What are the common symptoms of erectile dysfunction. How does age affect ED. Can certain diseases contribute to impotence. What psychological factors may worsen erectile issues. Which medications potentially cause ED as a side effect. How do lifestyle choices impact erectile function.

Understanding Erectile Dysfunction: More Than Just a Physical Issue

Erectile dysfunction (ED), formerly known as impotence, is a complex condition that affects millions of men worldwide. It’s characterized by the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. While often associated with aging, ED can occur at any stage of life and may be indicative of underlying health concerns.

The impact of ED extends beyond physical intimacy, often affecting a man’s self-esteem, relationships, and overall quality of life. Understanding the multifaceted nature of this condition is crucial for effective management and treatment.

Recognizing the Symptoms: When to Seek Help

Identifying the symptoms of erectile dysfunction is the first step towards addressing the issue. Common signs include:

• Difficulty achieving an erection
• Inability to maintain an erection throughout sexual activity
• Reduced sexual desire
• Persistent trouble with sexual performance

Is occasional difficulty normal? Yes, it’s not uncommon to experience occasional erectile issues. However, if these problems persist or become frequent, it’s advisable to consult a healthcare professional.

The Spectrum of Erectile Function

Erectile dysfunction isn’t always an all-or-nothing condition. Many men experience varying degrees of ED, including:

• Being able to get an erection sometimes, but not consistently
• Achieving an erection, but not maintaining it long enough for satisfactory intercourse
• Complete inability to attain an erection

The Underlying Causes: Unraveling the Complexity of ED

Erectile dysfunction often serves as a symptom of other health issues. Understanding the potential causes is essential for effective treatment and overall health management.

Physical Factors Contributing to ED

Numerous physical conditions can lead to or exacerbate erectile dysfunction:

• Cardiovascular diseases (e.g., atherosclerosis, hypertension)
• Diabetes mellitus
• Neurological disorders (e.g., multiple sclerosis, Parkinson’s disease)
• Hormonal imbalances (e.g., low testosterone)
• Peyronie’s disease
• Chronic kidney disease

How does diabetes affect erectile function? Men with diabetes are two to three times more likely to develop ED compared to those without diabetes. This increased risk is due to the potential damage diabetes can cause to blood vessels and nerves essential for erectile function.

Iatrogenic Causes: When Treatment Leads to ED

Sometimes, medical interventions for other conditions can inadvertently cause erectile dysfunction:

• Prostate cancer treatments (radiation therapy, surgery)
• Bladder cancer surgery
• Pelvic or spinal cord injuries

Medications and ED: The Hidden Culprits

Certain medications can contribute to or cause erectile dysfunction as a side effect. It’s crucial to be aware of these potential interactions:

• Antihypertensive drugs
• Antidepressants, particularly SSRIs
• Antiandrogens used in prostate cancer treatment
• Tranquilizers and sedatives
• Appetite suppressants
• Some ulcer medications

Should you stop taking medication if you suspect it’s causing ED? Never discontinue prescribed medication without consulting your healthcare provider. They can often adjust dosages or suggest alternatives that may alleviate ED symptoms while still treating the original condition.

The Mind-Body Connection: Psychological Factors in ED

Erectile dysfunction isn’t always purely physical. Psychological and emotional factors can play a significant role in sexual function:

• Anxiety, including performance anxiety
• Depression
• Stress (both general life stress and sexual stress)
• Relationship issues
• Low self-esteem
• Guilt or shame related to sexual activities

How do psychological factors impact erectile function? Mental health issues can interfere with the complex interplay of brain signals, hormones, and physical responses necessary for healthy erectile function. Additionally, the stress of experiencing ED can create a cycle of anxiety and further performance issues.

Lifestyle Choices and Their Impact on Erectile Health

Daily habits and lifestyle choices can significantly influence erectile function. Common factors that may contribute to ED include:

• Smoking tobacco
• Excessive alcohol consumption
• Use of illegal drugs
• Obesity or being overweight
• Sedentary lifestyle

Can lifestyle changes improve erectile function? Absolutely. Many men find that adopting healthier habits, such as regular exercise, balanced nutrition, stress management, and moderating alcohol intake, can lead to significant improvements in erectile function.

