Summary for HealthiNation’s Erectile Dysfunction

Hosted by Dr. Paul Knoepflmacher, Internal Medicine

What Is Erectile Dysfunction?

Erections are the result of a complex process. It starts with signals from the brain, the right levels of testosterone and healthy blood vessels in the penis. If something affects any of these factors, erectile dysfunction can result.

What Happens With Erectile Dysfunction?

The key to erection is blood flow. Inside the penis are two long, slender chambers called the corpora cavernosa. These chambers are made up of muscle tissue. During arousal, nerve signals from the brain cause the muscles to relax. When that happens, blood flows in at about seven times the normal amount, inflating the chambers and creating an erection. Continued sexual arousal maintains that higher rate of blood flow, keeping the erection firm.

During orgasm, sperm is released from the testicles and travels through tubes called the vas deferens. Along the way, it mixes with fluid from the prostate and other glands and becomes semen. This fluid travels out of the body through the urethra. When the sexual arousal passes, the excess blood drains out of the chambers, and the penis returns to its non-erect size.

Causes of Erectile Dysfunction

Erectile Dysfunction can occur for a number of different reasons and can be either physiological or psychological. In most cases—about 80 to 90 percent—the problem is caused by a physical problem.

Physical problems of ED include:

• Nerve damage from diabetes
• Kidney disease
• High blood pressure
• Multiple sclerosis
• Hormone imbalance
• Problems with blood circulation

These problems can be serious if they aren’t treated. You may have one or some of these problems and not even know it, so speak to your doctor about what you’re experiencing.

Some other physical causes for ED include:

• Being overweight
• Side effects from medications, like blood pressure drugs, antihistamines, antidepressants and diet drugs
• Surgery for prostate and testicular cancer
• Injury to the penis, spinal cord, prostate, bladder or pelvis. These can cause nerve and muscle damage, which can lead to ED

Some psychological causes of ED include:

• Stress
• Anxiety
• Fatigue
• Depression
• Negative feelings toward your partner, like anger or lack of interest

Preventing Erectile Dysfunction

Occasional bouts of ED are common and will usually go away if you follow these guidelines for good health. By adopting a healthy lifestyle, you can prevent erectile dysfunction from becoming a problem for you.

Prevention Tips:

• Limit alcohol and drugs. Limit or avoid alcohol intake and recreational drug use.
• Stop smoking. Smoking can damage your blood vessels and cause circulation problems.
• Exercise regularly. This will help keep you at a healthy weight and lower your blood pressure.
• Reduce stress. Stress affects the whole body, from your mind to your muscles and blood vessels.
• Get enough sleep. This will help keep you both physically and mentally fit.
• Deal with anxiety and depression. These may be contributing to psychological factors causing ED.
• Get screenings. See your doctor for regular checkups and routine health screenings.

Diagnosing Erectile Dysfunction

If Erectile Dysfunction lasts longer than two months, or is a recurring problem, talk to your doctor about it. He or she may ask about your health history, stress level and everyday life. You may also have a blood test to check your hormone levels and to rule out other medical problems that need to be addressed.

Treating Erectile Dysfunction

Erectile Dysfunction isn’t something you have to live with. Treatments for ED vary from taking a pill to surgical options. It may take some time to get it right, so it’s important to communicate with your doctor and be patient.

Medication Options

• Oral Medications. These are called PDE-5 inhibitors, or phosphodiesterase inhibitors. They work by relaxing muscles in the penis. When these muscles relax, blood flows into the chambers and allow you to have an erection. These medications allow an erection to occur, but only when you’re aroused.

Patients who have had a recent heart attack or stroke, or use nitrate medications for heart problems, should not use these drugs.

• Injections. This approach uses a drug, which is injected into the penis, to simulate a natural hormone in the body. This hormone, called Prostaglandin E, relaxes muscles in the penis. The difference between this method and oral medications is that this method will automatically result in erection regardless of sexual arousal. It typically produces an erection in five to 20 minutes and then last up to an hour. This drug also comes as a small pellet that is inserted right into the opening of the penis, using an applicator. An erection will begin within eight to 10 minutes and may last 30 to 60 minutes.
• Hormone Replacement Therapy. This can help the small number of men who have low levels of testosterone. A boost can help relax muscles in the penis, which improves the blood flow needed for an erection.External Vacuum. This is a medical device that involves placing a plastic cylinder over the penis. A pump on the opposite end of the cylinder creates a low-pressure vacuum around the penis and triggers erection. To maintain the erection, once the plastic cylinder is removed, a rubber constriction band is placed around the base of the penis.
• Surgery. Vascular surgery may be an option if medication and device therapy don’t help. This procedure can be done when blood flow to the penis has been blocked by an injury to the penis or pelvic area. However, the long-term success of this surgery is unclear.Implants. Implants work by placing two inflatable balloons into the penis. They’re connected to a pump into the scrotum, and a reservoir near the bladder. When inflated by the pump, fluid from the reservoir flows into the balloons, creating an erection. A key point to remember is that these implant operations can’t be reversed.

If you experience erectile dysfunction on occasion, don’t assume it’s permanent. It’s also important to remember your sexual partner’s feelings; she may worry that your problem is related to her, or your relationship. It’s important to be open with your partner if you think you have ED. It’s very common, and nothing to be ashamed of.

HealthiNation offers health information for educational purposes only; this information is not meant as medical advice. Always consult your doctor about your specific health condition.