Erectile Dysfunction (ED)

Dr. Virendra is a senior consultant urologist, andrologist, and transplant surgeon at Chandigarh healthcare, sector 16, Mohali and Apollo hospital sector 8C, Chandigarh. In this video, he will talk about Erectile Dysfunction. Erectile dysfunction is a very common problem. Statistically speaking, ⅓ of the male population suffers from erectile dysfunction below the age of 30 years. 

What is erectile dysfunction?

Inability to achieve or maintain an erection during sexual intercourse is known as erectile dysfunction. When the blood from the body rushes to the penis, it causes strain. This stain is enough for the male to perform sexual intercourse. But due to some unknown reason, this hardening of the penis is not developed, or it does not last long during intercourse. So this is what we call erectile dysfunction. 

What causes erectile dysfunction? 

To understand erectile dysfunction, we should first understand the process; whenever the male has arousal, the blood flows to the penis increases. This increased blood flow causes the penis to harden. And this produced helps in intercourse. But sometimes there is not adequate blood flow, or the blood comes, and without entering inside, it flows back, or sometimes it’s not enough. One other cause can be the nerves, which can cause erectile dysfunction. 

Types of erectile dysfunction 

• Organic: when it has a cause. 
• Psychogenic: which does not have a reason. 

30% of the cases of erectile dysfunction are organic, and the other 70% are psychogenic. 

What are the organic causes? 

Diabetes, blood pressure, heart diseases, spinal injury, drugs (antidepressants, antipsychotic drugs), overuse of recreational drugs are all the causes of organic erectile dysfunction. 

What is psychogenic erectile dysfunction? 

In psychogenic erectile dysfunction, there is no physical cause found for this problem. However, any sexual trauma or sexual fear or anxiety can cause failure to perform sexual acts. This is not caused because the partners are stressed or busy. But it happens because of any sex-related trauma or anxiety. 

How can you differentiate between organic and psychogenic ED?

An average male gets an erection in the morning. This morning’s erection is a sign that the blood flow and the physiological process of the erection are working well. This rules out the possibility of organic ED. So, what one may be experiencing would be psychogenic ED. This is a very simple way of differentiating between organic and psychogenic ED. The morning erection is the perfect way to know that your erection system is working well. 

Treatment

After you’ve realized that you have erectile dysfunction, it should be treated accordingly. But, unfortunately, sex and sex-related problems are considered to be taboo in India. And we do not openly discuss such issues. As a result, many people tend to avoid going to doctors and go to an hakim or vaidya instead. And the problem is not treated, but rather, it reaches the last stage without proper medical care. So erectile dysfunction should always be professionally treated by a qualified person. 

A person can consult a urologist or an andrologist, a psychologist, or a psychiatrist, as these professionals might adequately help the patient. CBC, Liver function test, lipid profile, testosterone, or PSA are the tests that a male should get done to diagnose ED. 

If the cause is not organic or psychogenic, the doctor does a Penile Doppler test for diagnosis. First, the doctor gives the patient a pill of viagra to examine the erection. Or the penis is injected, and then the doppler, the direction of the flow of blood, whether the blood is coming in from the arteries, the nerves, etc., are studied. This can help us find out if arterial insufficiency or venous incompetence is causing erectile dysfunction. 

So this is how the condition is first diagnosed and then treated accordingly. 

Lifestyle changes

The first step of treatment is switching to a healthier lifestyle. One should lower the alcohol intake, quit smoking, and stop doing recreational drugs. One should start eating healthy. If the person has a fit body, then automatically, the person has a good sex life. 

Things to be avoided: 

1. Alcohol 
2. Smoking 
3. Drugs
4. Bodyweight

Exercise daily can improve your lifestyle as well as your sexual health as well. 

Medication 

The second part of the treatment is medication. In medication, we recommend phosphodiesterase  like viagra. If the person achieves an erection with these medications, then the doctors continue the treatment with them. When needed, this can be given in a full dose or a low dose for a longer period to improve the patient’s psychogenic health. When he thinks he’s over the problem, then the drugs can be discontinued. 

Injections 

If the medications are not working and the Penile doppler test results are normal, the patient is given injection therapy. As the diabetes patients have to take insulin shots, similarly the ED patient takes an injection to perform a sexual act. The effect of these injections lasts for about 20-3- minutes. 

Lithotripsy

The other treatment is Lithotripsy, which is used to break stones. Lithotripsy with a low frequency is given to the penile region. This helps new blood vessels to grow and increases the chances of an erection by 60-70%. 

Vacuum devices 

There are vacuum devices available. If there is a problem with glands, these devices are used to create a vacuum and get an erection. 

Penile implant 

If all the methods mentioned above fail, then the last option is a penile implant. This treatment involves surgically placing devices into both sides of the penis. And this may help achieve an erection. 

There are two types of penile implants, semi-rigid, and inflatable. Semirigid is permanently erect. Whereas in an inflatable implant, there is a pipe inserted in the muscle of the penis, and the button is placed below the testicles. And there is a reservoir. When the patient presses the button, the liquid flows through the pipes, and an erection is achieved. The exact process is used to deflate it as well. 

So these were the various treatments for erectile dysfunction. 

Bottom line

When you have erectile dysfunction, the best way is to alter your lifestyle. Opt for a healthier lifestyle, stop smoking, consume alcohol or any recreational drugs, and eat healthily. Also, always consult a qualified medical professional regarding this problem. Lastly, eat healthily and stay fit as your health affects your sexual health.