The Age Factor: Debunking Myths About ED and Aging

While the prevalence of erectile dysfunction tends to increase with age, it’s crucial to understand that ED is not an inevitable consequence of aging. Many older men maintain healthy sexual function well into their later years.

As men age, they may notice changes in their sexual response:

• Needing more direct stimulation to achieve an erection
• Longer refractory periods between erections
• Changes in the firmness or duration of erections

Are these changes normal? Yes, some changes in sexual function are a normal part of aging. However, significant or persistent difficulties should be evaluated by a healthcare professional, as they may indicate underlying health issues.

Diagnosis and Treatment: Navigating the Path to Sexual Health

Diagnosing erectile dysfunction involves a comprehensive approach:

1. Medical history review
2. Physical examination
3. Blood tests to check for underlying conditions
4. Psychological evaluation when necessary

Treatment options for ED are diverse and tailored to individual needs:

• Oral medications (e.g., sildenafil, tadalafil)
• Injectable or suppository drugs
• Vacuum erection devices
• Penile implants
• Psychological counseling
• Lifestyle modifications

Can ED be cured? In many cases, especially when caused by reversible factors or treatable conditions, erectile dysfunction can be effectively managed or resolved. The key is early intervention and a comprehensive treatment approach.

Beyond the Bedroom: The Broader Impact of Erectile Dysfunction

Erectile dysfunction can have far-reaching effects on a man’s life, including:

• Relationship strain
• Decreased self-confidence
• Anxiety and depression
• Reduced overall quality of life

How can partners support men with ED? Open communication, understanding, and patience are crucial. Encouraging medical evaluation and participating in treatment decisions can foster a supportive environment for recovery.

The Importance of Holistic Health

Addressing erectile dysfunction often leads to improvements in overall health. Many men discover underlying conditions through ED diagnosis, allowing for early intervention in potentially serious health issues.

Erectile dysfunction, while challenging, is a treatable condition that shouldn’t be ignored or accepted as an unavoidable part of aging. With the right approach, most men can find effective solutions that restore sexual function and improve overall quality of life. Remember, seeking help is a sign of strength, not weakness, and the first step towards reclaiming your sexual health and well-being.

Symptoms & Causes of Erectile Dysfunction

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What are the symptoms of erectile dysfunction?

Symptoms of ED include

• being able to get an erection sometimes, but not every time you want to have sex
• being able to get an erection, but not having it last long enough for sex
• being unable to get an erection at any time

ED is often a symptom of another health problem or health-related factor.

Erectile dysfunction (ED) is often a symptom of another health problem.

What causes erectile dysfunction?

Many different factors affecting your vascular system, nervous system, and endocrine system can cause or contribute to ED.

Although you are more likely to develop ED as you age, aging does not cause ED. ED can be treated at any age.

Certain diseases and conditions

The following diseases and conditions can lead to ED:

• type 2 diabetes
• heart and blood vessel disease
• atherosclerosis
• high blood pressure
• chronic kidney disease
• multiple sclerosis
• Peyronie’s disease
• injury from treatments for prostate cancer, including radiation therapy and prostate surgery
• injury to the penis, spinal cord, prostate, bladder, or pelvis
• surgery for bladder cancer

Men who have diabetes are two to three times more likely to develop ED than men who do not have diabetes. Read more about diabetes and sexual and urologic problems.

Taking certain medicines

ED can be a side effect of many common medicines, such as

• blood pressure medicines
• antiandrogens—medicines used for prostate cancer therapy
• antidepressants
• tranquilizers, or prescription sedatives—medicines that make you calmer or sleepy
• appetite suppressants, or medicines that make you less hungry
• ulcer medicines

View a list of specific medicines that may cause ED.

Certain psychological or emotional issues

Psychological or emotional factors may make ED worse. You may develop ED if you have one or more of the following:

• fear of sexual failure
• anxiety
• depression
• guilt about sexual performance or certain sexual activities
• low self-esteem
• stress—about sexual performance, or stress in your life in general

Certain health-related factors and behaviors

The following health-related factors and behaviors may contribute to ED:

• smoking
• drinking too much alcohol
• using illegal drugs
• being overweight
• not being physically active

Last Reviewed July 2017

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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.

The NIDDK would like to thank:
Tom Lue, M.D., University of California San Francisco

Erectile dysfunction: Symptoms, Diagnosis, Treatments

Table of Contents

What is erectile dysfunction?

