What is it?
Erectile Dysfunction, also called impotence, is a medical condition found in male patients where they either cannot get or keep an erection firm enough for sex.
If the patient has erectile dysfunction from time to time, it is not a cause for concern. However, if this condition lasts for a long time then it can cause stress, affect their self-confidence and also might cause problems in their relationship.
It advisable for patients suffering from erection problems to consult a doctor as in some cases, it can be cured if an underlying problem is treated.

When to see a doctor?

It is recommended that the patient consult the doctor if any of the following symptoms are present:

• Cannot get an erection
• Cannot keep an erection
• Diminished sexual desire
• Concerns about other sexual problems
• Premature or delayed ejaculation

The doctor would need to know if the patient has any health conditions like diabetes, heart disease or any other health conditions that can be linked to erectile dysfunction.

Diagnosis
The doctor usually performs the following tests to confirm the diagnosis of erectile dysfunction:

• Physical Examination: involves the examination of the penis and testicles carefully and check the nerves for sensation.
• Blood Tests: involves testing the patient’s blood for heart disease, diabetes, low testosterone level, and other medical conditions.
• Urine Tests: will be done to look for signs of diabetes and other underlying medical conditions.
• Ultrasound: is usually done in combination with an injection of medications into the penis to stimulate the blood flow and cause an erection.
• Psychological Examination: might be done to rule out depression or any other psychological problems that can cause erectile dysfunction.

Treatment
The doctor might opt for the right treatment options depending on the cause and severity of the erectile dysfunction. Some of the treatment options are:

• Medications: include the following types:
  
  • Oral Medications: like viagra etc., will help enhance the effects of nitric oxide produced by the body to relax the muscles of the penis, allowing for an increase in blood flow helping for an erection when stimulated sexually.
  • Alprostadil Self-Injection: is done directly into either the base or side of the penis to create an erection that can last nearly an hour.
  • Alprostadil Urethral Suppository: involves in placing this suppository inside the penis in the penile urethra allowing for an erection that will start in 10 minutes and lasting from 30-60 minutes.
  • Testosterone Replacement: might be recommended in combination with other therapies for patients with low levels of testosterone.
• Penis Pumps, Surgery, and Implants: are usually recommended when medications are not effective.
  
  • Penis Pump: consists of a hollow tube with a pump, either hand-powered or battery-operated, which are placed over a penis and the pump is used to suck out the air inside the pump. This leads to a vacuum that will help pull blood into the penis.
  • Penile Implants: involves in surgically placing implants, consisting of either inflatable or bendable rods, on both sides of the penis. These devices will help in controlling the time and length of the erection.

Authored by Dr. Anitha Mani - Infertility Specialist & Laparoscopy Surgeon