Will I Ever Have Sensitivity and Erections Again in My Penis

Overview

Dr. Drogo Montague discusses handling options for erectile dysfunction.

What is erectile dysfunction (ED)?

Erectile dysfunction (ED) is the inability to get and keep an erection firm enough for sexual intercourse. Estimates propose that ane of every 10 men will endure from ED at some point during his lifetime. It is important to understand that in most cases, ED is a symptom of another, underlying problem. ED is not considered normal at any historic period, and may exist associated with other problems that interfere with sexual intercourse, such equally lack of desire and bug with orgasm and ejaculation.

How common is erectile dysfunction?

Approximately i in 10 adult males will suffer from ED on a long-term basis.

Many men do experience occasional failure to achieve erection, which can occur for a diversity of reasons, such equally drinking likewise much booze, stress, relationship problems, or from beingness extremely tired.

The failure to get an erection less than twenty% of the time is not unusual and typically does non require treatment. However, the failure to achieve an erection more than 50% of the time generally ways that there is a problem and treatment is needed.

ED does non have to be a part of getting older. While it is true that some older men may need more than stimulation, they should notwithstanding be able to attain an erection and relish intercourse.

Symptoms and Causes

What causes erectile dysfunction (ED)?

ED tin be acquired past a number of factors, including:

• Vascular disease: Blood supply to the penis can become blocked or narrowed as a consequence of vascular disease such as atherosclerosis (hardening of the arteries).
• Neurological disorders (such equally multiple sclerosis): Nerves that send impulses to the penis can become damaged from stroke, diabetes, or other causes.
• Psychological states: These include stress, depression, lack of stimulus from the brain and performance anxiety.
• Trauma: An injury could contribute to symptoms of ED.

Chronic affliction, certain medications, and a condition called Peyronie'due south affliction can also crusade ED. Operations for the prostate, float, and colon cancer may also be contributing factors.

What medications could cause erectile dysfunction (ED)?

Erectile dysfunction (ED) is a common side effect of a number of prescription drugs. While these medications may treat a disease or condition, in doing so they can affect a human being's hormones, nerves or blood circulation, resulting in ED or increasing the risk of ED.

If you feel ED and think that it may exist a outcome of the medication you are using, do not end taking the medication. If the problem persists, contact your doc and he or she may exist able to prescribe a different medication. Mutual medications that may list ED as a potential side issue include:

• Diuretics (pills that crusade increase urine flow).
• Antihypertensives (loftier blood pressure drugs).
• Antihistamines.
• Antidepressants.
• Parkinson's disease drugs.
• Antiarrhythmics (drug for irregular heart activeness).
• Tranquilizers.
• Muscle relaxants.
• Nonsteroidal anti-inflammatory drugs.
• Histamine H2-receptor antagonists.
• Hormones.
• Chemotherapy medications.
• Prostate cancer drugs.
• Anti-seizure medications.

Other substances or drugs that tin cause or atomic number 82 to ED include these recreational and frequently abused drugs:

• Alcohol.
• Amphetamines.
• Barbiturates.
• Cocaine.
• Marijuana.
• Methadone.
• Nicotine.
• Opiates.

These drugs not only affect and oft suppress the central nervous organisation, but tin also cause serious harm to the blood vessels, leading to permanent ED.

What prescription drugs may cause erectile dysfunction?

Erectile dysfunction (ED) is a common side effect of a number of prescription drugs. While these medications may treat a disease or status, in doing so they tin can impact a human being's hormones, nerves or blood circulation. The issue may be ED or an increment in the risk of ED.

If you have ED and think that information technology may exist a result of the medication you are using, practice not finish taking the medication. If the problem persists, contact your md and he or she may be able to prescribe a different medication. Mutual medications that may list ED every bit a potential side issue include:

• Diuretics (pills that cause an increase in urine period).
• Antihypertensives (medication for loftier blood pressure).
• Antihistamines.
• Antidepressants.
• Parkinson'due south disease drugs.
• Antiarrhythmics (medication for irregular heart action).
• Tranquilizers.
• Muscle relaxants.
• Non-steroidal anti-inflammatory drugs.
• Histamine H2-receptor antagonists.
• Hormones.
• Chemotherapy medications.
• Prostate cancer drugs.
• Anti-seizure medications.

