexually, can help to explore different treatment options, and can help you to work through any emotional and psychological issues.
If you are willing to find a counsellor whois specialises in erectile dysfunction, you can ask your doctor for a referral or search online for a therapist in your area.
After treatment effects
After the treatment of erectile dysfunction, most people experience considerable improvement in their symptoms. After treatment, men can
experience the following things.
- After receiving the treatment, the patient’s ability to get and maintain an erection improves, and it is firm enough for sexual intercourse. The men’s ability to get and maintain an erection after treatment depends on what was the underlying cause of the ed and the type of treatment done.
- Sometimes, the effects of treatment may be seen immediately, or they may take some time than usual to appear. It is very important to be patient with your doctor to find the right treatment plan for you.
- Men who receive treatment will be able to have erection without taking any medication or using any other aids and can have sex for a longer period.
- The treatment will make you feel more confident and self-assured in your sexual experience.
- ED can be very frustrating and embarrassing for men, but successful treatment can give improved sexual satisfaction for both men and their partners.
- In addition to all the physical benefits received from treatment, it can also have a positive effect and improvement on a man's mental and emotional health, which will help him to connect with his partner.
If medical treatments don’t give the desired and expected effect, then the doctor may suggest the following:
- Change the dosage that was prescribed by the doctor previously.
- Reviewing the instructions again may help to reveal a missing part of a treatment plan.
- Planning some other different ed treatment options may be necessary, such as emotional/relationship counseling, a vacuum erection device, or a penile implant are all good alternatives when other methods fail.
Frequently Asked Questions
Erectile dysfunction is an inability to get or maintain a penile erection long enough to have sexual intercourse and it is a very common condition that affects up to 50% of men more than the age of 50. But if it happens in younger men, they should get a hesitation-free
consultation from the doctor.
Yes. Definitely, you can get combined therapy. However, combination therapy is often more effective than monotherapy; you should get it only under the supervision of your healthcare provider.
There are several things you can do to help prevent ED, such as maintaining a healthy lifestyle, managing stress, doing yoga, meditation, and getting consultation from a doctor.
Yes, there may be side effects such as headache, pain, swelling, flushing, and discomfort. But these are not severe side effects.
All the treatment options are very effective although penile implant is a surgery that also carries risks, they have the highest possibility of success rate and satisfaction among ed treatment options.