What is Erectile Disfunction?
Erectile dysfunction (ED) means the inability to get an erection when you want to or the inability to keep an erection long enough to enjoy the sexual activity that you choose. ED is common. Up to 50% of men will have ED at some point in their life. It is more common in older men but is definitely not just part of the normal aging process. ED is embarrassing and frustrating for men and their partners. Most family doctors and urologists are used to talking to men about ED and you should not be afraid to discuss it.
How do Erections Work?
During sexual activity the brain signals the body to increase blood flow to the penis. Nerves that go to the penis also become more sensitive. Blood flows into special tissue inside the penis called the corpora cavernosa. The corpora contain spongy muscle tissue that fills with blood. The increased pressure inside the penis causes an erection. After orgasm, the process is reversed, blood flows out of the penis and the penis becomes soft again.
What Causes ED?
There are many, many reasons for men to have problems with erections. ED can be a sign of a medical problems such as heart disease, high blood pressure or diabetes. Problems with nerves or blood flow can cause ED. Stress is a factor for some men. Here are some of the more common things to consider:
⦁ Side effects of medication
⦁ Heart disease
⦁ High blood pressure
⦁ Drug and alcohol use
⦁ Pelvic surgery such as for prostate, colon or bladder cancer
⦁ Peripheral artery disease
⦁ Pelvic injuries such as pelvic fracture
⦁ Neurologic problems such as spinal cord injury or multiple sclerosis
⦁ Hormone problems such as low testosterone
⦁ Peyronie’s disease
How do We Diagnose ED?
Your family doctor or urologist will start by talking to you to find out about your general health and the exact nature of the problem. A physical exam is also important to check for problems with the penis, testicles or prostate. Some men may need to be checked for prostate cancer. Sometimes blood tests are needed to look for hormone problems, diabetes, thyroid problems, prostate cancer, etc. Less commonly, penile ultrasound or other advanced testing is a good idea.
How is ED Treated?
Fortunately, there are many ways to deal with ED and one or another is almost always successful. A full discussion of these options is more than we can include here but your urologist can go over all of these things in detail with you. Here is a basic list of what we can do:
⦁ If there is an underlying medical problem, we first treat the problem.
⦁ Lifestyle changes might be important
⦁ Weight loss
⦁ Smoking cessation
⦁ Limit alcohol consumption
⦁ Get plenty of sleep.
⦁ Exercise regularly.
⦁ Medications (pills) called PDE–5 inhibitors
⦁ Medications that you inject into the side of the penis that increase the blood flow to the penis
⦁ Medications that are placed in the urethra to increase blood flow to the penis
⦁ A mechanical device called a vacuum erection device
⦁ Testosterone supplements if you actually have low testosterone
⦁ Injections to treat Peyronie’s disease
⦁ Surgery for a penile implant
⦁ Some men may benefit from counseling to deal with emotional problems or stress.
The bottom line is that ED is a medical problem which you should feel free to discuss with your family doctor or urologist. It is treatable and, most of the time, treatment is successful.
Call Gallatin Urology (406–551–2306) for an appointment if you would like more information or if you are having problems with ED.