What other substances or drugs may cause erectile dysfunction?

Other substances or drugs that tin can cause or lead to ED include these recreational and often abused drugs:

• Alcohol.
• Amphetamines.
• Barbiturates.
• Cocaine.
• Marijuana.
• Methadone.
• Nicotine.
• Opiates.

Aside from the well-known complications that the use and abuse of these drugs can cause, ED is not often mentioned. However, use of these drugs is a risk cistron for ED. These drugs not just bear upon and often times slow down the central nervous system, just can besides cause serious damage to the claret vessels, leading to permanent ED.

How are low and erectile dysfunction related?

For some men, low can accompany the condition of erectile dysfunction (ED). It is mutual for men with ED to experience angry, frustrated, pitiful, unsure of themselves, or even less "manly." Such feelings may lead to a lack of cocky-esteem and, in astringent cases, to depression.

Depression that accompanies ED is treatable. The commencement step in addressing your concerns about ED-related depression is to be honest with yourself, your partner, and your md. After depression has been brought out into the open, coping with it will be easier and less stressful.

Diagnosis and Tests

How is erectile dysfunction (ED) diagnosed?

Considering there are a diverseness of causes for ED, at that place are several dissimilar tests your doctor may utilize to diagnose the condition and determine its cause. Only afterwards the cause of ED is determined can it exist finer treated.

Before ordering any tests, your doctor will review your medical history and perform a thorough physical test. The doctor will also "interview" you most your personal and sexual history. Some of these questions will exist very personal and may experience intrusive. Still, it is important that you respond these questions honestly. The questions asked may include:

• What medications or drugs are you currently using? This includes prescription drugs, over-the-counter drugs, herbals, dietary supplements and illegal drugs.
• Take y'all had any psychological problems such equally stress, anxiety and low?
• When did you first notice symptoms of ED?
• What are the frequency, quality and elapsing of whatsoever erections you take had?
• What are the specifics of the circumstances under which ED first occurred?
• Practice/did y'all experience erections at night or during the forenoon?
• What sexual techniques do you use?
• Are there problems in your electric current relationship?

The doctor may besides wish to interview your sexual partner since your partner may be able to offer in sight virtually the underlying causes.

After your physical examination and discussion, your medico may then lodge any 1 of the following tests to further diagnose your condition:

• Complete blood count (CBC): This is a set of blood tests that, among other things, tin can discover the presence of anemia. Anemia is acquired by a depression red blood jail cell count and can cause fatigue, which in plow tin can cause ED.
• Liver and kidney function tests: These blood tests may indicate whether ED may be due to your kidneys or liver functioning improperly.
• Lipid contour: This blood test measures the level of lipids (fats), like cholesterol. High levels may indicate atherosclerosis (hardening of the arteries), which can impact claret circulation in the penis.
• Thyroid function exam: 1 of the thyroid hormones' functions is to regulate the production of sex hormones, and a deficiency in these hormones may contribute to or cause ED.
• Claret hormone studies: Testosterone and/or prolactin levels in the claret may exist measured to see if abnormalities in either of these sex hormones are present.
• Urinalysis: Analysis of urine can provide a wealth of information, including information on protein, sugar and testosterone levels. Abnormal measurements of these substances can indicate diabetes, kidney disease or a testosterone deficiency, all which tin can cause ED.
• Duplex ultrasound: This is perhaps the best test for evaluating ED. An ultrasound uses high-frequency sound waves to take "pictures" of the body's tissues. For people with ED, an ultrasound may be used to evaluate blood menstruum and check for signs of a venous leak, atherosclerosis (hardening of arteries) or tissue scarring. This test is performed both while the penis is erect (normally induced by an injection of a drug that stimulates erection) and also while it is soft.
• Bulbocavernosus reflex: This exam evaluates nerve sensation in the penis. During the test, your md will squeeze the head of your penis, which should immediately crusade your anus to contract. If nerve function is abnormal, there will be a delay in response fourth dimension.
• Nocturnal penile tumescence (NPT): This examination measures a human being'due south erectile office while he is sleeping. Normally, a human being will have v or half-dozen erections while asleep. A lack of these erections may indicate there is a problem with nerve part or circulation to the penis. The exam uses two methods, the snap estimate method and the strain guess method. The snap gauge method is performed by wrapping iii plastic bands of varying forcefulness around the penis. Erectile function is and so measured based on which of the 3 bands breaks. The strain estimate method works by placing rubberband bands effectually the tip and base of operations of the penis. If the penis becomes erect during the night, the bands stretch, measuring the changes in penile circumference.
• Penile biothesiometry: This test involves the apply of electromagnetic vibration to decide sensitivity and nerve role. A decreased sensitivity to these vibrations may indicate nerve damage.
• Vasoactive injection: During this examination, an erection is produced by injecting special solutions that cause the blood vessels to dilate (enlarge) allowing blood to enter the penis.
• Dynamic infusion cavernosometry: This examination is used for men with ED who have a venous leak. During this test, fluid is pumped into the penis at a predetermined rate. By measuring the rate at which fluid must be pumped to attain a rigid erection, doctors tin make up one's mind the severity of the venous leak.
• Cavernosography: Used in conjunction with the dynamic infusion cavernosometry, this exam involves injecting a dye into the penis. The penis is then 10-rayed so that the venous leak can exist seen.
• Arteriography: This exam is given to people who are candidates for vascular reconstructive surgery. A dye is injected into the artery believed to exist damaged and X-rays will exist taken.

