Erectile Dysfunction
"Erectile Dysfunction affects at least 12 million men in the United States"
I am pretty sure you would have probably seen this statement on erectile dysfunction somewhere..
But did you know that India of all countries is currently the…
“Impotence capital of the world“
Surprised!. I am not…
In this article I am going to tell you everything you need about erectile dysfunction (ed)
Erectile Dysfunction affects at least 50% of men above 40 years of age….
…..Another interesting fact is that ed affects 100% of men at least once in a lifetime.
Erectile Dysfunction definition
Erectile Dysfunction is defined as the inability to achieve a state of erection or to maintain a state of erection that is sufficient enough for a satisfying sexual performance or to complete the sexual act in a way sex is enjoyed mutually by both partners. As one would commonly expect the frequency and incidence of Erectile dysfunction increases as a man ages.
Erectile Dysfunction Test
How do I test for ed?….. …… Simple go to a Sexologist! Just Kidding…jokes apart there is a really easy way to assess whether you suffer from erectile dysfunction and really require medical intervention. Although the questionnaire mentioned below may not replace a professional sexologist opinion it is the closest we have to assess ed as objectively as possible You can download these pdf’s below from the links on our site. Answer the questions as honestly as possible and resubmit it to us and we can help you with your issue….if required. Here is another questionnaire you can fill and answer if you think or feel you suffer from erectile dysfunction….Table :
Impotence is frequently defined as not being able to get and keep an erection that is rigid enough for satisfactory sexual activity.
How would you describe yourself from a sexual view point?
- Not impotent: always able to get and keep an erection good enough for sexual intercourse.
- Minimally impotent: usually able to get and keep an erection good enough for sexual intercourse.
- Moderately impotent: sometimes able to get and keep an erection good enough for sexual intercourse.
- Completely impotent: never able to get and keep an erection good enough for sexual intercourse
Erectile Dysfunction Causes
Erectile dysfunction is caused by numerous conditions some directly being a cause and some be an associated medical finding. I have listed over 20 odd common conditions that could lead to erectile dysfunction. Look at the table below.
What would be interesting for you to know is that …
the causes of erectile dysfunction is broadly divided into two categories. Erectile dysfunction caused due to an organic problem and ed caused due to a psychogenic problem..
Erectile Dysfunction Causes (Organic) | Clinical Work up – what is done? |
Heart Disease | History /exam/cardiac evaluation |
Diabetes | History/ exam/sugar tests |
Hypogonadism (deficient sex and reproductive hormones | Hormonal evaluation/history/exam and semen analysis |
Hyperprolactinemia (Increased Prolactin levels from a pituitary tumour) | Hormonal evaluation/history/exam and CT scan brain |
Thyroid problems | History /exam/thyroid hormone evaluation |
Increased Blood Cholesterol | History /exam/BMI/Blood lipid estimation/cardiac assessment |
Genital Pain | History /exam |
Obesity | History /exam/BMI/Blood lipid estimation/waist measurement |
Hypertension | History /exam |
Neurological conditions | History /exam |
Multiple sclerosis | History /exam |
Parkinson’s disease | History /exam/CT scan brain |
Spinal Cord Injury | History /exam/CT scan spine |
Stroke | History /exam/ CT scan brain/cardiac assessment |
Peyronie’s disease | History /exam/Penile doppler |
Prostate surgeries | History /exam |
Cancer therapies | History /exam |
Radiation therapies | History /exam |
Erectile Dysfunction (Psychological) | Clinical Work up – what is done? |
Anxiety | History /exam/Anxiety assessment questionnaire |
Depression | History /exam/Mental health assessment |
Guilt | History /exam |
Extramarital affairs | History |
Childhood sexual abuse | History |
Traumatic sexual events | History |
Domestic violence | History |
Masturbation addiction | History |
I am sure you are convinced of one thing…erectile dysfunction in the context of other diseases requires an expert trained to treat the condition…
….in the RIGHT WAY.
Do not pop a pill called VIAGRA!, without a prescription. The implications of unsupervised self medications can be severe…
Next …
Medications or substances that cause erectile dysfunction
Numerous of the following medications or substances mentioned in the table below commonly prescribed for other medical disease states can lead to erectile dysfunction.
