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What is Erectile dysfunction ??

Erectile dysfunction (ED)

What is Erectile dysfunction ??

Erectile dysfunction (ED) is the inability to get or maintain an erection firm enough for sexual intercourse. It can be a temporary or chronic condition and may result from a variety of causes, both physical and psychological.

Erectile dysfunction
Erectile dysfunction

Causes of Erectile Dysfunction Physical Causes:

  1. Cardiovascular Diseases: Conditions like atherosclerosis (clogged blood vessels), high blood pressure, and high cholesterol can impede blood flow to the penis.
  2. Diabetes: This can damage blood vessels and nerves that control an erection.
  3. Obesity: Excess weight can impact cardiovascular health and hormone levels.
  4. Hormonal Imbalances: Low testosterone levels or other hormonal issues can contribute to ED.
  5. Neurological Disorders: Conditions such as Parkinson’s disease, multiple sclerosis, or spinal cord injuries can affect nerve signals necessary for an erection.
  6. Medications: Some medications can cause ED as a side effect, including antidepressants, antihistamines, and medications for high blood pressure.
  7. Substance Abuse: Alcohol, tobacco, and illicit drugs can impair erectile function.
  8. Peyronie’s Disease: Development of scar tissue inside the penis can cause curved, painful erections.
Erectile dysfunction
Erectile dysfunction

Psychological Causes:

  1. Stress and Anxiety: High levels of stress or anxiety about sexual performance can lead to ED.
  2. Depression: This can reduce sexual desire and result in ED.
  3. Relationship Problems: Poor communication or other issues within a relationship can lead to ED.

Diagnosis

Diagnosis typically involves a combination of:

  1. Medical History: Understanding symptoms and underlying health conditions.
  2. Physical Examination: Checking for physical causes of ED.
  3. Blood Tests: Measuring hormone levels, cholesterol, and glucose levels.
  4. Urinalysis: Checking for signs of diabetes or other underlying health conditions.
  5. Ultrasound: Assessing blood flow to the penis.
  6. Psychological Examination: Identifying stress, depression, or anxiety.
Healthy penis erection
Healthy penis erection

Treatment Options

  1. Lifestyle Changes: Improving diet, exercise, quitting smoking, and reducing alcohol intake.
  2. Medications: PDE5 inhibitors like sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).
  3. Therapy: Counseling for anxiety, depression, or relationship problems.
  4. Vacuum Erection Devices: Mechanical pumps to induce an erection
  5. Hormone Therapy: For men with low testosterone levels.
  6. Penile Injections: Medications injected directly into the penis to induce an erection.
  7. Urethral Suppositories: Medicated pellets inserted into the urethra.
  8. Surgery: Penile implants or vascular surgery for severe cases where other treatments are ineffective.

Prevention

While not all cases of ED can be prevented, certain lifestyle choices can reduce the risk:

  1. Regular Exercise: Improves cardiovascular health and blood flow.
  2. Healthy Diet: Supports overall health and can prevent conditions that contribute to ED.
  3. Weight Management: Reduces the risk of diabetes and cardiovascular diseases.
  4. Avoiding Tobacco and Excessive Alcohol: Protects vascular and nervous system health.
  5. Stress Management: Techniques such as mindfulness, meditation, or therapy can reduce stress and anxiety.
  6. Regular Check-ups: Monitoring and managing health conditions that could lead to ED.

When to See a Doctor If you experience persistent problems with erections, it is essential to consult a healthcare provider. They can help determine the cause and recommend appropriate treatment. Seeking help early can improve the chances of successful treatment and prevent complications.

Mixed Psychogenic and organic ED

Benign prostatic hyperplasia

Treatment of Erectile dysfunction

  • Try to find out the reason for ED
  • Try to understand physical and psychological condition
  •  Evaluation the testosterone level
  • Check blood glucose level or diabetics condition
  • Check blood pressure

If  patient  have enough  testosterone level  and have no spinal cord injuries and no record of BPH or Have not significant diabetics prb or blood pressure.

Check patients  psychological & behavioral activities.

If patient are

  • Psychological stress
  • Drug addicted
  • Anxiety

Medication 1

patient should treat

1.1. Antidepressant drug ( eg. fluoxetine,  flupentixol + metifracin combination drug etc.)

Dose : Twice a day

1.2. Calcium + D3

Dose : once a day

1.3. Vitamin E 400 mg

Dose : Twice a day

In this condition no need phosphodiesterase inhibitor ( PDE5). If patient condition does not improve within two months then added  at  low dose ( eg. Sildenafil, tadalafil or vardenafil).

  • Sildenafil

Dose : 50- 100 mg  a day 40 minutes before to intercourse for 7 days.

Or

  • Tadalafi

Dose : 5mg or 10 mg  twice a week 40 minutes before to intercourse for 1 months.

Contraindication:

Should not use coadministration with Alpha adrenergic blocker drugs ( eg. prazosin ) or Nitroglycerine drugs.

Medication 2

If   patient has no BPH  record or  prostatitis or prostate cancer but  testosterone level below than 325 mg/dl. Medication should be testosterone replacement therapy with co- administration with other Drugs.

Suggested that –

  1. Administration testosterone replacement therapy-

It is better to use testosterone intramuscular dose form ( eg. Testosterone cypionate, Testosterone enanthate).

Dose : 50-400 mg two times a month.

Or

A Combination group of testosterone (eg.Testosterone propionate 30 mg + Testosterone Phenylprop 60 mg + Testosterone Isocaproate 60 mg + Testosterone Decanoate 100 mg)

Dose : 1-2 dose a month.

Coadministration Other Drugs

1.1.Vardenafil : 20 mg daily 40 minutes before intercourse for 15 days

or

1.2.Sildenafil : 50-100 mg daily 40 minutes before intercourse for 15 day.

or

1.3.Tedalafil : 10-20 mg daily 40 minutes before intercourse for 15 day.

2.1. Calcium + Vitamin D3: (500+200 mg) onec daily for 2 months.

3.1. Vitamin E :  400 mg tow times daily for 2 months.

If patient are suffering in diabetics mellitus or high blood pressure or BPH disease. At first treatment should required for that co-morbidity disease and then treatment for ED. 

For seeing treatment regimen specifically please click treatment for ED. 

If anyone want to more information please send to me your question through the given email address.

Email address: mallicktarun@rocketmail.com

For getting treatment base suggestion please contact or request an appointment.

You can also visit you tub channel that may more helpful to you.

https://youtu.be/k9mcYWvDSh4

Thanks.