29. Andersson DP, Landucci L, Lagerros YT, et al. Association of phosphodiesterase-5 inhibitors versus alprostadil with survival in men with coronary artery disease. J Am Coll Cardiol. 2021;77(12):1535-1550.
Inman BA, Sauver JL, Jacobson DJ, et al. A population-based, longitudinal study of erectile dysfunction and future coronary artery disease. Mayo Clin Proc 2009; 84: 108–13.
These causes of ED can be categorized into two types: psychogenic (mental) and organic (physical). Psychogenic causes include depression, low self-esteem, anxiety, and negative feelings about sex.Organic causes account for about 80 percent of ED cases and can be further classified as endocrine or non-endocrine. Endocrine-related causes are often connected to low testosterone levels, though more research is required to fully understand how the two intersect. Of the non-endocrine related causes of ED, vasculogenic causes, which affect blood supply and flow, are the most common. How to Get Diagnosed With Erectile Dysfunction
Poor sleep patterns can be a contributing factor for erectile dysfunction, Mucher says. One review published in the journal Brain Research emphasized the intricate relationship between the level of sex hormones like testosterone, sexual function, and sleep, noting that testosterone levels increase with improved sleep, and lower levels are associated with sexual dysfunction. Hormone secretion is controlled by the body’s internal clock, and sleep patterns likely help the body determine when to release certain hormones.
For some men, vacuum pump devices, rigid or inflatable surgical penile implants or testosterone replacement (only for men with unequivocally low levels of this hormone) may also be options. Constriction bands at the base of the penis can be a treatment option for men with non-sustained erections. Discuss these options with your doctor.
Diabetes mellitus can cause ED. Thankfully those with diabetes-induced ED (DMED) tend to respond very well to ED treatments. If you’re prediabetic or your family has a history of diabetes, this is something you should bring up in your consultation.
11. Levitra (Vardenafil) [Prescribing Information]. Research Triangle Park, NC: GlaxoSmithKline; November 2018.
These findings suggest that patients who present with ED and CV risk factors should be evaluated for silent CVD and should undergo a thorough CV evaluation.
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The read-only self-assessment questionnaire (SAQ) can be found after the CME section in each edition of Clinical Medicine. RCP members and fellows (using their login details for the main RCP website) are able to access the full SAQ with answers and are awarded 2 CPD points upon successful (8/10) completion from: https://cme.rcplondon.ac.uk About Menu Toggle What is GAINSWave ? What to Expect? How it Works? Comparing Treatments FAQs Medical Advisory Board Expected Results Menu Toggle Erectile Dysfunction Treatment Peyronie’s Disease Treatment Sexual Enhancement Clinical Research Testimonials Am I a Candidate? Testimonials Resources Menu Toggle Men’s Health Guide Provider Resources Magazine Press Become a Provider Find A Provider About Menu Toggle What is GAINSWave ? What to Expect? How it Works? Comparing Treatments FAQs Medical Advisory Board Expected Results Menu Toggle Erectile Dysfunction Treatment Peyronie’s Disease Treatment Sexual Enhancement Clinical Research Testimonials Am I a Candidate? Testimonials Resources Menu Toggle Men’s Health Guide Provider Resources Magazine Press Become a Provider Find A Provider
Ginseng. Korean red ginseng has long been used to stimulate male sexual function, but few studies have tried systematically to confirm its benefits. In one 2002 study involving 45 men with significant ED, the herb helped alleviate symptoms of erectile dysfunction and brought "enhanced penile tip rigidity." Experts aren't sure how red ginseng might work, though it's thought to promote nitric oxide synthesis. "I would recommend ginseng [for men with ED]," says Espinosa. Discuss with your doctor before taking it since ginseng can interact with drugs you may already be taking and cause allergic reactions.
Oral drugs or pills are often prescribed for ED (Viagra, Cialis, Levitra, Stendra)Testosterone Therapy (if blood tests indicate low testosterone)Penile Injections (ICI, intracavernosal Alprostadil)Intraurethral medication (IU, Alprostadil)Vacuum Erection DevicesPenile ImplantsSurgery to bypass penile artery damage for some younger men with a history of severe pelvic trauma (this procedure is not recommended for older men with hardened arteries)
Young adult men who frequently turn to pornography for stimulation, or who may even be struggling with a porn addiction, are much more likely to experience sexual dysfunctions in their lifetime.
Besides PDE5 inhibitors and among second-line therapies are VCDs which are clear plastic chambers placed over the penis, tightened against the lower abdomen with a mechanism to create a vacuum inside the chamber. This directs blood into the penis. If an adequate erection occurs inside the chamber, the patient slips a small constriction band off the end of the VCD and onto the base of the penis. An erection beyond 30 min is not recommended. These devices can be a bit cumbersome, but are very safe.40
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But even if a prescription treatment isn’t the best course of action, it’s still wise to consult with a healthcare provider. This is because there are so many possible causes of ED, and your erection difficulties might signal an underlying condition that requires medical attention.