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Erectile dysfunction (Impotence): Treatment, symptoms, advice and help

About erectile dysfunction (impotence)

Erectile dysfunction implies an inability to obtain or maintain an erection sufficient for sexual intercourse. A large number of men are affected by erectile dysfunction due to various causes. In most cases, there is satisfactory response with treatment.

Erectile dysfunction (impotence): Incidence, age and sex

It is estimated that 1 in 10 men report having erectile dysfunction at some point in life. About half of men above 40 years of age have some degree of erectile dysfunction.

Signs and symptoms of erectile dysfunction (impotence): Diagnosis

Erectile dysfunction is characterized by the inability to obtain or maintain an erection. Initially, this may be intermittent and later it may become more frequent. In erectile dysfunction because of an organic cause, there may be loss of early morning erections which are normally seen. It may be associated with psychological problems like anxiety or depression which may be both the cause and effect. Also erectile dysfunction may signify an underlying heart disease.

The diagnosis is usually established by a careful history. Blood tests for certain hormones like testosterone, thyroid hormone and prolactin may be required. A doppler study of the penis is sometimes needed, wherein blood flow in the arteries of penis is assessed after injecting an erection producing drug into the penis.

Causes and prevention of erectile dysfunction (impotence)

There are numerous causes of erectile dysfunction. The commonest cause is the use of certain drugs like anti-depressants, certain anti-hypertensives, nicotine, alcohol, cocaine and heroin. It can also be caused by a hormonal disorder like low testosterone or high prolactin produced by a pituitary gland tumour. Low testosterone can also be caused by head injury, subarachnoid haemorrhage and cranial radiation. Other causes are nerve-related problems like spinal cord injury, stroke or multiple sclerosis; hypertension and vascular disorders compromising blood flow to the penis. Diabetes is an important cause which affects both the nerve supply and blood flow to the penis. Certain surgical procedures like prostate and bladder surgeries and radiation therapy to the pelvic region can also result in erectile dysfunction. Psychological problems are also important contributors to this problem. Some of these include stress, depression, anxiety including performance anxiety and schizophrenia.

Erectile dysfunction (impotence): Complications

Erectile dysfunction can have serious psychological consequences which can result in disturbed inter personal relationship. It may be a harbinger of coronary artery disease.

Erectile dysfunction (impotence): Treatment

The treatment of erectile dysfunction depends upon the cause. In many cases, it can be treated by oral drugs (Sildenafil, Tadalafil or Vardenafil) which need to be taken sometime before intercourse. Drugs can also be injected into the penis or inserted into the urethra. When drugs fail to achieve desired effect, mechanical methods like a vacuum pump can be used which work on simple principles of hydraulics and mechanics. Sometimes inflatable or rigid implants are fitted surgically into the penis.

Hormonal disorders need to be treated appropriately. Diabetes and hypertension should be adequately managed. If psychological causes are suspected, counselling of the patient as well as the partner should be considered.

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