Erectile Dysfunction (ED)

What is Erectile Dysfunction (ED)?

Erectile dysfunction is also commonly known as impotence, which means a man is persistently unable to achieve or maintain an erection for sexual performance. Erectile dysfunction is the most common men’s health issue that affects many men worldwide. It is also one of the issues that men feel shy to seek treatment. Erectile dysfunction not only affect men’s sexual activity, but it will also affect psychologically and lead to a poor relationship with his partner.

Signs that suggest you might experience Erectile Dysfunction

  • Takes longer time to become firm or erection to happen
  • Unable to maintain erection to complete sexual activity
  • Less firm compares to younger days
  • Reduce sex drive
  • A loss of force in ejaculation

Causes of Erectile Dysfunction

There are many causes that can cause erectile dysfunction. We can classify the causes according to the system: blood circulation system, nervous system, endocrine system (hormone) and psychological. The most common cause of erectile dysfunction is caused by insufficient blood flow to the penis.
Common causes or risk factors of erectile dysfunction:

  • Those with underlying diseases that will affect blood flow in the penis like diabetes, hypertension, heart disease and obesity
  • Medications: some medications for high blood pressure, depression, psychiatric disorder or prostate disease will cause or worsen erectile dysfunction
  • Hormonal: Low testosterone level will cause low sex drive and erectile dysfunction
  • Nerve or spinal cord injury
  • Psychological factors: A stressful life or working environment will leads to low sex drive or erectile dysfunction. Beside this, poor relationship or poor sexual performance also will cause erectile dysfunction
  • Bad daily habit: smoking, drug uses, heavy alcohol consumption

How Erectile Dysfunction is being diagnosed?

Usually, your doctor will get a full and detailed history from the patient which includes medical history, social history and sexual history. Then, the whole systemic examination will be performed to look for any underlying disease/illnesses. Next, some laboratory tests will be offered to find out/confirm the cause of erectile dysfunction.

A laboratory test that usually will be ordered to investigate erectile dysfunction:

  • Comprehensive health screening test which includes: full blood count, liver function test, renal profile, thyroid hormone, fasting lipid profile, fasting blood glucose and urine test.
  • Hormonal/Infertility study test: Luteinizing hormone (LH), Follicle stimulating hormone (FSH), Testosterone, Prolactin and Prostate specific antigen

Treatment for Erectile dysfunction

Treatment will be started once the cause of erectile dysfunction is identified. There are two different types of treatment options that are available: medical therapies or surgical therapies. Usually, medical therapies alone are enough to solve or treat erectile dysfunction.

Medical therapies:

  • Oral medications: this is the first line treatment for patient who experience erectile dysfunctions. Example of medications are Viagra and Cialis.
  • Topical cream: topical alprostadil can be used by applying on the tip of penis and surrounding skin 30 minutes before sex.
  • Penile injection: Alprostadil can be injected into intracavernosal if oral therapies fail
  • Hormone therapy: Testosterone replacement therapy will be started if blood report shows low testosterone (either oral medications, topical medication or injection)
  • P-shot or PRP injection: platelet rich plasma will be injected into intracavernosal to encourage the growth of new blood vessels.
  • Extracorporeal shock wave therapy (ESWT): clearing plaque therapy out of blood vessel and encouraging the growth of new vessels.
  • Vacuum erection: use a device call penis pump to get erection and maintain the erection

Surgical Therapies:

  • Penile prosthetic implant: a device will be implanted into penis and can get erection by squeezing a part of the device
  • Vascular Surgery

The most important treatment for erectile dysfunction is lifestyle modification. Everyone who is experiencing erectile dysfunction should do exercise regularly, lose weight, quit smoking, make sure compliance to medicine for underlying disease to control the disease well.

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