ERECTILE DYSFUNCTION

What It Is
An erection begins with sensory or mental stimulation that sends impulses from the brain to nerves within signaling the penis to relax, allowing blood to flow in. The excess blood creates pressure that causes the to penis expand, producing an erection by straightening and stiffening the penis.

Damage to nerves, arteries, or muscles due to disease are the most common causes of ED, and many men that suffer from it have diabetes, chronic alcoholism, kidney disease, prostate cancer, or multiple sclerosis. Smoking, being overweight, and little to no exercise are additional risk factors. Anxiety, stress, guilt, depression, low self-esteem, and fear of failure, can also produce ED. Furthermore, blood pressure medications, antihistamines, antidepressants, tranquilizers, appetite suppressants, and ulcer drugs increase your chance of developing it.

Symptoms
You may be unable to have an erection at all, the capacity to have an erection may be inconsistent, or the erection may only last for a brief span of time. ED is diagnosed when an individual experiences the Inability to have an erection at least once every four tries.

Standard Treatments

Phosphodiesterase-5 inhibitors
Taken orally one hour before sexual activity, phosphodiesterase inhibitors such as Viagra, Levitra, and Cialis enhance the effects of nitric oxide, a chemical that relaxes muscles during sexual stimulation and therefore increases blood flow. These drugs do not trigger an erection immediately.

Alprostadil
Alprostadil is a hormone that helps relax muscles in the penis. It can be administered by means of an injection with a fine needle into the side or base of the penis or with a disposable applicator inserted an inch deep into the urethra. The erection will begin in approximately 10 minutes later and last nearly an hour. Other drug injections include papaverine, and phentolamine (Resitine).

Vacuum devices
The penis is placed into a plastic cylinder, and a pump draws air out of the cylinder, drawing blood into the penis, engorging and expanding it. An elastic band is placed around the base of the penis to prevent blood from flowing back into the body after the cylinder has been removed.

Inplantable devices
Malleable implants, typically paired rods, can be placed within the penis, enabling the user to manually adjust the position of the penis or inflatable cylindrical implants can be inserted into the penis and expand using pressurized fluid. Tubes connect the implants to a fluid reservoir and pump, located beneath the skin of the scrotum. Such devices are implanted when the patient has not responded to conventional treatments.

Vascular surgery
Vascular surgery repairs arteries to increase blood flow to the penis.

Ligation
Arteries are blocked that control blood flow in and out of the penis are blocked in order to reduce leakage of blood from the penis and to increase rigidity of the penis during an erection. This surgery is rarely preformed, however, due to concerns over its long-term effectiveness.

Psychotherapy
Seeing a therapist may enable patients to overcome the emotions that are hindering their sex life.

Living With Erectile Dysfunction
If you think you’re experiencing ED, don’t wait to seek medical attention. Philadelphia is full of doctors who can help.