23/02/2018
Definition
Erectile dysfunction (ED) is a man’s inability to achieve or maintain an erection enough for satisfactory sex.
Erections occur when a man is sexually aroused, nerves and chemicals work together to relax smooth muscle tissue and widen arteries so that the penis can fill with blood. Veins constrict to keep the blood inside the penis, forming the erection. We can imagine that penile erection like pressing air into tire in which blood is pressed and filled fully in penis. Once the man ejaculates, the blood is released back into the circulation system.
ED becomes more common in ageing men. It’s also associated with some medical conditions, like heart disease and diabetes. In fact, an estimated 50% of diabetic men have ED.
Cause of ED
Poor blood flow to the penis. This is one of the most common causes of ED and can be the result of diabetes, heart disease, high cholesterol, and high blood pressure.
Nerve damage. Normally, when a man is sexually aroused, his brain sends messages to his penis to start the erection process. But if there is nerve damage, these messages cannot be transmitted properly. Thus, conditions that affect the nervous system – like diabetes, spinal cord injury, multiple sclerosis, and stroke – can lead to ED.
Hormonal issues. Low testosterone, high prolactin level, high estrogen level or thyroid disorders affect erections though at least 2 mechanisms such as: poor sexual stimulation and low blood flow intake.
Medicine. Side effect of some medications, such as those prescribed for high blood pressure, heart disease, peptic ulcers, insomnia, and depression…
Peyronie’s disease. Peyronie’s disease is a wound healing disorder (forming scar) marked by a distinct curvature of the penis. This condition it restricts blood flow to penis and it makes difficult to fill enough blood into penis because of abnormal of penile structure.
Psychological and emotional problems: Fighting with a partner, anxiety, depression, stress, past sexual abuse, and concerns about sexual performance can all affect one’s sexual well-being.
Lifestyle: Smoking, obesity, drug and alcohol abuse, an unhealthy diet, and poor exercise habits can contribute to other health conditions associated with ED
ED treatment options
There are various options for ED managent. The task of the physician is to identify which treatment would be most appropriate and most likely to have long-term success. Thus, ED treatment should be treat base on its causes. Each cause has a suitable and appropriate treatment.
Psycho-sexual treatments. These approaches are applied for all ED patients, especially, for no organic ED cause, these approaches may reduce anxiety for men and his partner, enhance arousal, and offer pleasurable options. These treatments usually take more time to reduce time, and they also can be performed separately or parallel to medical treatments.
Oral medications. Phosphodiesterase type 5 (PDE5) inhibitors such as: Viagra, Cialis,Levitra they help increase blood flow to the penis. These drugs are usually the first line treatment for ED patient.
Penile injections: Papaverin, prostaglandin (Caverject)…inject directly in cavernous tissue, these medications helps blood vessels dilate, allowing more blood for erection.
Urethral suppositories: These medications are inserted into the urethra at the tip of the penis.
Vacuum erection devices: The man put his penis into a vacuum cylinder and pumps air out. He then places a constriction ring at the base of the penis after penis become erection, which keeps the erection.
Low-intensity shock wave therapy
Low-intensity shock wave therapy has proved effective in mild and moderate ED patients. The mechanism of action is presumably promotion of revascularization in the penis.
Penile implants are surgically placed prosthesis inside the penis and allow a man to get an erection when he want
Men who undergo erectile dysfunction are encouraged to see a doctor soon to treat ED and also screen other combination diseases. Because ED is an early warning sign of a more serious medical condition like diabetes or heart disease, so it’s important to have a complete checkup.
By Nguyen Ba Hung
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Andrology and Fertility Hospital of Hanoi
? (+84) 1900 56 56 01
➡ https://www.facebook.com/afhanoi/
➡ 431 Tam Trinh Street, Hoang Mai District, Hanoi, Vietnam.
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