An alternative medication can be prescribed if you are suffering from erectile dysfunction and are taking any of the following medications on a long term basis
Medication routinely prescribed leading to erectile dysfunction | Substances when abused that can lead to erectile dysfunction |
Anticonvulsant medications (seizure disorder) | Alcohol consumption |
Anti histamines (taken for allergies and common cold) | Analgesic (pain killer) abuse |
Antidepressants (taken for depression) | Cocaine abuse |
Antihypertensive medications (taken for high blood pressure) | Marijuana abuse |
Antipsychotics (taken for Parkinson’s, Alzheimer’s and host of other conditions | Tobacco abuse (smoking) |
Cardiac medications (for heart problems) | Amphetamine abuse |
Diuretics (drugs for cardiac/renal problems) | |
Cytotoxic agents (taken for cancer treatments) | |
Hormonal medications and injections |
Erectile Dysfunction and Diabetes
There is a very strong link between diabetes and erectile dysfunction. An estimated 1 in 10 men who have diabetes will have erection problems.
The reason?…
Diabetes goes hand in hand with increased body weight, so what happens is that the body fat converts the male sex hormone testosterone to the female sex hormone oestrogen…
The reduced levels of testosterone directly affect the quality of a man’s erection!.
What’s also been proved by studies is that the chance of getting problems with erection significantly increases with higher values of fasting blood sugar, obesity and associated cardiovascular disease. These three conditions are intimately linked…as below…
What’s also been proven beyond doubt is that the longer the duration of Diabetes the higher the risk or chance of developing Erection problems
Erectile Dysfunction and Heart Disease
Recent research also suggests that if erectile dysfunction in itself can be an independent risk factor for developing cardiac disease at a later stage in life.
Not only cardiac issues, but erection problems seem to go closely associated with the risk of developing hypertension, angina, stroke and other high mortality conditions.
If a patient is diagnosed with erectile dysfunction a complete cardiovascular check up is an absolute must. Never ignore erectile dysfunction!
Furthermore numerous studies have clearly found out that erection problems is usually the first sign that a man can get heart disease especially more so when his age is between 40 to 49 years.
Erectile Dysfunction Treatment
Treatment of erectile dysfunction proceeds as below Step 1 – First the sexologist has to assess whether the patient has erectile dysfunction using the IIEF questionnaire (International Index of Erectile Function Questionnaire) Step 2 – Next a complete sexual history, psychological history, medical and surgical history is taken followed by a physical exam to check for normal secondary sex character development Step 3 – Assessment of BMI, Waist circumference and blood pressure is done Step 4 – Laboratory blood tests are ordered as relevant.Cardiac stress testing is done if a cardiovascular disease risk is suspected
Life style modification
Specialized Kegel’s exercise
Erection friendly diet
Stage 1 plus the use of
Sildenafil or Tadalafil or Vardenafil (PDE-F inhibitors). The dosages are always individualized based on patient profile.
Patients who are not responsive to stage 1 and stage 2 treatments can be taken up for stage 3 treatments which include
Penile vacuum devices and/or intra-urethral or penile injectable Alprostadil. The risks of injections include the fear of pricking a needle in the penis. Furthermore there is also a small risk of developing fibrosis in the penis while using these injections. Where possible penile vacuum devices are better.
The last line of managing erectile dysfunction is by usage of penile prosthesis. This is a major surgical approach and there is always a risk of penis shortening, penis being semi erect or infection with the usage of these prosthesis. A surgical approach is taken only when all other conservative management strategies fail.
Well I hope this article gave you adequate info about ed and all its associated nuances. Please feel free to contact us for more info!
FAQ's on Erectile Dysfunction
To put it in simple words the main cause of erectile dysfunction is psychological, atleast 80% of the time. The other well known causes include diabetes, high cholesterol, hypertension and use of certain medications
Of course it is a disease. No two ways about that!. Erectile dysfunction precedes many diseases that can affect your health if left untreated. Most patients who have erectile dysfunction will at somet point into the future develop heart problems and diabetes.
Numerous studies have clearly pointed out that simple life style changes like walking daily and eating healthy food in itself can reverse erectile dysfunction.
- Eat a diet rich in green leafy vegetables
- Walk at least 5 times a week with each walking session lasting for atleast 30 minutes
- Do pelvic strengthening exercises
Meet Dr. Shah at the Male Infertility & Sexual health Clinic
Dr. Shah is Consultant Andrologist and Sexologist in Chennai. His passion for helping men facing infertility issues stems from the fact that “Men never ever get the care they deserve as far as fertility treatments is concerned”