Erectile dysfunction (ED) is when a man cannot get or keep an erection. The condition prevents the man from having sex or finishing sex. This condition used to be called impotence. ED can occur at any age, but it is more common in men older than 75 years of age.

ED doesn’t have to be a part of getting older. As a man ages, he may need more stimulation (stroking and touching) to get an erection. He might also need more time between erections. Older men should still be able to get an erection and enjoy sex.

Symptoms of erectile dysfunction

The primary symptom of ED is not being able to get or keep an erection for sex.

What causes erectile dysfunction?

Erectile dysfunction can be caused by:

• Diabetes (high blood sugar)
• Hypertension (high blood pressure)
• Atherosclerosis (hardening of the arteries)
• Stress, anxiety, or depression
• Alcohol and tobacco use
• Some prescription medicines. This includes antidepressants, pain medicine, and high blood pressure medicine
• Fatigue
• Brain or spinal cord injuries
• Hypogonadism (a condition that leads to low levels of the male hormone, testosterone)
• Multiple sclerosis
• Parkinson’s disease
• Radiation therapy to the testicles
• Stroke
• Some types of prostate or bladder surgery

Problems in your relationship with your sexual partner can also cause erectile dysfunction. Improving your relationship may help your sex life. If you decide to seek therapy, it will probably be most effective if your sex partner is included.

Couples can learn new ways to please one another and to show affection. This can reduce anxiety about having erections.

Certain feelings can lead to erectile dysfunction, including:

• Feeling nervous about sex. This could be because of a bad experience or a previous episode of ED.
• Feeling stressed, including work and family stress.
• Feeling depressed.
• Feeling self-conscious about your body or performance.
• Thinking your partner is reacting negatively toward you.

How is erectile dysfunction diagnosed?

ED is usually easy to diagnose. If you are tempted to self-diagnose, talk to your doctor. They will want to make sure it isn’t related to another health condition.

Your doctor will do a physical exam and ask you questions about your symptoms. They may do a blood or urine test. Your doctor may consider other tests to rule out other conditions.

Can erectile dysfunction be prevented or avoided?

This depends on whether you know what it is causing your ED. There are some things you can do that may help prevent ED, including:

• Avoid drinking too much alcohol, smoking, or abusing drugs.
• Ask your doctor if ED is a side effect of a new or current medicine you are taking. He or she may have an alternative medicine.
• Control your blood sugar and blood pressure.
• Try to relax and avoid stress.

Erectile dysfunction treatment

Treatment depends on what is causing it. If it is caused by uncontrolled blood sugar and high blood pressure, take your medicine and follow your doctor’s instructions.

If your doctor rules out other causes, he or she may prescribe Sildenafil (brand name: Viagra), tadalafil (brand name Cialis), and vardenafil (brand name Levitra). These medicines are taken by mouth to help you maintain an erection.

Not everyone can use these medicines. Your doctor may talk to you about alprostadil if oral medicines aren’t an option for you. Alprostadil is a synthetic version of prostaglandin E. It can be injected into the penis or inserted as a tiny suppository into the urethra (the hole at the end of the penis). Your doctor will help you decide which treatment is best for you.

Follow your doctor’s instructions when taking ED medicine. Usually, a man takes 1 tablet 30 minutes to 1 hour before he plans to have sex. Sildenafil works for 4-8 hours; vardenafil works for up to 8 hours; and tadalafil works for up to 36 hours.

You should not take more than 1 dose in 24 hours. Tadalafil and vardenafil come in tablets of 2.5 mg, 5 mg, 10 mg and 20 mg. Sildenafil comes in tablets of 25 mg, 50 mg and 100 mg.

Even if you take the medicine, you still need physical and mental stimulation and desire to have an erection. If your first dose doesn’t help, call your doctor. Your doctor may want to change your tablet strength.

The side effects of ED medicine are mostly the same. Sildenafil and vardenafil can cause:

• Headache
• Flushing (face and upper body turning red and warm)
• Upset stomach
• Runny nose
• Vision changes (things look blue)

Tadalafil has the same side effects, except for the flushing and possible changes in vision. It can also cause back pain and muscle aches. For each of the medicines, headache is the most common side effect. Vision changes are the least common. Talk to your doctor if you have any side effect that bothers you.