Earlier you are given any of these tests, your doctor will explain what is involved. If you accept any questions, do not hesitate to ask your doctor.

Direction and Treatment

What doctors treat erectile dysfunction?

The type of medical specialist who treats ED will depend on the cause of the trouble. Based on your family'due south medical history, as well as your own medical history and current health, your doctor may treat you with oral medications (Viagra®, Levitra®, Cialis®).

If these options neglect, you may be referred to a urologist who can assist with other non-surgical options such every bit vacuum device or injections or surgical treatment options. If needed, your dr. may as well refer you to a psychologist specializing in sexual dysfunction.

How is erectile dysfunction treated?

ED can be treated in many ways, including:

• Oral medications.
• Sex therapy.
• Penile injections.
• Vacuum devices.
• Intraurethral medication.
• Surgery (penile implant).

Each type has its own pros and cons. Discuss your options with your medico to make up one's mind the best treatment for you lot.

The first stride to treating ED is to find the underlying cause. And then the appropriate treatment can begin. There are a number of non-surgical and surgical options that can help a homo regain normal sexual function.

What not-surgical treatments are there for erectile dysfunction (ED)?

Teaching and communication

Didactics about sex activity, sexual behaviors, and sexual responses may aid a human overcome his anxieties about sexual dysfunction.

Talking honestly with your partner well-nigh your needs and concerns may also help to overcome many barriers to a healthy sex life.

Medication

Medications such as sildenafil (Viagra®), vardenafil (Levitra®), or tadalafil (Cialis®) may help improve sexual function in men by increasing blood menstruation to the penis. Men who are on medicines that contain nitrates such as nitroglycerine should not take oral ED medications. The combination of nitrates and these specific medications tin can cause low claret pressure (hypotension).

The well-nigh common side effects of these medications are indigestion, nasal congestion, flushing, headaches and a temporary visual disturbance.

Mechanical aids

Aids such as vacuum devices and penile constriction rings serve equally erectile aids for some men.

A vacuum constriction device (above) is a cylinder that is placed over the penis. The air is pumped out of the cylinder, which draws claret into the penis and causes an erection. The erection is maintained past slipping a ring off of the base of operations of the cylinder and onto the base of the penis. The band can stay in place for up to xxx minutes. The vacuum device can exist safely used to care for most causes of erectile failure. Lack of spontaneity, discomfort, and cumbersomeness of the device seem to exist the biggest concerns of patients.

Penile injection therapy (intracavernosal injection therapy)

Men are taught how to inject medications directly into the erection chambers of the penis to create an erection. Injection therapy is constructive in treating a wide variety of erection issues caused by blood vessel, nerve and psychological conditions.

Using a tiny needle and syringe, the homo injects a pocket-sized amount of medicine into the side of his penis. The medicine relaxes the blood vessels, allowing blood to catamenia into the penis. This treatment has been widely used and accustomed since the early on 1980s. The three nearly common medicines are prostaglandin E1 (alprostadil), papaverine (Papacon®), and phentolamine (Regitine®).

