Erectile Dysfunction (ED): What It Is and How to Treat It ?

Erectile Dysfunction

What is erectile dysfunction (ED)?

Erectile dysfunction (ED) is the inability to get and keep an erection firm enough for sexual intercourse. Estimates suggest that one of every 10 men will suffer from ED at some point during his lifetime. It is important to understand that in most cases, ED is a symptom of another, underlying problem. ED is not considered normal at any age, and may be associated with other problems that interfere with sexual intercourse, such as lack of desire and problems with orgasm and ejaculation.

How common is erectile dysfunction?

Approximately one in 10 adult males will suffer from ED on a long-term basis.

Many men do experience occasional failure to achieve erection, which can occur for a variety of reasons, such as drinking too much alcohol, stress, relationship problems, or from being extremely tired.

The failure to get an erection less than 20% of the time is not unusual and typically does not require treatment. However, the failure to achieve an erection more than 50% of the time generally means that there is a problem and treatment is needed.

ED does not have to be a part of getting older. While it is true that some older men may need more stimulation, they should still be able to achieve an erection and enjoy intercourse.

What causes erectile dysfunction (ED)?

ED can be caused by a number of factors, including:

Vascular disease: Blood supply to the penis can become blocked or narrowed as a result of vascular disease such as atherosclerosis (hardening of the arteries).
Neurological disorders (such as multiple sclerosis): Nerves that send impulses to the penis can become damaged from stroke, diabetes, or other causes.
Psychological states: These include stress, depression, lack of stimulus from the brain and performance anxiety.
Trauma: An injury could contribute to symptoms of ED.

Chronic illness, certain medications, and a condition called Peyronie’s disease can also cause ED. Operations for the prostate, bladder, and colon cancer may also be contributing factors.

What medications could cause erectile dysfunction (ED)?

Erectile dysfunction (ED) is a common side effect of a number of prescription drugs. While these medications may treat a disease or condition, in doing so they can affect a man’s hormones, nerves or blood circulation, resulting in ED or increasing the risk of ED.

If you experience ED and think that it may be a result of the medication you are using, do not stop taking the medication. If the problem persists, contact your doctor and he or she may be able to prescribe a different medication. Common medications that may list ED as a potential side effect include:

  • Diuretics (pills that cause increase urine flow).
  • Antihypertensives (high blood pressure drugs).
  • Antihistamines.
  • Antidepressants.
  • Parkinson’s disease drugs.
  • Antiarrhythmics (drug for irregular heart action).
  • Tranquilizers.
  • Muscle relaxants.
  • Nonsteroidal anti-inflammatory drugs.
  • Histamine H2-receptor antagonists.
  • Hormones.
  • Chemotherapy medications.
  • Prostate cancer drugs.
  • Anti-seizure medications.

Other substances or drugs that can cause or lead to ED include these recreational and frequently abused drugs:

  • Alcohol.
  • Amphetamines.
  • Barbiturates.
  • Cocaine.
  • Marijuana.
  • Methadone.
  • Nicotine.
  • Opiates.

These drugs not only affect and often suppress the central nervous system, but can also cause serious damage to the blood vessels, leading to permanent ED.

What prescription drugs may cause erectile dysfunction?

Erectile dysfunction (ED) is a common side effect of a number of prescription drugs. While these medications may treat a disease or condition, in doing so they can affect a man’s hormones, nerves or blood circulation. The result may be ED or an increase in the risk of ED.

If you have ED and think that it may be a result of the medication you are using, do not stop taking the medication. If the problem persists, contact your doctor and he or she may be able to prescribe a different medication. Common medications that may list ED as a potential side effect include:

  • Diuretics (pills that cause an increase in urine flow).
  • Antihypertensives (medication for high blood pressure).
  • Antihistamines.
  • Antidepressants.
  • Parkinson’s disease drugs.
  • Antiarrhythmics (medication for irregular heart action).
  • Tranquilizers.
  • Muscle relaxants.
  • Non-steroidal anti-inflammatory drugs.
  • Histamine H2-receptor antagonists.
  • Hormones.
  • Chemotherapy medications.
  • Prostate cancer drugs.
  • Anti-seizure medications.