Call your doctor right away if you take one of these medications and have a prolonged erection that lasts 4 hours or longer. This condition may cause permanent impotence if not treated.

Can everyone use ED medications?

You shouldn’t use these medicines if you take nitroglycerin or any other nitrates for chest pain. If you have heart problems, tell your doctor before taking any ED medicines. These medicines can have serious side effects in people who have heart problems.

If you use sildenafil, tadalafil, or vardenafil and get chest pains, be sure to tell the paramedics, nurses or doctors at the hospital that you use it and when you used it last.

Living with erectile dysfunction

If the medicines aren’t right for you, you could try using a penile implant, vacuum pump devices, or have surgery. Your doctor may send you to a urologist to talk about these options.

Questions to ask your doctor

• How long will I have to take medicine for erectile dysfunction?
• What is the difference between tadalafil (Cialis), vardenafil (Levitra), and sildenafil (Viagra)?
• Are there any lifestyle changes I should make?
• How can I talk with my partner about my problem?
• Is there something I can do other than take medicine to help?
• What other medicines cause this problem?

Resources

National Institutes of Health, MedlinePlus: Erectile Dysfunction

Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Signs of impotence in men – prices for treatment in Moscow “Medline-Service”

Every man should know how impotence manifests itself in order to identify the problem in time and start treatment. The disease develops gradually and in the initial stages may not cause concern to the patient. But over time, the characteristic symptoms of impotence in men become more pronounced, bring a lot of discomfort, negatively affecting sexual life. It is important to remember that in the initial stages, impotence is successfully and quickly treated conservatively, and the risk of complications is minimal.

Treatment of impotence at the first sign

The first signs of impotence in men often appear at an older age, but modern young people have become more likely to encounter the disease, as they do not take care of their health, abuse bad habits, lead an inactive lifestyle, and do not have full-fledged sexual relationships. All these factors negatively affect erectile function, causing its decline.

The initial stage of impotence, the symptoms of which are not very pronounced, is primarily manifested by the lack of erection with full excitement. Other signs that should make a man alert and make an appointment with a doctor:

• weak erection not enough for sex;
• loss of erection during intercourse;
• premature ejaculation;
• absence or prolongation of sexual arousal;
• loss of nocturnal erection.

Over time, the symptoms of the pathology will worsen. Consequences of impotence: infertility, stress, anxiety, low self-esteem, problems in family relationships. To avoid complications, at the first symptoms of erectile dysfunction, you need to make an appointment with a urologist.

Treatment depends on the cause of the disease, the age of the man, the condition of other organs. If the nature of impotence is organic, conservative or surgical treatment is prescribed. The scheme of drug therapy includes drugs that contribute to short-term stimulation of erection, as well as systemic agents. Possible destination options:

• testosterone hormone replacement therapy;
• selective PDE5 inhibitors;
• agents that affect cavernous tissue and have a vasodilating effect;
• the use of drugs of plant and animal origin, eliminating erectile dysfunction.

If conservative methods of impotence correction do not bring the desired result, the doctor suggests the patient to resort to surgical techniques. Common operating procedures:

• use of vacuum devices to increase circulation;
• implantation of a plastic or hydraulic prosthesis into the penis;
• vascular bypass.

Benefits

• Experts
• State of the art equipment
• Comprehensive services

Cost of impotence treatment

The cost of impotence treatment is calculated individually, taking into account the etiology of the disease, the nature of its course, and the presence of complications. To get a detailed consultation and find out the current prices for services at the Medline-Service clinic, call the phone number +7 (495) 125-23-71 or fill out the feedback form.

Impotence in men – treatment at the Research Institute of Urology and Interventional Radiology named after. ON THE. Lopatkina, causes and signs of impotence

Table of contents

Impotence is a complete lack of erection, which is characterized by insufficient rigidity, volume and straightness of the penis, necessary for a full sexual intercourse. Sometimes impotence is called erectile dysfunction, although this is not entirely accurate – according to the latest ICD-10 data, impotence is of exclusively organic origin, while erectile dysfunction can also occur in a man against the background of psychosomatic problems.

Impotence is characterized by the fact that a man’s desire, sexual desire is preserved, but there are no opportunities to have sexual intercourse.

