You're likely to start by seeing your family doctor. Depending on your particular health problems, you may go directly to a specialist, such as a doctor who specializes in male genital problems (urologist) or a doctor who specializes in hormonal systems (endocrinologist). Urologists treat conditions affecting the urinary tract and male reproductive organs, including erectile dysfunction (ED). They may perform tests to determine the cause of the condition and recommend treatments.
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The Urology Care Foundation provides free, evidence-based patient educational materials on urological health to patients, healthcare providers and the general public. We support and improve urological care by funding research, developing patient education and seeking philanthropic support around the world. Erectile dysfunction, or ED, is the most common sexual problem that men report to their doctor. Affects 30 million men.
Erectile dysfunction is defined as difficulty achieving or maintaining an erection firm enough to have sex. Although it is not uncommon for a man to have some erection problems from time to time, ED that is progressive or that occurs routinely with sexual intercourse is not normal and should be treated. Finding the cause (s) of your ED will help treat the problem and improve your overall well-being. As a rule, what is good for heart health is good for sexual health.
During sexual arousal, nerves release chemicals that increase blood flow to the penis. Blood flows into two erection chambers in the penis, made of spongy muscle tissue (the corpus cavernosum). The chambers of the corpus cavernosum are not hollow. During erection, spongy tissues relax and trap blood.
Blood pressure in the chambers causes the penis to firm and causes an erection. When a man has an orgasm, a second set of nerve signals reach the penis and cause the muscles of the penis to contract and blood returns to the man's circulation and the erection decreases. When you are not sexually excited, the penis is soft and loose. Men may notice that penis size varies with heat, cold, or worry; this is normal and reflects the balance of blood entering and exiting the penis.
With erectile dysfunction (ED), it's hard to get or maintain an erection that's firm enough to have sex. When ED becomes a routine and annoying problem, your primary care provider or urologist can help. If erectile dysfunction is affecting a man's well-being or relationships, it should be treated. Treatment aims to correct or improve erectile function, help circulatory health and improve a man's quality of life.
Even though erectile dysfunction becomes more common as men age, getting older isn't always going to cause. Some men remain sexually functional until they are 80. Erectile dysfunction may be an early sign of a more serious health problem. Finding and treating the reason for erectile dysfunction is a vital first step.
Normal sex needs mind and body to work together. Emotional or relationship problems can cause or worsen ED. Finding the cause of your ED will help guide your treatment options. The diagnosis of ED begins when the health care provider asks questions about your heart and vascular health and your erection problem.
Your provider may also perform a physical exam, order laboratory tests, or refer you to a urologist. Knowing your history of erectile dysfunction will help your healthcare provider know if your problems are due to your sexual desire, erectile function, ejaculation, or orgasm (climax). Some of these questions may seem private or even embarrassing. However, rest assured that your doctor is a professional and that your honest answers will help you find the cause and the best treatment for you.
Your doctor may ask you questions about depression or anxiety. He or she may ask you about problems in your relationship with your partner. Some health care providers may also ask if they can talk to their sexual partner. The doctor may order blood tests and collect a urine sample to check for health problems that cause ED.
Health experts often use questionnaires to assess your ability to initiate and maintain erections, measure your satisfaction with sex, and help identify any problems with orgasm. For some men with erectile dysfunction, specialized tests may be needed to guide treatment or re-evaluate treatment after treatment fails. Treatment for erectile dysfunction begins with taking care of your heart and vascular health. The doctor may indicate “risk factors” that can be changed or improved.
You may be asked to change certain eating habits, stop smoking, increase workouts, or stop using drugs or alcohol. You may be offered alternatives to the medicines you take. Never stop or change prescription drugs without first talking to your healthcare provider. These could be due to relationship conflicts, life stressors, depression, or anxiety from past problems with erectile dysfunction (performance anxiety).
The following treatments are available to treat ED directly. Drugs known as PDE type 5 inhibitors increase blood flow to the penis. These are the only oral agents approved in the U.S. UU.
By the Food and Drug Administration for the Treatment of ED. For best results, men with erectile dysfunction take these pills about an hour or two before having sex. Drugs require normal nerve function for the penis. PDE5 inhibitors improve normal erectile responses by helping blood flow to the penis.
About 7 out of 10 men do well and have better erections. Response rates are lower for diabetics and cancer patients. If you are taking nitrates for your heart, you MUST NOT take any PDE5 inhibitors. Always talk to your healthcare provider before using a PDE5 inhibitor to learn how it might affect your health.
In those rare cases where low sex drive and low blood testosterone levels are to blame for ED, testosterone therapy may correct normal erections or help when combined with erectile dysfunction medications (PDE type 5 inhibitors). Alprostadil is injected into the side of the penis with a very thin needle. It is of great value to get the first injection in the doctor's office before doing it on your own. Self-injection classes should be taught in your doctor's office by an experienced professional.
The success rate for getting an erection firm enough to have sex is as high as 85% with this treatment. Many men who don't respond to oral PDE5 inhibitors can be “rescued” with ICI. ICI Alprostadil can be used as a mixture with two other medicines to treat ED. This combination therapy, called bimix or trimix, is stronger than alprostadil alone and has become the standard treatment for ED.
Only the ingredient in alprostadil is approved by the FDA for ED. An experienced healthcare professional can change the amount of each medication used depending on the severity of your ED. Your healthcare professional will train you on how to inject yourself, how much to inject, and how to safely increase the dose of the medication if needed. Men who have penile erections that last longer than two to four hours should seek care in the emergency room.