The most common side effects are pain and penile scarring (fibrosis). In extremely rare cases, patients with cognitive and vascular disease or astringent cardiovascular diseases might not exist able to tolerate the dizziness and high blood pressure occasionally caused by injection therapy.

A painful erection that lasts longer than two to iii hours is called priapism and may occur with injection therapy. This can be lessened with proper dosing and by post-obit the treatment guidelines.

Psychology and sex activity therapies

Psychological causes may contribute to erectile failure fifty-fifty when there is a clear organic cause.

Therapy with a trained counselor tin can help a person address feelings of anxiety, fear or guilt that may have an impact on sexual dysfunction.

Sex therapy tin be beneficial to most men when counseling is provided by a skilled sex therapist. Sex activity therapy also helps a human being'due south partner accept and cope with the problems.

A patient whose ED has a clear psychological cause should receive sex therapy counseling before any invasive treatments are pursued.

Hormone

Low hormone levels may play a function in ED. Hormone replacement in the form of topical gels, creams, patches, injections and pellets are only used after physician evaluation.

What are surgical treatment options for erectile dysfunction (ED)?

Penile prosthesis surgery

Inflatable penile prostheses are implanted during outpatient surgery. One time they are office of a man's trunk, they enable him to take an erection whenever he desires. The use of a prosthesis preserves penile sensation, orgasm and ejaculation for nigh men.

The most commonly used penile implant consists of a pair of inflatable cylinders that are surgically implanted in the erection chambers of the penis. The cylinders are connected through tubing to a reservoir of fluid under the lower abdominal muscles, and to a pump inside the scrotal sac.

To inflate the penile prosthesis, the man compresses the pump a number of times to transfer fluid from the reservoir to the cylinders. This causes the penis to go erect. When inflated, the prosthesis makes the penis potent and thick, which is very similar to a natural erection.

A penile prosthesis does not change the sensation on the skin of the penis or a human being'southward ability to achieve orgasm or ejaculate. Pressing on a deflation valve attached to the pump returns the fluid to the reservoir, which returns the penis to a flaccid state.

The surgical procedure is performed through 1 or ii minor incisions that are generally well hidden. Other people will be unable to tell that a man has an inflatable penile prosthesis. Complications post-obit surgery are not common, but primarily include infection and mechanical device failure.

Approximately 95% of penile implant surgeries are successful in producing erections that enable men to have sexual intercourse. Moreover, patient satisfaction questionnaires show that up to 90% of men who have undergone penile implants say they would choose the surgery once more, and overall satisfaction ratings are higher than those reported by men using oral medication or penile injection therapy.

Prevention

Tin can erectile dysfunction (ED) be prevented?

For people who are at take a chance of developing ED due to personal behavior, steps may exist taken to endeavor to forestall its occurrence. However, other causes may non be preventable.

A number of studies now suggest a link between ED and obesity, high cholesterol, hypertension, diabetes and center illness.

The following recommendations may help forbid ED or improve the problem if it is already present:

• Swallow a good for you nutrition. A diet that limits saturated fat intake and includes several portions of fruits, vegetables and whole grains can do good men with ED.
• Reduce cholesterol. High cholesterol tin harden, narrow or block the arteries (atherosclerosis) leading to the penis. Men can lower cholesterol through nutrition, exercise and medication.
• Maintain a healthy weight.
• Exercise regularly. Regular exercise may reduce the risk of ED. Choose exercises that you relish and will make a regular part of your day. In addition to reducing the adventure of ED, practise also can help you manage stress. Check with your medico before starting any practice program.

Living With

What should I do if I am having problems achieving/keeping an erection?

If you lot doubtable you have erectile dysfunction, please see your master care medico or a urologist. He or she can perform tests to observe out what is causing your problem and refer you to a specialist if needed. One time the cause is identified, there are several treatment options to cull from.

Does insurance cover erectile dysfunction (ED) treatment?

Insurance coverage for ED depends on the type of handling prescribed and whether your insurance covers sexual dysfunction at all. Speak with your insurance provider to determine if the option y'all are considering will be covered.

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Source: https://my.clevelandclinic.org/health/diseases/10035-erectile-dysfunction