ERECTILE DYSFUNCTION (IMPOTENCE)

Erectile dysfunction, also known as Impotence is when it is hard for a man to get or keep an erection that's firm enough for sex. Most men have problems with erections occasionally, but when this happens more than half of the time, then erectile dysfunction is present.

An erection is the result of increased blood flow into the penis, due to stimulation by either sexual thoughts or direct contact with the penis. When a man becomes sexually excited, muscles in the penis relax, which allows for increased blood flow through the penile arteries. This blood fills two chambers inside the penis called the corpora cavernosa, which makes the penis grow rigid. Erection ends when the muscles contract and the accumulated blood flow out through the penile veins. Erectile dysfunction can occur because of problems at any stage of the erection process. It can cause low self-esteem, stress and depression and it may also affect the quality of a marriage or intimate relationships.
Below are some of the common risk factors for Erectile Dysfunction.

• Age over 50
• Diabetes
• Hypertension
• High cholesterol
• Cardiovascular disease
• Obesity
• Prostate cancer
• Trauma to pelvis or penis
• Low testosterone
• Cigarette smoking
• Drug or alcohol abuse
• Some medications
• Lack of exercise
• Depression*
• Relationship conflicts*
• Stress at home or work*
• Performance Anxiety*

TREATMENT

Most of the treatments for erectile dysfunction work well and are safe, they include:

• Oral Medication
• Vacuum Erection Device
• Drugs in the penis
• Surgery

Oral Medications

Oral medications are the most common and most successful treatment for many men with erectile dysfunction. Drugs known as PDE-5 inhibitors enhance the effects of nitric oxide, which relaxes muscles in the penis and increase blood flow. These medications allow you to get an erection in response to sexual stimulation. You may have seen these drugs on TV and in Internet ads: Viagra® (sildenafil citrate), Levitra® (vardenafil HCl) and Cialis® (tadalafil). Possible side effects include flushing, nasal congestion, headache, visual changes, backache and upset stomach. Do not take these medications if you have heart disease, low blood pressure or are taking nitrates (medication for chest pain).

Vacuum Erection Device (VED)
A vacuum Erection Device is a plastic tube that slips over the penis, making a seal with the skin of the body. A pump at the other end of the tube creates a low-pressure vacuum around the penis, which results in an erection. An elastic Constriction ring may then be slipped onto the base of the penis; this holds the blood in the penis (and keeps it hard) for up to 30 minutes. (An adequate erection can be achieved with a VED in 30 seconds to 7 minutes.) See video below for further information.
https://www.youtube.com/watch?v=xYpHty0p1Cw

Drugs in the Penis
If oral drugs don't work, Alprostadil is another drug that could be used. It is a Prostaglandin E1 vasodilator.  It comes in two forms: 1) Self-Injection Therapy, where the drug is injected into the side of penis with a very fine needle, and 2) Intra-urethral Therapy, where a tiny medicated pellet of the drug is placed in the urethra (the tube that carries urine out of your body). Erections are usually achieved within 10-15 minutes. These methods have good success rates but can have significant side effects including burning and erections lasting more than 4 hours. Click the link below for more information.
https://patient.info/medicine/alprostadil-for-erectile-dysfunction

Surgical Treatment

When other treatments do not improve erectile dysfunction, surgery may be a last resort. Surgeries include penile implant surgery and surgery to fix problems with blood vessels in the penis. Fixing blood vessels only helps in very specific cases, such as in pelvic or penile injuries. Penile implants are devices that are placed completely inside your body. They produce a stiff penis that lets you have normal sex. Click the links below to learn more about surgical options for erectile dysfunction.
https://www.youtube.com/watch?v=YAdnjKdFOs0
https://www.urologicalcare.com/penile-implants-prosthesis/types-of-penile-implants/ 


Talk Therapy

Psychological factors are a common cause of erectile dysfunction, including stress, anxiety, post-traumatic stress disorder (PTSD) and depression. If you still wake up with erections at mornings, but frequently have difficulty attaining or maintaining erections for sexual intercourse, then your erectile dysfunction may be due to a psychological cause. You may benefit from “talk therapy”, which can help you manage your mental health. You will work with your therapist who will address issues such as major stress or anxiety, feelings around sex, and more. Also, if erectile dysfunction is affecting your relationship, you may also consider speaking with a relationship counselor. Relationship counseling can help you reconnect emotionally with a partner, which may also help your erectile dysfunction.

 
Tip#1:

Penis Ring/ Cock Ring
A penis ring or cock ring may be used if you are able to get an erection but have trouble maintaining it. A penis ring fits around the base of the penis, (or the penis and testicles) and applies pressure to the surrounding area. Penis rings work by trapping the blood inside your penis so it remains harder for longer.  It is a good affordable option that may be used to treat erectile dysfunction. You can purchase one in a sex store or online.  Learn more information about it below.
https://onlinedoctor.superdrug.com/penis-rings.html

Tip#2:

Porn/ Masturbation
If you are masturbating to very stimulating porn on a regular basis then it might be difficult to get as aroused in the bedroom with your partner.  Watching video pornography is very stimulating and often men have difficulty creating that same level of arousal or stimulation with their partners.  Consider masturbating without porn; try this for two weeks and see if your erection quality improves.

Tip#3:

Communication
Communicate with your partner what you like during the process of sex.  If you are not aroused then you might experience erectile dysfunction, so make sure you tell your partner what turns you on.  Also, communicating about intimacy should lead to you feeling more connected with your partner, which could help you be more relaxed during sex.

Tip#4:

Non-Penetrative Sex
Experiencing erectile dysfunction can also be a reason to try “non-penetrative sex”. Things like kissing, licking, sucking, foreplay and teasing, are all super stimulating and don't focus on penetration.  You can try to bring each other to orgasm using these ideas, which may put the fun back into having sex. Many couples have found success using this technique.

Tip#5:

Vascular health
Hypertension, Diabetes, and high cholesterol can all damage arteries (blood vessels) in the heart (causing heart attack), in the brain (causing stroke), and in the penis (causing erectile dysfunction). Make sure that you follow up with your health practitioner regularly and ensure that these conditions are under control as they can lead to or worsen erectile dysfunction.

Tip#6:

Diet and Exercise
A healthy diet and regular exercise would not only improve overall health but could improve or prevent erectile dysfunction. Quit cigarette smoking and limit your alcohol intake also, as this could improve or prevent erectile dysfunction.
 
I hope these tips on ERECTILE DYSFUNCTION/ IMPOTENCE were helpful; Remember, your health is invaluable.

By Dr. J. Lawarna Matthew


Acknowledgements
American Urological Association
(Urology Care Foundation)
Visit https://www.urologyhealth.org/urologic-conditions/erectile-dysfunction for more information.