Priapism is a prolonged erection that lasts more than four hours. If priapism is not undone, permanent damage to the penis and intractable erectile dysfunction will result. For UI therapy, a small drug granule of the drug, alprostadil, is placed in the urethra (the tube that carries urine out of the body). Using the medication this way means you don't have to give yourself an injection, unfortunately it may not work as well as ICI.
Like ICI therapy, IU Alprostadil should be tested in the office, before use at home. The most common side effects of alprostadil UI are a burning sensation in the penis. If an erection lasts longer than four hours, you will need medical attention to slow it down. The main surgical treatment of erectile dysfunction involves the insertion of a penile implant (also called penile prosthesis).
Because penile vascular surgery is not recommended for older men who have failed treatments with oral PDE5 inhibitors, ICI or UI, implants are the next step for these patients. While penile implant placement is risky surgery, it has the highest success and satisfaction rates among erectile dysfunction treatment options. Penile implants are devices that are placed completely inside the body. They make a stiff penis that allows you to have normal sex.
This is a great option to improve uninterrupted intimacy and make relationships more spontaneous. There are two types of penile implants. The simplest type of implant is made of two easy-to-bend rods, which, in most cases, are made of silicone. These silicone rods give the man's penis the firmness necessary for sexual penetration.
The implant can be bent downwards for urination or upward for sex. With an inflatable implant, cylinders filled with liquid are placed along the length of the penis. A tube attaches these cylinders to a pump that is placed inside the scrotum (between the testicles). When the pump is activated, the pressure in the cylinders inflates the penis and hardens it.
Inflatable implants make a normal looking erection and are a natural sensation for your partner. The surgeon may suggest a lubricant to your partner. With the implant, men can control the firmness and sometimes the size of the erection. Implants allow a couple to have spontaneous intimacy.
There is usually no change in a man's sensation or orgasm. Penile implants are most often placed under anesthesia. If a patient has a systemic, skin or urinary tract infection, this surgery should be postponed until all infections are treated. If a man is taking blood thinners, he may need to talk to a medical expert about stopping medications for elective surgery and healing.
Most often, a small surgical incision is made. The cut is made above the penis, where it joins the abdomen, or below the penis, where it joins the scrotum. The patient will go home the same day or spend a night in the hospital. Prosthetic surgery carries risks and patients are advised before the procedure.
If there is a postoperative infection, the implant will likely be removed. The devices are reliable, but in case of mechanical malfunctions, the device or a part of the device will have to be replaced surgically. If a penile prosthesis is removed, other non-surgical treatments may no longer work. Most men with penile implants and their partners say they are satisfied with the results and that they return to having more spontaneous intimacy.
These are not currently approved by the FDA for the treatment of ED, but may be offered through research studies (clinical trials). Interested patients should discuss the risks and benefits (informed consent) of each, as well as the costs before starting any clinical trial. Most therapies not approved by the FDA are not covered by public or private insurance benefits. Supplements are popular and often cheaper than prescription ED drugs.
However, supplements have not been tested to see how well they work or if they are a safe treatment for ED. Patients should be aware that many OTC drugs have been found in drug tests to have “smuggled” PDE 5 inhibitors as their main ingredient. The amounts of Viagra, Cialis, Levitra or Stendra that may be in these supplements are not under quality control and may vary from pill to pill. The FDA has issued warnings and alerts for consumers.
All treatments for erectile dysfunction (except implant surgery) are used as needed for sex and then go away. Treatments help relieve symptoms, but they don't fix the underlying problem in the penis. Health care providers now realize that most men have an underlying physical cause of. For most patients, there are physical and emotional factors that lead to erectile dysfunction.
It is impossible to prove that there is no psychological part in a man's erectile dysfunction. Nothing happens in the body without the brain. Worrying about your ability to have an erection can make it difficult to achieve one. This is called performance anxiety and can be overcome with education and treatment.
However, only combine treatments after talking to your healthcare provider about it. Erections can last too long with drug therapy, which is dangerous. Ask your doctor for proper instructions. Never stop or change a prescription medication without first talking to your healthcare provider.
Many medications can cause erectile dysfunction, but some cannot be changed because the benefits of the medication are too important to you. If you are sure that a specific medication has caused the problem of erectile dysfunction, ask your healthcare provider if you can change medications. If you must continue to take the medication that is causing the problem, there are treatments for erectile dysfunction that may help. Information and resources to help you stay up to date.
Find out how a clinical trial may be a good fit for you with this informative video. Powered by trusted doctors from Support UCF when you shop on Amazon In the lives of urological patients. This website has been optimized for user experience and security, so Internet Explorer (IE) is not a recommended browser. Use the latest version of Microsoft Edge, Chrome, Firefox or Safari (macOS).
Your primary care doctor, urologist or endocrinologist is able to diagnose and treat erectile dysfunction. Although their areas of expertise are different, everyone is likely to perform a physical exam and ask questions about your medical history. You can work with a healthcare professional to treat an underlying cause of erectile dysfunction (ED). Erectile dysfunction specialists are doctors who have been specifically trained in the fields of urology or endocrinology, with a focus on erectile dysfunction and related problems.
They not only treat sexual dysfunction, but also treat diseases of the kidneys, bladder, prostate, urethra, and pelvic muscles, including cancer, kidney stones, incontinence, and infections. Different doctors can help diagnose and treat erectile dysfunction, including primary care doctors, urologists, and psychologists. You should not take any of these medications to treat ED if you are taking nitrates to treat a heart condition. .