Erectile dysfunction can be caused by many factors and may have a gradual or sudden onset. It can be very upsetting and result in a lot of stress and worry. It can feel embarassing to discuss this with your doctor but it is important that you do, so that you can receive the appropriate help. Erectile dysfunction can also be a sign of other illnesses such as heart disease or diabetes, so it is important that you seek medical advice. What are the facts about impotence? Erectile dysfunction becomes commoner with increasing age and is seen in 50 - 55% of men between 40 and 70 years old; It is often associated with obesity, high blood pressure, high cholesterol & diabetes which are all significant risks to health; Investigation is only indicated if both partners wish to pursue treatment; Most treatable causes can be identified by a clinical history, physical examination and routine blood tests; If there is no treatable cause, treatment with tablets is the first option for most men; Other methods of treatment are only indicated if medication proves ineffective, causes side-effects or cannot be used because of specific medical conditions. What should I expect when I visit my GP?
It's more likely to be an emotional problem if you only have erection problems some of the time. For example, you get an erection when waking up in the morning, but not during sexual activity. .
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While ED is not life threatening, the condition may result in withdrawal from sexual intimacy, reduced quality of life, decreased working productivity, and increased healthcare utilization. Patterns of care may shift away from surgical and device therapies provided by urologists and toward pharmacologic treatments and/or multidisciplinary approaches. With men increasingly seeking to preserve sexual function and quality of life as they age, the treatment of ED will take on even greater importance in the years to come.
Treatment options for ED have evolved considerably over the past decade to encompass psychological counseling; oral, topical, intraurethral, and intracavernosal vasoactive therapy; oral therapies with other or unknown mechanisms; hormone replacement; vacuum constriction devices; and surgery, including vascular bypass procedures and penile implants. The goal of treatment is to restore satisfactory erections with minimal adverse effects. Men have demonstrated a strong preference for oral treatments even if they have low efficacy.
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Monitoring erections that occur during sleep (nocturnal penile tumescence) can help you and your doctor to understand if the erectile dysfunction is due to psychological or physical causes. The nocturnal penile tumescence test is a study to evaluate erections at night. Normally men have three to five erections per eight hours of sleep. The test can be performed at home or in a sleep lab. The most accurate way to perform the test involves a special device that is connected to two rings. The rings are placed around the penis, one at the tip of the penis and the other at the bottom (base) of the penis. The device records how many erections occur, how long they last, and how rigid they are. The test is limited in that it does not assess the ability to penetrate.
Unfortunately, some men may not recover their ability to have a natural erection.
Your doctor might prescribe testosterone if your levels of this hormone are low. It won't help if circulation or nerve problems cause your ED.
Urology Care Foundation is an organization that supports and improves urological care by funding research, developing patient education, and pursuing financial support. They offer downloadable fact sheets and patient guides to help you understand ED.
Remember that treatment, specifically lifestyle changes, such as losing weight or doing more active, can require some time. Talk to your doctor to discover the solution or combination of the most effective remedies for you.
You have a pelvic floor too! Exercising the muscles you use to hold in urine or gas can sometimes help you control erections and ejaculations. Squeeze them a few times a day, in quick bursts and long ones, for 10 seconds or so. Don’t hold your breath while you’re doing it. Those are different muscles.
The role of the endothelium in erectile function became clearer with the observation that the phosphodiesterase type 5 (PDE5) inhibitor, sildenafil, enhanced erectile function. Erection occurs with the release of nitric oxide (NO) from the vascular endothelial cells.17 The reduction in endothelial cell production of NO results in the negative impact on the smooth muscles in the corporal bodies and results in less relaxation of the smooth muscle cells with decrease in blood supply and resulting ED. A similar phenomenon is well known to impact the coronary arterial system resulting in CVD.
Ultrasound with Doppler imaging (ultrasound plus evaluation of blood flow in the arteries and veins) can provide additional information about the blood flow of the penis and may help in the evaluation of patients prior to surgical intervention. This study is typically performed after the injection of a chemical that causes the arteries to open up, a vasodilator (prostaglandin E1), into the corpora cavernosa in order to cause dilation of blood vessels and promote blood flow into the penis. The rate of blood flow into the penis can be measured along with an evaluation of problems with compression of the veins.
Our physicians are experienced in treating the complete range of urologic conditions and diseases, from kidney stones and sexual dysfunction to prostate cancer, incontinence and infertility. Male Urology > Erectile Dysfunction Erectile dysfunction is a challenging and embarrassing problem for men.
OverviewWhat is erectile dysfunction?What are the risk factors for erectile dysfunction?How is erectile dysfunction treated?What else should you know about ED?What makes Yale Medicine’s approach to treating erectile dysfunction unique?