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Erectile Dysfunction

  Erectile Dysfunction (ED) is when a man often has problems getting or keeping an erection. Your penis may never be erect or only once in a while. You can also get erections, but they don't last long enough.

  1. It is normal for a man to have erection problems from time to time; doctors do not consider this to be ED unless these disorders occur often.
  2. ED can be caused by injuries, psychological problems, disorders of the nervous system and blood vessels, certain medications, and surgery.
  3. ED is common in men over 40.
  4. ED can usually be treated.

Sometimes ED is a sign of more serious health problems.

See a doctor right away if you have ED and:

Feel numbness in the area between your legs (crotch)

Numbness accompanied by ED could be a sign of a spinal cord problem.

Ask your doctor if you need to be examined quickly in the following cases :

  1. You never get erections at night or when you wake up in the morning.
  2. You have cramps in your leg muscles after exercising, and these cramps go away with rest.

Most of the time, ED is caused by problems with blood flow to your penis or problems with the nerves in your penis.

The most common causes of ED include:
  1. Hardening of the arteries of the body (atherosclerosis).
  2. Diabetes.
  3. Side effects of prostate surgery.
  4. Taking certain medicines (especially medicines to treat high blood pressure or depression).
ED can also be caused by:
  1. Low testosterone levels.
  2. Substances or drugs such as alcohol or cocaine.
  3. Stress, performance anxiety, depression or extreme fatigue.
  4. Diseases that affect your nerves, for example, stroke, multiple sclerosis and spinal cord injury.
  1. Will order blood tests to measure testosterone levels and check for diabetes or other disorders.
  2. Will sometimes do an ultrasound to check blood flow to your penis.
First, doctors:
  1. Treat any health problem you have that could cause ED.
  2. Consider changing any medications you are taking that cause ED.
Your doctor may also advise you to:
  1. Lose weight.
  2. Stop smoking.
  3. Drink less alcohol.
However, the main treatment for ED is medication. In general, doctors prescribe:
  • Tablets, such as sildenafil (Viagra)

Tablets like sildenafil are called phosphodiesterase inhibitors. You should take them about an hour before you have sex. You should not take these tablets if you are also taking a certain type of heart medicine called nitrates. Nitrates such as nitroglycerin are medications used to treat chest pain.

If you cannot take phosphodiesterase inhibitors, your doctor may:
  1. Prescribe medication that you inject into your penis before having sex.
  2. Prescribe medication that you insert into the opening of your penis before having sex.
  3. Make you use a vacuum pump.

A vacuum pump is a round plastic tube that you place over your penis. It includes a manual pump used to remove the air. This gives you an erection. Once you are erect, you will place a ring or band around the base of your penis to maintain your erection when you remove the pump.

If you have severe ED and none of these treatments work, doctors may:
  • Perform surgery to place a device in your penis.

The device can be a stiff silicone rod that keeps your penis constantly erect. It can also be an inflatable device that you pump to give you an erection.