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Treatment for Impotence or Erectile Dysfunction
The Physical Causes
The good news is that the majority of cases of impotence/erectile dysfunction can be treated. There is a wide range of treatments that result in over 90% of patients finding a suitable and effective treatment.
There is a simple process of elimination to follow to determine what treatment is best for you. To start with your doctor will try to establish the cause. Part of this will be to determine if there is a reversible cause of your impotence/erectile dysfunction. This may be due to new medication you are taking and if this is the case then changing the dose may be the simple answer to your problems. The following list gives some of those cases:
Medication for high blood pressure
Medication for depression
Patients who have endocrine problems, like thyroid or pituitary problems
Stress or anxiety
Smoking
Recreational drugs like alcohol, marijuana or cocaine
Abnormality of the penis
Please understand that every patient is different and what works with one man may not work for another.
Which treatment is for you?>
Every man is different and what works for one man may not work for another. It is advised that you consult with your doctor on all aspects of any medication you plan to take. It is also a good idea to discuss it with your partner.
Before you make your final decision you should consider how this medication might affect you and your lifestyle, look at the cost implications and thoroughly investigate the history of the medication.
Lifestyle Changes and Prevention
A healthier lifestyle can often be beneficial and help prevent any further deterioration.
Try to cut down or stop smoking.
Try to exercise more. Take a walk instead of the bus or take the stairs instead of the lift. Even small changes can dramatically affect your health.
Eat a balanced diet rich in fruit and vegetables and low in fat.
If you drink more than the recommended amount try to cut down
Recreational drugs can cause impotence/erectile dysfunction.
If you lead a stressful life look at ways to limit the way this affects you. Make time for you to relax.
Sex and Your Heart
Sex makes the heart work harder and can put significant stress on the heart. As part of the diagnostic process your doctor will look at your medical history and perform various tests to establish the healthiness of your heart. If necessary a cardiologist may be consulted. Sex is not always advisable with some of these heart conditions. The list below shows areas where it is very important to consult with your doctor before any sexual activity:
Heart attack
Heart failure
Heart valve disease (aortic stenosis)
Heart rhythm problems
Stroke
Angina
High blood pressure
If you do experience and heart or chest pains during sex stop and consult your doctor immediately. If you have any concerns relating to your general health or the medication you have been prescribed also consult with your doctor immediately.
Oral Medication
Before taking any medication it is advised that you consult with your doctor who will advise you on the best course of action.
Viagra
Viagra, or Sildenafil citrate, was originally developed to treat high blood pressure. In1993, Pfizer Pharmaceuticals started clinical trials of Viagra. This involved more than 3,000 men with varying degrees of impotence associated with diabetes, spinal cord injury, history of prostate surgery, and other illnesses. The results were phenomenal with nearly half of men tested who suffered from severe impotence able to achieve an erection and over two thirds with less severe cases reporting positive results.
Viagra is an orally consumed medication coming in the form of a pill. It is taken an hour before sexual activity. Viagra acts by enhancing the effects of a chemical the body normally releases into the penis when sexually aroused.
Viagra should not be taken more than once a day.
However there are side affects of Viagra. These include:
• Headaches
• Flushing
• Indigestion
• Temporary changes in vision including seeing a 'blue haze.'
CAUTIONS
Men with sickle cell anemia, leukemia, or multiple myeloma should not take Viagra. It is feared that they may develop priapism. This is when the erection does not subside. It can cause permanent damage to the penis. If you take Viagra and your erection does not subside consult with your doctor immediately.
Men with a history of heart trouble, heart attacks, and low blood pressure should be examined carefully before getting a prescription for the drug.
Heart patients taking nitrate-based like nitroglycerin must not take Viagra. The combination may cause a deadly dip in blood pressure.
Additionally, men are cautioned against using other treatments for impotence while taking Viagra as such combinations have not been tested yet.
Levitra
Levitra® works quickly and provides consistent results. It improves sexual function in most men from the first time they take the drug. It has been shown to be effective in men of all ages, in patients with diabetes mellitus, and in men who have undergone radical prostatectomy.
Cialis
Cialis® stays in the body longer than the other selective enzyme inhibitors. It facilitates an erection within half an hour and enhances the ability to achieve an erection for up to thirty six hours.
There are side effects associated with enzyme inhibitors. These include:
• Headaches
• Nausea
• Flushing
• Indigestion
• Nasal congestion.
Cialis® may cause muscle aches and back pain. This usually disappears within 48 hours.
Uprima
Uprima works differently from the other medications acting on the brain.
Yohimbine
Yohimbine only works for a small percentage of men (clinical tests are still ongoing but seem to suggest a success rate of up to 20%). It works by stimulating the parasympathetic nervous system. It has several side effects some of which are listed below:
• elevated heart rate
• elevated blood pressure
• dizziness
• nervousness
• irritability
The patient needs to follow a course of around six weeks to determine if it is going to work.
Ease of administration makes oral medication advantageous. Some drugs, however, are suitable for only a relatively small group of men, and in many cases, oral medications may by less effective than other treatments.
Other treatments
All of these medicines are only legally approved for use in men and have not been officially shown to be safe for women.
Vacuum Device
The various vacuum devices work as follows. The patient slips a hollow, plastic cylinder over his flaccid penis. He then uses a hand pump to suck air out of the cylinder. This creates a vacuum that draws blood into the penis. After one to three minutes an adequate erection is achieved. The patient then slips a soft rubber ring over the cylinder and onto the base of his penis to trap blood and maintain an erection until he removes the ring. The cylinder is then removed. The ring will keep blood from flowing out, thus maintaining the erection and allowing intercourse. The ring can be left in place for up to thirty minutes.
