ED, which stands for erectile dysfunction (impotence) is a condition in which men cannot acquire or maintain an erection.
Treatment for erectile dysfunction is aimed at enabling a man to achieve and maintain an erection for sexual intercourse.
One treatment for ED is a vacuum pump. ED pumps, also called penis pumps, are vacuum-assisted erection devices that involve placing the penis in a plastic cylinder and creating a vacuum around the penis to increase blood flow into the penis. A rigid tension ring is placed at the base of the penis to hold the blood inside the penis, keeping it erect.
ED pumps generally do work to help a man get and maintain an erection long enough for sexual intercourse. The constriction ring is removed after sex.
ED pumps do not work to help enlarge the penis.
Benefits of using ED pumps to get an erection include:
- Lower risk of side effects compared to medications
- Cheaper than medications and surgery
- Can be re-used repeatedly
- Is non-invasive
- May be used with ED meds to help get a harder erection
Side effects from use of a pump are minimal, usually related to the application of the constriction band, and may include:
- Skin breakdown
- Penile pain
In addition to an ED pump, erectile dysfunction may be treated with lifestyle modifications, medications, medical procedures, and counseling.
Lifestyle modifications to treat erectile dysfunction may include:
- Don’t smoke
- Limit or avoid alcohol
- Weight loss in men who are obese
- Exercise regularly
- Eat a healthy, balanced diet
- Talk to your doctor about using different medications to treat hypertension and pain. Do not stop taking any prescribed medication without first talking to your doctor.
- Pelvic floor exercises
Medications used to treat erectile dysfunction may include:
- Phosphodiesterase-5 inhibitors
- Avanafil (Stendra)
- Sildenafil (Viagra)
- Tadalafil (Cialis)
- Vardenafil (Levitra)
- Testosterone replacement therapy
- Used when man's testes do not make enough of the hormone testosterone
- Does not work to improve sexual function in men who produce normal amounts of testosterone
- May be used alone or with a phosphodiesterase-5 inhibitor
- Medications for depression and/or anxiety
Medical treatments used to treat erectile dysfunction may include:
- Penile self-injection in which a man injects a medication (alprostadil or papaverine) into the two chambers of the penis that are filled with spongy tissue and blood (corpora cavernosa) to cause an erection by allowing the blood vessels within the penis to expand so the penis swells and stiffens to create a fully rigid erection
- Intraurethral alprostadil (MUSE) uses the same medication (alprostadil) as penile self-injection but instead a man inserts a device with an alprostadil pellet (suppository) into the urethra to create an erection
- Penile prostheses are surgically implanted devices that inflate to allow the penis to become erect
- Revascularization is a surgical procedure used for young men who have experienced pelvic trauma
Because depression and anxiety can cause erectile dysfunction, psychotherapy and psychoactive medications may be recommended. Counseling with a sex therapist may be helpful for men with performance anxiety.
What Causes Erectile Dysfunction?
Causes of erectile dysfunction include:
- Limited blood flow to the penis
- Cigarette smoking
- High blood pressure (hypertension)
- Prescription medications, such as antihypertensive medications
- Neurological causes
- Multiple sclerosis
- Pelvic trauma
- Previous episodes of prolonged erection (priapism)
- Prostate surgery that damage nerves to the penis
- Spinal cord or back injury
- Drugs that affect the nervous system or that lower testosterone levels or inhibit testosterone action
- Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs)
- Blood pressure medications, such as beta-blockers
- Recreational drugs, such as cocaine and heroin
- Sympathetic blockers such as clonidine, guanethidine, or methyldopa
- Thiazide diuretics
- Psychological causes
- Depression, which may include loss of sex drive
- Lack of focus
- Performance anxiety
- Other risk factors
- Autonomic dysfunction
- Chronic kidney disease
- Endocrine disorders
- Peripheral neuropathy
- Peripheral vascular disease
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