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Erectile Dysfunction

2024/05/20

What is Erectile Dysfunction (ED)?

Erectile dysfunction (ED) is the persistent inability to achieve or maintain an erection sufficient for sexual intercourse. While occasional erection issues are common and normal, persistent difficulties should be further evaluated.

What are the causes of ED?

ED is a multifactorial disease - involving biological, psychological and social factors.

In some cases, ED can even be the first sign of a more serious underlying medical problem such as:

Heart disease
Clogged blood vessels (atherosclerosis)
High blood pressure
Diabetes mellitus
Obesity
Metabolic syndrome

Other causes of erectile dysfunction include:

Alcoholism, smoking, or drug abuse
Certain prescription medications (including treatment for prostate cancer)
Hormonal disorders resulting in low testosterone (hypogonadism)
Peyronie's diseas
Surgeries or injuries that affect the pelvic area or spinal cord
Other diseases: Diabetes, Parkinson's disease, multiple sclerosis, stroke
Psychosocial causes: depression, anxiety, stress, fatigue, relationship issues and poor communication/conflict with partner

ED is multifactorial, involving biological, psychological and social elements.

It can also be an early indicator of more serious health issues, including:

Heart disease
Atherosclerosis (clogged blood vessels)
High blood pressure
Diabetes mellitus
Obesity
Metabolic syndrome

Additional causes include:

Alcoholism, smoking or drug abuse
Certain prescription medications, such as those for prostate cancer
Hormonal disorders leading to low testosterone levels
Peyronie's disease
Surgeries or injuries that affect the pelvic area or spinal cord
Other health conditions: Diabetes, Parkinson's disease, multiple sclerosis, stroke
Psychosocial factors: depression, anxiety, stress, fatigue, relationship conflicts and communication issues

How is ED diagnosed?

Diagnosis starts with a comprehensive evaluation, including a detailed sexual and general medical history, physical examination and necessary blood tests (such as testosterone levels, blood sugar). In some cases, specialised tests to assess penile blood flow may be required.

How is ED treated?

ED treatment is tailored to the cause. Initial conservative measures include lifestyle modifications such as weight loss, smoking cessation and reducing alcohol intake.

If these are insufficient, oral medications may be prescribed, with potential side effects like headaches, dizziness, flushing, indigestion, visual disturbances and back pain. Patients on certain heart medications (e.g. nitrates) should discuss potential drug interactions with their doctor before starting any new medication.

For low testosterone-related ED, testosterone injections are an option. Other treatments include extra-corporeal shockwave therapy (ESWT), vacuum-assisted devices, penile injections or penile implant surgery.

Psychological treatment plays a crucial role in managing ED. If psychological factors are identified, counselling with a qualified psychologist may be recommended.