Men’s Health Month Erectile Dysfunction

By Harry Tsai, M.D. –

Normal erectile functions depends on multiple factors such as blood flow, normal signals from the brain to the nerves and muscles in the penis, and testosterone levels.  Men who have difficulty obtaining, keeping an erection are considered to have erectile dysfunction.

Cause
. Lifestyle choices: being overweight, smoking, excessive alcohol, drug abuse
. Health conditions: diabetes, heart disease, high blood pressure, high cholesterol, low testosterone, neurologic diseases such as Alzheimer’s, Parkinson’s, multiple sclerosis
. Medicines: high blood pressure drugs, antidepressants, antihistamines
. Mental or emotional concerns: Stress, depression, anxiety (performance anxiety)

Symptoms
. Trouble getting an erection
. Trouble getting a firm or rigid erection for intercourse
. Trouble keeping an erection

Detection
There are not many invasive tests that are required to make a diagnosis.  Urinalysis is need to rule out infection and blood in the urine.  A thorough history and physical can reveal potential medical causes.  Physical exam can reveal curvature or plaques in the penis (Peyronie’s disease).  A testosterone level is required to evaluate potential hormonal cause of ED.

 Treatment
. Treat the underlying cause such as adjusting the medicine that is triggering ED
. Stop smoking and drinking
. Oral medications are known as 5-phosphodiesterase inhibitors : Cialis, Levitra, Viagra; this class of medications work by boosting the effect of nitric oxide which in turn relaxes the muscles to the blood vessels of the penis.  As a result, there is increased blood flood to the penis.

. Intraurethral suppository: MUSE can be deposited inside the urethra
. Injection therapy: medications can be mixed and injected into the soft tissue of the penis
. Vacuum device: this is a pump which is placed over the penis and draws blood into the penis
. Surgery: An implant can be placed surgically into the penis to obtain an erection

Prevention
Maintaining a healthy diet, regular exercise, monitoring medical conditions can lead to better erections.  Avoid drinking, smoking, losing weight and decreasing stress are also vital.

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