Causes of development of impotence in men

Impotence can develop in a man at a young age, and in the elderly – there are reasons for this:

• disorders in the work of the central nervous system;
• previous infections of the genitourinary system in severe form;
• certain diseases of the vascular system;
• incorrect functionality of the hormonal system;
• frequent, persistent stressful situations;
• genetic disorders;
• inflammatory diseases of the reproductive system (prostatitis).

Most often, impotence develops in men aged 50 and older, but it can also begin at a young age. In the latter case, often the causes of impotence are congenital pathologies such as Down’s syndrome, insufficient brain activity. Impotence can appear on the background of diabetes, after injuries of the pelvic organs.

Separately, doctors identify provoking factors – impotence may not develop against their background, but there is a high risk. These include:

• the presence of bad habits – the use of alcohol, drugs: impotence may be early;
• obesity, if it is at stages 2-3 of development: impotence begins due to metabolic disorders;
• excessive exercise;
• use of steroids, anabolics without control.

Men have an opinion that impotence will certainly begin after 50 years, but this is absolutely not true! Sexual activity can last much longer if a man has a clear daily routine, no bad habits.

Symptoms and signs of impotence in men

In most cases, impotence in men begins gradually, so it is worth paying attention to certain symptoms and signs that are the reason for a visit to the doctor. The first signs are:

• ejaculation (ejaculation) occurs much earlier than before – this may be a sign of an inflammatory disease, hormonal problems, which are the causes;
• insufficient hardness of the penis – the man is unable to initiate or complete sexual intercourse;
• loss of erection (complete or partial) directly during sex and while maintaining arousal;
• seminal fluid is excreted in much smaller volumes than before;
• difficulty in getting an erection on the background of strong arousal and in habitual conditions;
• no involuntary morning erection.

Impotence also has non-specific first signs – for example, discomfort or pain in the perineum during intercourse. This may be a sign of genital infections and inflammatory processes, which are considered the immediate causes of impotence.

The listed first signs should alert men at a young age – early impotence in them is almost always associated with venereal diseases. Treatment of the latter restores and erection.

If two or more of the symptoms listed above appear, a man should immediately contact a urologist. The doctor will diagnose and prescribe treatment, which will help to avoid the development of irreversible processes – impotence is perfectly treated.

Treatment of impotence in men

Treatment of impotence is a complex approach, both medication prescriptions and psychotherapy sessions are necessarily used as part of therapy. The first signs, even specific ones, do not necessarily indicate that impotence has already begun. An accurate diagnosis can only be made by a doctor, and for this diagnostic measures will be taken:

• tests for the presence of sexually transmitted diseases – impotence may develop against the background of indolent chronic infections;
• ultrasound examination of the prostate, testicles – impotence occurs due to inflammatory diseases and the growth of neoplasms;
• blood and urine tests for hormonal status – such disorders are often the cause of early impotence.

Since psycho-emotional problems may be the cause, it may be necessary to consult a psychotherapist – impotence often appears against the background of stress, troubles at work, in the family.

Before a visit to a doctor, a man should make a list of all changes in his sexual health – when erection problems began, whether there are any during each sexual intercourse, what exactly happens, and so on. Based on these data and the results of the diagnosis, the doctor will prescribe treatment.

Impotence is treated conservatively or by surgery. If conservative treatment is chosen, doctors use:

• tablets/capsules and injections;
• prostate massage;
• topical ointments and gels;
• physiotherapy exercises;
• acupuncture;
• spa treatment.

Depending on the causes of impotence, a man may be prescribed antibacterial and antiviral drugs, vasodilators and antispasmodics, non-steroidal anti-inflammatory drugs. In men, impotence in almost every case is accompanied by a decrease in general immunity, so you will need to take a course of vitamin therapy, taking immunomodulators.

Conservative treatment involves a psychologist working with the patient. A specialist will be able to stabilize the emotional state of a man, because he will need to convince him of his own viability. Sometimes only psychotherapy does not help, and then the treatment is supplemented with sedatives, “light” sleeping pills.

Surgical treatment is operations on the vessels of the penis, if impotence has developed due to vascular diseases, and phalloplasty. The latter is often used if early impotence has developed against the backdrop of a spinal injury.

Impotence in men is treated by a urologist, home / folk remedies will not solve the problem. The use of dietary supplements and stimulants will only give a short-term effect, because they work on the principle of Viagra – they provide a strong blood flow to the penis.