What other substances or drugs may cause erectile dysfunction?

Other substances or drugs that can cause or lead to ED include these recreational and frequently abused drugs:

  • Alcohol.
  • Amphetamines.
  • Barbiturates.
  • Cocaine.
  • Marijuana.
  • Methadone.
  • Nicotine.
  • Opiates.

Aside from the well-known complications that the use and abuse of these drugs can cause, ED is not often mentioned. However, use of these drugs is a risk factor for ED. These drugs not only affect and often times slow down the central nervous system, but can also cause serious damage to the blood vessels, leading to permanent ED.

How are depression and erectile dysfunction related?

For some men, depression can accompany the condition of erectile dysfunction (ED). It is common for men with ED to feel angry, frustrated, sad, unsure of themselves, or even less “manly.” Such feelings may lead to a lack of self-esteem and, in severe cases, to depression.

Depression that accompanies ED is treatable. The first step in addressing your concerns about ED-related depression is to be honest with yourself, your partner, and your doctor. After depression has been brought out into the open, coping with it will be easier and less stressful.

Treatment

The first thing your doctor will do is to make sure you’re getting the right treatment for any health conditions that could be causing or worsening your erectile dysfunction.

Depending on the cause and severity of your erectile dysfunction and any underlying health conditions, you might have various treatment options. Your doctor can explain the risks and benefits of each treatment and will consider your preferences. Your partner’s preferences also might play a role in your treatment choices.

 

What are the Types of Therapy for Erectile Dysfunction? - Men's Health Clinic United Kingdom

Oral medications

Oral medications are a successful erectile dysfunction treatment for many men. They include:

  • Sildenafil (Viagra)
  • Tadalafil (Adcirca, Cialis)
  • Vardenafil (Levitra, Staxyn)
  • Avanafil (Stendra)

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All four medications enhance the effects of nitric oxide — a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation.

Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing normal penile function in some people. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in people who get normal erections.

The medications vary in dosage, how long they work and side effects. Possible side effects include flushing, nasal congestion, headache, visual changes, backache and stomach upset.

Your doctor will consider your particular situation to determine which medication might work best. These medications might not treat your erectile dysfunction immediately. You might need to work with your doctor to find the right medication and dosage for you.

Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor’s OK. Medications for erectile dysfunction do not work in everyone and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes. Some medications might also be dangerous if you:

  • Take nitrate drugs — commonly prescribed for chest pain (angina) — such as nitroglycerin (Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket) and isosorbide dinitrate (Isordil, Bidil)
  • Have heart disease or heart failure
  • Have very low blood pressure (hypotension)

Other medications

Other medications for erectile dysfunction include:

Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Caverject, Edex) into the base or side of your penis. In some cases, medications generally used for other conditions are used for penile injections on their own or in combination. Examples include alprostadil and phentolamine. Often these combination medications are known as bimix (if two medications are included) or trimix (if three are included).

Each injection is dosed to create an erection lasting no longer than an hour. Because the needle used is very fine, pain from the injection site is usually minor.

Side effects can include mild bleeding from the injection, prolonged erection (priapism) and, rarely, formation of fibrous tissue at the injection site.

Alprostadil urethral suppository. Alprostadil (Muse) intraurethral therapy involves placing a tiny alprostadil suppository inside your penis in the penile urethra. You use a special applicator to insert the suppository into your penile urethra.

The erection usually starts within 10 minutes and, when effective, lasts between 30 and 60 minutes. Side effects can include a burning feeling in the penis, minor bleeding in the urethra and formation of fibrous tissue inside your penis.

Testosterone replacement. Some people have erectile dysfunction that might be complicated by low levels of the hormone testosterone. In this case, testosterone replacement therapy might be recommended as the first step or given in combination with other therapies.

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