It is strongly advised that you consult regularly with your doctor whilst using a vacuum device as misuse can severely damage the penis.
Vacuum devices are recommended for men who can still achieve a partial erection on their own. After instruction by your doctor or a professional consultant, they are easy to use and improve erections regardless of the cause of impotence.
Self-Injection
This is a treatment that involves an injection into the corpus cavernocum of the penis. These drugs, such as papaverine, phentolamine and prostaglandin-E, increase blood flow. The injection is nearly painless. It produces a more natural erection than a vacuum device or an implant. The drugs take effect after about ten minutes. The effects last from as little as half an hour up to several hours.
As with all medication the erects vary from patient to patient. Until the correct dosage is established a prolonged erection can occur. There have been rare occurrences of an erection not subsiding. It is recommended that self-injection be performed no more than once every 4 to 7 days.
Side effects have been reported. They are as follows:
• Infection
• Bleeding
• Bruising at the injection site
• Dizziness
• Heart palpitations
• Flushing .
Repeated injection may cause scarring of erectile tissue. This can further impair the ability to achieve and maintain an erection.
Penile Implants
Surgical implants are also an option. They can be used if other treatment fails to get the desired results. There is a small risk of malfunction but the problem can nearly always be fixed. Over 90% of patients are satisfied with these devices. The two major types of penile implants are:
Malleable Rods
Semi-rigid prostheses, a silicon covered flexible metal rod, are inserted into the outer channels of the penis. This is done by making a small incision in the lower abdomen or scrotum. Each rod is one solid piece. It remains erect at all times but they can be bent close to the body for concealment. Because there are no moveable or inflatable parts, malfunctions are rare.
Inflatable Cylinders
These devices consist of one or two inflatable cylinders, silicone or bioflex tubes, a finger-activated pump and an internal reservoir that stores the liquid used to inflate the cylinders. The cylinders, pump and reservoir are implanted within the penis, scrotum and lower abdomen respectively. The patient manually squeezes the pump several times. This pumps the fluid from the reservoir into the cylinders. They expand and create an erection. The erection is maintained until the release valve on the pump is squeezed to return the fluid to the reservoir.
The surgical procedure to implant the inflatable prosthesis is slightly more complicated than for a semi-rigid implant. Also, because there are more mechanical parts, there is a higher risk for mechanical failure requiring repair or adjustment.
Vascular Reconstructive Surgery
Revascularization involves bypassing blocked veins or arteries. It works by transplanting a vein from the leg and attaching it so that it creates a path to the penis that bypasses the blockage. Young men with only local arterial blockage are the best candidates for this procedure.
Venous ligation is performed to prevent venous leak. Problematic veins are bound (ligated) or removed. This allows an adequate amount of blood to remain in the penis. It works in around half of patients but there have been reports of discomfort.
Vascular surgery for impotence/erectile dysfunction is rarely performed. Risks include nerve damage and the creation of scar tissue, both of which are causes of impotence.
Urethral suppositories containing prostaglandin (aprostadil) are an alternative to injection. This works by inserting a prostaglandin pellet through the meatus into the urethra via a hand held applicator. Prostaglandin is absorbed through the urethral mucosa into the surrounding erectile tissue. It is available with a prescription. Around 60% of men who have used it have reported positive results.
Side effects such as pain in the scrotum and rectum have been reported.
Natural Products for treatment.
Today more and more people are looking for natural remedies for a wide range of ailments. This is even more the case where there is no guaranteed cure or modern medicine fails to offer a medication that the patient feels comfortable with.
There are natural therapies for sexual problems. Psychologically caused depressant associated impotence/erectile dysfunction has been improved using Gingko biloba extract. Ginseng and yohimbine may also help psychologically caused depressant associated impotence/erectile dysfunction. However there seems to be a much higher incidence of side effects including hypertension.
Damiana is another herb that has been used to stimulate sexual desire. However studies have not progressed far enough to confirm the medical case behind its use.
The Psychological Causes
Sex Therapy
A number of men develop impotence from psychological causes that can be treated. When a physiological cause is treated the associated psychological effects may impair normal sexual performance. Qualified therapists work with couples to address the many psychological causes of impotence/erectile dysfunction such as tension, anxiety and stress. They also try to improve sexual communication between partners and create a realistic expectation of sex.
It is recommended to consult with a specialist about counselling. Creating preconceived ideas about treatment and expectation only creates problems with the treatment.
Hypnosis
Frequently impotence/erectile dysfunction is a short-term problem. However when it does happen it can develop into a bigger problem because of the psychological effect. The brain starts to ask questions like “what if it happens again?” The problem with doing this is that this is the beginning of a vicious cycle which only makes the problem worse. Focusing on what might go wrong and therefore increasing stress will only make things go wrong.
Hypnosis can help because it puts the control back in the unconscious mind where it belongs and it reduces the anxiety and stress that you have created a mind association with about sex.
Get healthy
Live healthily. The healthier the body is, the less the chance of physical causes of impotence/erectile dysfunction. Studies have shown that physically active men have better erections than those who live sedentary lives. Regular exercise, the equivalent of running for at least three hours a week, showed the best results. Bad lifestyle habits such as being overweight, staying sedentary for long periods such as watching television or playing on a computer and smoking are conducive in promoting impotence/erectile dysfunction.
Impotence is not the end of your sex life. Live healthily and if you do have any complications talk to your doctor!
For Further Information
Diagnosis
Causes
Treatment
How an erection Occurs
FAQ's
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