Sexual (Sex) Problems in Men (cont.)

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What are the symptoms of erectile dysfunction?

Erectile dysfunction will cause the penis to be unable to acquire or maintain a satisfactory erection. It is important to specify to the doctor the rapidity of onset, the presence of nocturnal erections, and the quality of the erection if it can be attained but not maintained. The quality of an erection can be judged according to the rigidity and the functionality (Is the penis erect enough to allow for vaginal penetration?).

Erectile dysfunction with sudden onset and no previous history of sexual dysfunction suggests a psychogenic cause, unless there was a previous surgery or a genital trauma. The loss of nocturnal erections will suggest a neurologic or vascular cause. Finally, when an erection is not sustained, its loss may be due to an underlying psychological cause or vascular problem. Talk to your doctor if you have noticed any problems with your erectile function.

What is the treatment for erectile dysfunction?

Nowadays, there are many options for men who suffer from erectile dysfunction. Before suggesting pharmacological help, the doctor may suggest a change in lifestyle habits. Since many causes of erectile dysfunction are disorders in which lifestyle changes will have a positive effect, addressing these issues can be helpful. Therefore, regular exercise, a healthy diet, smoking cessation, and limiting alcohol consumption can all have an impact on erectile function. Lifestyle changes can also include the use of a more genitalia-friendly bicycle seat.

What are nonsurgical treatments for erectile dysfunction?

There are many nonsurgical treatments available for erectile dysfunction.

Oral pharmacological treatment

The first line of pharmacological treatment is a class of medication called phosphodiesterase (PDE-5) inhibitors. This class includes sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). They will improve the ability to attain and maintain the erection, but sexual stimulation is still required for this medication to work. It should be taken some time before the sexual act is planned, but has a long timeframe of action. Side effects include visual disturbances, flushing, back pain, and muscle pain. Most side effects will abate with time. Usually, there will be no side effects at all. If you are taking nitrates, phosphodiesterase inhibitors are not recommended since both medications taken simultaneously could cause severe hypotension.

Other types of oral medication are available. Apomorphine will enhance penile erection. And there are others. You should ask your doctor for other types of medication if the first one didn't work. Other treatment options should also be discussed.

Transurethral therapy

Another type of pharmacological solution is a solution that can be applied in the urethra that manages to improve erection. The erection can be maintained by applying an elastic band at the base of the penis.

Intracavernous injection

Injections at the base of the penis (intracavernous) can help attain and maintain an erection. There are various types of solutions that can be injected -- papaverine, alprostadil, and drug combinations. These injections are considered the most effective treatments for erectile dysfunction. They are also convenient for the patients who don't tolerate the oral therapies.

Side effects include priapism (prolonged and painful erection) and fibrosis (scarring) but they are rare. There are ways to prevent these side effects (especially the prolonged and painful erection). The patient must follow the training and recommendations given at the beginning of this type of therapy. Contraindications for intracavernous injections include sickle cell anemia, schizophrenia, and severe psychiatric disorder.

Vacuum constriction device

This is a plastic cylinder connected to a vacuum-generating source that creates a negative pressure that draws the blood to the penis and makes way for an erection. An elastic band must be placed at the base of the penis to maintain the rigidity. The base of the penis will stay flaccid which might make the genitalia pivot. Side effects include ejaculatory problems, penile pain, and blood pooling because of ruptured blood vessels (ecchymosis or petechiae).

Medically Reviewed by a Doctor on 12/19/2013

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Sexual Problems in Men - Treatment Question: Have you had treatment for a sexual problem? Did it work?
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