Erectile Dysfunction

What is Erectile Dysfunction and what causes it?

Erectile dysfunction (ED) is when a man cannot maintain an erection for sexual function.  It is different from a lack of desire (libido) or problems with ejaculation, but the three issues often happen together.  This condition is very common and is age related.  40% of men over 40 and 70% of men over 70 have ED.  Some men cannot achieve any erection at all, but this is a small percentage of patients.  In addition to age, the following are potential causes for this condition:

  • Psychological issues
  • Medications
  • Cardiovascular disease
  • Postsurgical changes
  • Neurologic problems

How is Erectile Dysfunction diagnosed?

  • A questionnaire on your erectile function
  • A physical exam
  • And possible lab test may include: cholesterol, diabetes, low testosterone and PSA.

About general measures to take for Erectile Dysfunction

  • Erectile dysfunction is often a sign of cardiovascular disease.
  • To prevent or reduce the progression of ED, take some of the same steps you would to mitigate your risk of cardiovascular disease like:
    •  Quitting smoking, watching your cholesterol, controlling your diabetes and exercising, watching your weight and controlling stress.
    • Additionally for ED, having a partner that is supportive and understanding can reduce performance anxiety.

What is the treatment for Erectile Dysfunction?

Treatment for ED can be either with medication or by other methods.  Medication can be oral (pills, dissolving tablets) or injected.

About oral medication for Erectile Dysfunction

Some common oral medications for ED include Viagra (sildenafil), Cialis (tadalafil) and Levitra (vardenafil). They work by helping to increase blood flow to the penis in order to maintain an erection. Take as directed by your healthcare provider.  Use the following tips when taking either one:

  • These medications will not case an erection by themselves; you will need stimulation for them to work
  • Take the lowest does you need to achieve results, sometimes just ¼ to ½  of a pill
  • Avoid fatty foods and excessive alcohol intake
  • Take about 1 hour prior to sexual activity

About Erectile Dysfunction injection medication

Another treatment for ED is to inject the medication directly into the penis.  The benefit of this option is that you can achieve an erection even without stimulation.  A drawback about this option is the fear some patients have of needles.  In reality the needles used are very small and the process is very quick and easy. Your healthcare provider can provide an explanation and test injection at your request.

About non-medicinal treatments for Erectile Dysfunction

The non-medicinal treatments for ED include vacuum constriction devices and surgically implanted penile prosthetic devices.  Penile implants will generally be used as a last resort.

Side effects

Common side effects of the various treatment methods are as follows:

  • Oral medicines – facial flushing, nasal stuffiness and stomach acid reflux. Viagra can occasionally cause blue-tinted vision.
  • Injected medicines – minor penile bruising around the injection site, penile pain especially while increasing dosage and with the drug prostaglandin, and priapism – a prolonged erection.
  • Penile prosthetics – loss of penile length, no increase in girth and revision for mechanical failure or infection.

Priapism

Priapism is a prolonged erection (usually lasting more than 2 hours).  Left untreated it can cause a permanent loss of erection.  You can try to treat priapism yourself using the following methods but if these don’t work you must seek help from an emergency room.

  • Exercise – like walking
  • Cold shower

If these do not work, please go to the emergency department.

 

Michelle Strovski, Maple Ridge Urology, Serving Maple Ridge, Coquitlam, Mission, Abbotsford, Langley, and Vancouver.