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Patient history A diagnosis of erectile dysfunction is made in men who have repeated inability to achieve and/or maintain an erection for satisfactory sexual performance for at least 3 months. Candid communication between the patient and the doctor is important in establishing the diagnosis of erectile dysfunction, assessing its severity, and determining the cause. During patient interviews, doctors try to answer the following questions:
Treatments include psychotherapy, adopting a healthy lifestyle, oral PDE5 inhibitors (Viagra, Levitra, and Cialis), intraurethral medications, intracavernosa injections, vacuum devices, surgery, and working with doctors to avoid medications that can impair erectile function.
"Animal studies have already indicated that you may be able to achieve as much or more with a single dose of radiation than with a protracted course," Scardino noted. "So, the big question is, are you going to find more complications as a result of this kind of a shift in dosage? Now, cutting back from seven and a half weeks to five weeks is a slight move in this direction, but they found no difference in sexual side effects, and that's valuable. And I certainly think we'll be seeing a lot more research in this area."
The Massachusetts Male Aging Study surveyed 1709 men aged 40–70 years in the greater Boston area between 1987 and 1989 and reported a prevalence of erectile dysfunction of 52%, with 9.6% of respondents reporting complete erectile dysfunction.5 In 2000 the overall prevalence of erectile dysfunction in this study population was re-estimated to be 44%.6 The Massachusetts study is important because it is the first cross-sectional, community-based, random-sample multidisciplinary survey on the topic and involved a significant cohort followed up for nearly a decade beyond the initial assessment. A survey of 3009 men aged 18–70 years from all regions of Canada revealed a similar prevalence of erectile dysfunction.7
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In the past, the placement of prosthetic devices within the corpora was the only effective therapy for men with organic ED. Now, this is the last option considered, even though more than 90% of men with an implant would recommend the procedure to their friends and relatives.
Excessive stress is cause by the stressful life styles, no time for rest, putting yourself under the extreme conditions, too much of exercise, more exertion of body than body can face, and many other reasons. Excessive stress leads to the injure of entire health and makes you prone to many diseases. Stress activates the fight-or-flight response, where the adrenal glands release the hormones cortical and adrenaline into the blood stream. Cortical stimulate the liver to release sugar into the blood for quick energy. Adrenaline causes the blood vessels to constrict and increases breathing and heart rate, and shuts down the digestive system.
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Depression that accompanies ED is treatable. The first step in overcoming depression is to be honest with yourself, your partner, and your doctor. After depression has been brought out into the open, coping with it will be easier and less stressful.
An erection problem is the inability to get or maintain an erection that is firm enough for a man to have satisfactory intercourse. You may be unable to get an erection at all, or you may lose the erection during intercourse before you are ready. If the condition persists, the medical term is erectile dysfunction.
STUDY SELECTION AND DATA EXTRACTION: All identified research, review articles, and abstracts were assessed for relevance, and all relevant information was included. Priority was given to the primary medical literature and clinical trial reports.
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Transurethral alprostadil provides the same significant improvement in erectile function as injectable alprostadil with a better tolerated method of delivery. In one large study,15 65 percent of patients reported successful and satisfactory intercourse. This form of alprostadil is thought to diffuse into the corpus spongiosum and then into the corpus cavernosum. Once the drug enters the cavernosum, the arteriolar smooth muscle relaxes, resulting in erection. In a large double-blind, placebo-controlled study, the most common reported side effect was penile pain (10.8 percent), which was not judged by patients to prevent its use.15
The birth control patch, or Ortho Evra®, is a slim patch you apply once a week for three weeks at a time. When used correctly it is as effective as the birth control pill, with a failure rate less than one percent. However, it may not be as effective for women who are over 198 pounds, so they should use it in combination with condoms to avoid pregnancy, warns ACOG.
Tadalafil should not be used with alpha-blockers (except Flomax), medicines used to treat high blood pressure and benign prostate hypertrophy (BPH), because the combination of tadalafil and an alpha-blocker may lower the blood pressure greatly and lead to dizziness and fainting. Examples of alpha-blockers include tamsulosin (Flomax), terazosin (Hytrin), doxazosin (Cardura), alfuzosin (Uroxatrol), and prazosin (Minipress). The only alpha-blocker that can be used safely with tadalafil is tamsulosin (Flomax). When tadalafil (20 mg) was given to healthy men taking 0.4 mg of Flomax daily, there was no significant decrease in blood pressure and so patients on this dose of tamsulosin (Flomax) can be prescribed tadalafil. The only alpha blocker that has not been tested with tadalafil is alfuzosin (Uroxatrol) and no recommendations can be made regarding the interaction between the two.
Injury: Injuries to the pelvis, bladder, spinal cord, and penis that require surgery also commonly cause ED.
Men with organic ED can be treated with one or more of the various available therapies. However, if they have lost confidence in their ability to obtain and maintain an erection suitable for penetration, a few words of encouragement from their physician can be of great help.