❯What is erectile dysfunction (ED)?
Erectile dysfunction (also know as impotence) occurs when a man is unable to get an erection during sexual activity or is unable to maintain an erection long enough to finish having sex.
❯How common is erectile dysfunction in the Unites States?
ED is the most common sex-related problem men discuss with their physician. It is estimated that about 30 million men in the U.S. currently suffer with this condition.
❯Can ED occur at any age?
Yes, but it becomes more common as men age. This is particularly true for men as they enter middle age and beyond.
❯So is erectile dysfunction just a natural part of the aging process?
No. Every man has many physical and psychological life factors that interact to determine his overall risk for ED. Age is but one of these factors—and impacts some men more than others.
❯What medical conditions can contribute to reoccurring erectile dysfunction?
A wide variety of health issues can increase your chances of experiencing ED on a regular basis. Please tell Dr. Patel if any of these apply to you:
- Heart disease
- High cholesterol
- Clogged arteries (atherosclerosis)
- High blood pressure
- Parkinson's disease
- Multiple sclerosis
- Insomnia or other sleep disorders
- Treatments for an enlarged prostate or prostate cancer
- Surgeries or injuries involving the spinal cord or pelvic area
❯Are these the only risk factors for ED?
No. A number of personal characteristics and behaviors can also impact sexual functioning. These include:
❯Can emotional issues contribute to sexual problems as well?
Absolutely. Erectile dysfunction often has a psychological as well as a physical component. Men experiencing emotional issues such as depression, anxiety, irritation, and excess stress, especially on an ongoing basis, commonly have difficulties with sexual functioning.
❯Do sexual problems themselves often have emotional consequences?
Yes. Common psychological problems that can result from ED include anxiety, low self-esteem, and depression. It can also cause considerable emotional stress between a man and his sexual partner.
❯What physical conditions related to the penis can cause ED?
Certain medical diseases, injuries, surgeries, and treatments (especially cancer treatments) can negatively impact the sexual functioning of the penis. Biological problems that can hinder erections include:
- Restricted blood flow into the penis
- Inability to trap blood in the penis
- Scar tissue inside the penis (Peyronie's disease)
- Nerve signals not reaching the penis
- Vascular or nerve damage to the penis
❯Can certain commonly prescribed medications contribute to ED?
Yes. These include pain medications, antidepressants, appetite suppressants, high blood pressure medicines, antihistamines, ulcer medications, tranquilizers or sedatives, and prostate medicines. Please tell Dr. Patel if you are taking of these medications.
❯So erectile dysfunction can have multiple causes in a particular case?
Yes. As the Mayo Clinic states: “Male arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels.” This complexity is why Dr. Patel always uses a holistic approach when treating ED.
❯What oral medications are available to treat ED?
There are currently four prescription medications available to treat ED, each with a different chemical formulation. One pill often works better than another for a particular man. The four medications are:
- Sildenafil (Viagra)
- Tadalafil (Adcirca, Cialis)
- Vardenafil (Levitra, Staxyn)
- Avanafil (Stendra)
❯How do these oral medications work?
They all increase the amount of naturally occurring nitric oxide in the body. This relaxes the muscles in the penis and increases blood flow during sexual stimulation, allowing a man to get an erection.
❯What side effects are associated with these medications?
Possible side effects include headache, upset stomach, backache, vision or hearing changes, nasal congestion, and flushing. The most serious possible side effect is priapism—which involves having an erection that lasts four hours or longer. This condition requires immediate medical attention.
❯Who should not take these medicines?
Men who are already taking nitrates to treat chest pain or other heart conditions. Combining nitrates with ED drugs can cause a dangerous drop in blood pressure. The same is true for alpha-blockers used to treat prostate enlargement. Tell Dr. Patel about all the medications you are currently taking.
❯Do prescribed oral ED medications work for all men?
No. It is estimated that these oral medications work in about 70% of cases. But every man’s biological response and personal circumstances are different. As a result, drugs like Viagra or Cialis are not always the solution.
❯Are there other treatments available for men not helped by oral medications?
Yes. There are a variety of other treatment options. These include:
- Penile Injections
- Intraurethral medication
- Vacuum Erection Devices
- Penile Implants
❯What are penile injections?
Using a very fine needle, the drug Alprostadil is injected into the side of the penis. These injections are very effective for many men unable to get an erection from using oral medications. Dr. Patel will discuss whether this might be a treatment option in your case—and if so, will provide instruction on how to self-administer the injections.
❯How is intraurethral medication used to treat ED?
Using a special applicator, a tiny pellet of the drug Alprostadil is inserted into the urethra of the penis. (The urethra is the tube that carries urine out of the body.) When effective, men usually obtain an erection within 10 minutes, which usually lasts between 30 and 60 minutes. Dr. Patel will discuss whether intraurethral medication is an appropriate option for you—and if so, will provide instruction on how to self-administer the pellets.
❯What are vacuum erection devices?
Available by prescription, these devices produce an erection by pulling blood into the penis. The device consists of a hollow plastic tube that fits over the penis and a hand-powered or battery-powered pump which draws air out of the tube, creating a vacuum effect that causes an erection. In most cases the erection lasts long enough for a couple to have sex.
❯Can testosterone replacement therapy help with erectile dysfunction?
It might help when a man has clinically low testosterone levels. But testosterone therapy is not a proven method in and of itself to treat ED. In most cases the hormone is responsible for increasing the libido (sex drive), not improving sexual performance.
❯Does Dr. Patel perform surgery to correct erectile dysfunction?
No, he does perform procedures such as penile implants. That requires a urologic surgeon. But Dr. Patel can advise you when surgery might be a wise option to explore.