You may develop ED if you have one or more of the following:. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public.
Symptoms of ED include being able to get an erection sometimes, but not every time you want to have sex being able to get an erection, but not having it last long enough for sex being unable to get an erection at any time ED is often a symptom of another health problem or health-related factor.
Drugs known as PDE type-5 inhibitors increase penile blood flow. These are the only oral agents approved in the U. For best results, men with ED take these pills about an hour or two before having sex. The drugs require normal nerve function to the penis. PDE5 inhibitors improve on normal erectile responses helping blood flow into the penis.
Use these drugs as directed. About 7 out of 10 men do well and have better erections. Response rates are lower for Diabetics and cancer patients. Always speak with your health care provider before using a PDE5 inhibitor to learn how it might affect your health.
Most often, the side effects of PDE5 inhibitors are mild and often last just a short time. The most common side effects are:. In most cases, the side effects are linked to PDE5 inhibitor effects on other tissues in the body, meaning they are working to increase blood flow to your penis and at the same time impacting other vascular tissues in your body.
In those rare cases where a low sex drive and low blood levels of Testosterone are at fault for ED, Testosterone Therapy may fix normal erections or help when combined with ED drugs PDE type 5 inhibitors. 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 makes a low-pressure vacuum around the erectile tissue, which results in an erection. An elastic ring is then slipped onto the base of the penis.
This holds the blood in the penis and keeps it hard for up to 30 minutes. With proper training, 75 out of men can get a working erection using a vacuum erection device. If oral drugs don't work, the drug Alprostadil is approved for use in men with ED. This drug comes in two forms, based on how it is to be used: intracavernosal injection called "ICI" or through the urethra called "IU therapy". Alprostadil is injected into the side of penis with a very fine needle.
It's of great value to have the first shot in the doctor's office before doing this on your own. Self-injection lessons should be given in your doctor's office by an experienced professional.
This combination therapy called "bimix or trimix" is stronger than alprostadil alone and has become standard treatment for ED. The amount of each drug used can be changed based on the severity of your ED, by an experienced health professional. You will be trained by your health professional on how to inject, how much to inject and how to safely raise the drug's dosage if necessary.
ICI therapy often produces a reliable erection, which comes down after minutes or with climax. Since the ICI erection is not regulated by your penile nerves, you should not be surprised if the erection lasts after orgasm.
The most common side effect of ICI therapy is a prolonged erection. Men who have penile erections lasting longer than two to four hours should seek Emergency Room care. Priapism is a prolonged erection, lasting longer than four hours. It is very painful. Failure to undo priapism will lead to permanent penile damage and untreatable ED.
For IU therapy, a tiny medicated pellet of the drug, Alprostadil, is placed in the urethra the tube that carries urine out of your body. Using the drug this way means you don't have to give yourself a shot, unfortunately it may not work as well as ICI. The most common side effects of IU alprostadil are a burning feeling in the penis. If an erection lasts for over four hours, it will need medical attention to make it go down.
The main surgical treatment of ED involves insertion of a penile implant also called penile prostheses. Because penile vascular surgery is not recommended for aging males who have failed oral PDE5 inhibitors, ICI or IU therapies, implants are the next step for these patients. Although placement of a penile implant is a surgery which carries risks, they have the highest rates of success and satisfaction among ED treatment options.
Penile implants are devices that are placed fully inside your body. They make a stiff penis that lets you have normal sex. This is an excellent choice to improve uninterupted intimacy and makes relations more spontaneous. The simplest kind of implant is made from two easy-to-bend rods that are most often made of silicone. These silicone rods give the man's penis the firmness needed for sexual penetration. The implant can be bent downward for peeing or upward for sex.
With an inflatable implant , fluid-filled cylinders are placed lengthwise in the penis. Tubing joins these cylinders to a pump placed inside the scrotum between the testicles. When the pump is engaged, pressure in the cylinders inflate the penis and makes it stiff. Inflatable implants make a normal looking erection and are natural feeling for your partner. Your surgeon may suggest a lubricant for your partner. With the implant, men can control firmness and, sometimes, the size of the erection.
Implants allows a couple to be spontaneously intimate. There is generally no change to a man's feeling or orgasm. Penile implants are most often placed under anesthesia. If a patient has a systemic, skin, or urinary tract infection, this surgery should be postponed until all infections are treated. If a man is on blood thinners, then he may need to talk with a medical expert about stopping the medications for elective surgery and healing.
They know your medical history and can discuss whether you might benefit from treatment. The Sexual Advice Association has factsheets on medicines and other treatments for erectile dysfunction. They work for most men and can be used if medicine is not suitable or does not work. They're not always available on the NHS.
Speak to a doctor about where to get a vacuum pump. It's more likely to be an emotional problem if you only have erection problems some of the time. For example, you get an erection when waking up in the morning, but not during sexual activity.
Anxiety and depression can be treated with counselling and cognitive behavioural therapy CBT. A GP might recommend sex therapy, either on its own or in combination with other psychotherapy. Relate also offers sex therapy for a fee. Advice and support is also available from the Sexual Advice Association. Vacuum erection devices are a mechanical way of producing an erection for people who do not want to use drug treatments or find they are not working. A person makes their penis rigid by using a vacuum pump sealed around it that draws up blood.
The use of an accompanying band then prevents this blood from then leaving the penis. The lack of spontaneity with vacuum devices means that many people with ED find other treatments preferable. However, other treatments, such as oral medications, can also reduce spontaneity. Vacuum devices may also be susceptible to mechanical faults that affect their efficacy, such as poor seals.
There are several surgical treatment options available to patients, including penile implants. In this procedure, a doctor inserts a malleable or inflatable device into the penis. This surgery may help a patient reach and maintain erections if drug-based treatments have not worked. Typically a doctor will only recommend surgery only after exhausting all other treatment avenues.
No guidelines followed by doctors, nor any established sources of evidence, support the use of dietary supplements such as herbal pills. In addition to there being no evidence in favor of non-prescription alternatives for ED, alternative supplements and treatments may be harmful, and in some instances , fatal.
People may not always successfully achieve an erection. If this happens occasionally, it is not considered a medical problem. However, if a person is consistently unable to achieve an erection, then they may have ED.
There is no defined length of time frame over which a person must experience ED to receive a diagnosis. Some professionals suggest 6 months is suitable. However, ED does not only refer to a complete inability to achieve an erect penis. Symptoms can also include struggling to maintain an erection for long enough to complete intercourse or an inability to ejaculate. There are often emotional symptoms, such as embarrassment, shame, anxiety, and a reduced interest in sexual intercourse.
Research suggests that strengthening pelvic floor muscles through exercise can be a beneficial treatment for people with ED. Learn more about pelvic floor exercises here. Aerobic exercise, such as a jog or even a brisk walk, can also help the blood circulate better and can help improve ED in men who have circulation issues.
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