Treatment starts with diagnosis and progresses to medication and surgery.

Sexual health is essential to an individual’s general health, but sexual problems are estimated to affect between 20 and 30% of men, with the prevalence increasing as they age. Erectile dysfunction is the inability to get or keep an erection firm enough to have sexual intercourse.

Many men experience it during times of stress. If it is frequent it can be a sign of health problems or emotional or relationship difficulties that may require counselling.

Read: Erectile Dysfunction Treatment in India

Diabetes mellitus, cardiovascular disease, genitourinary disease, psychiatric or psychological disorders, and poor health have been identified as associated with sexual dysfunction. The importance of functioning normally from a sexual point of view is a major issue in men’s lives. The impact of this syndrome on marriages, family and social relationships is considerable.

How does a man get an erection?

An erection is the result of increased blood flow into the penis. Blood flow is stimulated by either sexual thoughts or direct contact with the penis. When a man becomes sexually excited, muscles in the penis relax. This allows for increased blood flow through the penile arteries. This blood fills two chambers inside the penis called the corpora cavernosa. As the chambers fill with blood, the penis grows rigid. Erection ends when the muscles contract and the accumulated blood can flow out through the penile veins. Erectile dysfunction can occur because of problems at any stage of the erection process.

Causes of erectile dysfunction

▶ Lifestyle related: obesity, drug use, alcohol use, smoking

▶ Mental problems: stress, anxiety, sleep disorders, depression or relationship problems

▶ Medical: cardiovascular (heart) disease, kidney disease, cholesterol problems, hormonal and neurological problems, diabetes, hypertension

▶ Damage: direct trauma or from cancer or surgery

▶ Medication: It can happen as a side-effect of medication, such as those for hypertension, or depression, antihistamines, some pain medication

▶ Some sport: Prolonged bicycling can compress nerves and affect blood flow to the penis that may lead to temporary or permanent erectile dysfunction

Symptoms of erectile dysfunction

ED is an inability to get or sustain an erection firm enough for sexual intercourse.

Treatment

It is a treatable condition. The type of treatment depends on the underlying cause. Treatment can involve counselling and lifestyle changes. Consult a doctor to find out the exact cause. Treatment can be medication or surgery to improve blood flow.

Common medications include:

Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra, Staxyn), Avanafil (Stendra) and Testosterone replacement

The first four medications enhance the effects of nitric oxide, a chemical the body produces that relaxes the muscles in the penis. This increases blood flow and allows an erection in response to sexual stimulation. Taking these tablets will not automatically produce an erection. Sexual stimulation is needed to cause the release of nitric oxide from the penile nerves. These medications amplify that signal.

The medications vary in dosage, how long they work and side-effects. Possible side-effects include flushing, nasal congestion, headache, visual changes, backache and an upset stomach. The doctor will consider the situation to determine which medication might work best.

These medications might not fix the erectile dysfunction immediately. Some men have erectile dysfunction complicated by low levels of the hormone testosterone. Testosterone replacement therapy might be recommended as the first step. The man might need to work with his doctor to find the right medication and dosage.

Erectile dysfinction is treatable

If medications aren’t effective or appropriate the doctor might recommend surgery that could involve:

▶ Penis pumps. A penis pump (vacuum erection device) is a hollow tube with a hand- or battery-powered pump. The tube is placed over the penis and the pump is used to suck out the air inside the tube. This creates a vacuum that pulls blood into the penis.

▶ Penile implants. This Penile Implant treatment involves surgically placing devices into both sides of the penis. These implants consist of inflatable or semirigid rods. These allow the patient to control when and for how long an erection occurs. The rods keep the penis firm but bendable.

Read: Penile Implant Surgery in India

▶ Blood vessel surgery. Leaking or obstructed blood vessels can cause erectile dysfunction. Surgical repair, such as vascular stenting or a bypass procedure, might be needed.

Lifestyle remedies

▶ Smokers should quit and get help if they can’t quit.

▶ Lose weight. Being overweight can cause or worsen erectile dysfunction.

▶ Exercise can help with underlying conditions that play a part in erectile dysfunction by reducing stress, helping you lose weight and increasing blood flow.

▶ Stop taking alcohol and drugs. Drinking too much or taking illegal drugs can worsen erectile dysfunction or cause long-term health problems.

▶ Work through relationship issues.