Erectile Dysfunction: Men’s Sexual Health

Erectile dysfunction is a frequent condition among men, as we will see later, that alters the quality of life of those who suffer from it and their family. In this blog we will talk about the most frequent causes and what changes we can make to improve erectile dysfunction.

What is erectile dysfunction (ED)?

It is considered as the inability to present or maintain an erection that allows a satisfactory sexual performance according to the desire of the person.

How common is erectile dysfunction (ED)?

According to the study reviewed, we can find prevalences (the total percentage of men who ever suffered or suffer from ED) up to 52% between the ages of 40 to 70 years, with an increase with the age. Which means that 1 in 2 men between these ages suffered at least once from this condition.

What are the causes of erectile dysfunction (ED)?

There are many causes of erectile dysfunction which (some) can be modified with healthy lifestyles and / or medical treatment: 

  • Cardiovascular diseases: arterial hypertension, dyslipidemia and / or type II diabetes mellitus
  • Psychological and / or psychiatric
  • Prostate diseases and / or surgeries
  • Peyronie’s disease
  • Hormonal diseases such as thyroid diseases, increased prolactin or low testosterone levels

Suggested Lifestyle Changes to Improve ED:

  • No Smoking
  • NO consumption of liquor or psychoactive substances
  • Be physically active and have an adequate weight
  • Identify if there is any drug associated with the onset of ED

Are there tests to study erectile dysfunction?

They exist, but they must be indicated by your GP and / or urology specialist. Each exam has a specific indication and it is your doctor who must evaluate if one is of any use to you, so for practical terms we will only name them:

  • Hemogram, glucose, lipid profile, TSH, thyroxine and total testosterone.
  • Intracavernous injection test
  • Duplex ultrasound of the penile arteries
  • Arteriography and cavernosometry or cavernosography
  • CT angiography

What should I do if I have erectile dysfunction (ED)?

The first thing is to write down in a diary how ED started (suddenly or progressively?), the duration of the erections, as well as if there are erections during the day with or without erotic stimulus, the presence of other alterations such as premature ejaculation, also quality of erection and the presence or absence of ejaculation.

The second thing is to attend your family doctor who will determine the need for tests to evaluate any of the conditions mentioned above, once you attend the consultation, your obligation as a patient is to ask all the questions that you still have about the condition and thus avoid misinformation.

The third, but not least, is to make the recommendations mentioned above.

For health personnel (Spanish-speaking), we suggest that you read the bibliography 2, to see a more exhaustive review of the subject. 

Are there medications for erectile dysfunction?

Yes, there have been since the 70s, however, erectile dysfunction is a symptoms rather than a disease, with this I want to explain that the important thing is to find the cause of erectile dysfunction to be able to carry out the proper management.

The drugs usually used belong to the family of phosphodiesterase-5 inhibitors, an enzyme that, when inhibited, favors the appearance of erections. The duration and onset of the effect depends on each medication, so you should consult your GP about this. It is important to emphasize that this type of medication requires an erotic stimulus to function. They can be used daily or as needed, depending on each patient. Its adverse effects include headache, facial flushing, nasal congestion, vision abnormalities, and dizziness. The medications that are being taken should be reported prior to the initiation of phosphodiesterase-5 inhibitors, as unwanted drug interactions may arise. Lastly, they should never be combined with drugs from the nitrate family.

In the event of failure to respond to treatment, several elements should be evaluated before considering moving on to other therapies, including:

  • Lack of sexual stimulation: remember that these drugs need an adequate erotic stimulus.
  • Lack of knowledge of the time between drug use and the onset of its effects: Each drug has a time when its effect begins and ends. Ask your doctor what these times are for your drug.
  • Consumption of large meals and the medicine: Some of the phosphodiesterase-5 inhibitors do not work if taken together with large meals.

What other treatments are there?

Its use is less frequent, they include:

  • Dopamine agonists
  • Vacuum constriction devices
  • Intracavernous injections
  • Penis prosthesis

Can all men receive erectile dysfunction medication?

No, there are some contraindications associated with the cardiovascular state of men, for example, a man who has had an acute myocardial infarction in the last 3 weeks should first ask his doctor and / or cardiology specialist if he can have sex or not.

Is Erectile Dysfunction Curable?

We have good and bad news about it. As such, the disease in most cases is not curable, however, it is treatable, which means that with proper management and changes in lifestyle, it is very likely that the man will be able to have a sexual performance according to Your expectations.

CONCLUSION

In case of presenting symptoms of erectile dysfunction, your obligation is to write down the characteristics of the erections, modify the causes associated with the lifestyle and consult your doctor for tests if necessary and start medications according to medical indications.

BIBLIOGRAPHY

  • Wespes, E., Amar, E., Eardley, I., Giuliano, F., Hatzichristou, D., Hatzimouratidis, K., … & Vardi, Y. (2010). Guía clínica sobre la disfunción sexual masculina: disfunción eréctil y eyaculación precoz. European Association of Urology, 842-99

del Pilar Ceballos, M., Villarraga, J. D. Á., Herrera, J. M. S., Uribe, J. F., & Mantilla, D. (2015). Guía de disfunción eréctil. Sociedad Colombiana de Urología. Revista Urología Colombiana, 24(3), 185-e2.

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