Understanding Erectile Dysfunction (ED)

Types of Erectile Dysfunctio

Erectile dysfunction (ED), also known as impotence, refers to the inability to achieve or sustain an erection long enough for sexual intercourse. ED is a common penile disorder that normally affects men aged 40 years and above.

Vascular erectile dysfunction

Vascular erectile dysfunction is the most common type of ED. It is caused by abnormalities with the blood vessels that provide blood to the tissues in the penis (to allow and maintain an erection), or the valves in the penis that normally keep blood inside.

Hormonal erectile dysfunction

Hormonal erectile dysfunction is caused by testosterone deficiency or, in certain cases, thyroid disorders.

Neurogenic erectile dysfunction

Neurogenic erectile dysfunction results from nerve abnormalities that restrict signals from travelling from the brain to the penis to produce an erection. This can occur as a result of trauma, pelvic surgery, radiation therapy, or neurological diseases such as stroke, spinal stenosis, and multiple sclerosis.

Psychogenic erectile dysfunction

Psychogenic erectile dysfunction refers to psychological conditions (that impact the thoughts, feelings, or behaviour) that can cause ED.

Symptoms of Erectile Dysfunction

Symptoms of ED include being able to obtain an erection prior to sexual intercourse only sometimes, but not every time you want to have sex; having the ability to get an erection prior to sexual intercourse but failing to sustain it during sex; complete inability to achieve an erection; and needing a lot of stimulation to keep an erection going.

Common Causes of Erectile Dysfunction

Certain diseases and conditions such as type 2 diabetes, heart disease, high blood pressure, high cholesterol, and chronic kidney disease can cause ED.

ED can be a side effect of certain medicines such as blood pressure medicines, prostate cancer drugs, antidepressants, chemotherapy drugs, diuretics, and more.

Psychological or emotional issues including fear of sexual failure, anxiety, depression, guilt about sexual performance, low self-esteem, and stress can cause ED.

Alcohol, as well as other substances that have addiction potential such as recreational drugs may cause ED.

Diagnosis of Erectile Dysfunction

Your doctor will ask you questions about your medical and sexual history such as how often your penis is firm enough for intercourse; how often you are able to maintain an erection during sexual intercourse; when did your ED symptoms start; are you currently taking any medications.

Your doctor may also ask some questions to diagnose any psychological or emotional problems that may be contributing to ED.

A physical examination will be performed - measure your blood pressure, look for blood flow issues, and examine your penis to determine the cause of ED.

Lab tests such as blood tests, complete blood count, lipid panel, liver function tests, kidney function tests, thyroid tests, testosterone test, and urine test will be performed. Imaging tests such as Penile Doppler ultrasound and magnetic resonance angiography (MRA) may be ordered.

Other forms of test include measuring if the nerves in your penis are responding to vibrations (penile biothesiometry), and an injection test (intracavernosal injection) whereby drugs that temporarily make your penis erect will be injected into your penis.

Treatment Options for Erectile Dysfunction

Stop smoking, limit your alcohol consumption, and increase your physical activity. It is also recommended to talk to a sex therapist or a counsellor to help manage your psychological or emotional issues.

Oral medications such as sildenafil and vardenafil can help increase blood flow to your penis, while injectable medications such as alprostadil and papaverine help trigger an automatic erection.

Testosterone replacement therapy is available as a gel, injection, patches, and pellets.

Vacuum constriction device, also known as a penis pump, can help create an erection by pulling blood into the penis.

Prevention of Erectile Dysfunction

Prevention tips for ED include:

• Quitting smoking.
• Lowering cholesterol level.
• Keeping a healthy weight.
• Following a healthy eating plan involving whole-grain foods, low-fat dairy foods, fruits and vegetables, and lean meats.
• Being physically active.
• Reducing alcohol consumption.
• Stopping illegal drug use.

Make an Appointment at Gleneagles Hospitals

If you want to know more erectile dysfunction or other treatments related to men’s health, get in touch with us to find out more about our Urology Services at your nearest Gleneagles Hospital.

You may also contact the Health Screening Centre at your nearest Gleneagles Hospital for health screening appointments.