Download Erectile-Dysfunction

Patient Handout
Sexual health
Causes | Symptoms | Treatment | Lifestyle & diet | Medicines | Support & resources
Erectile dysfunction
Overview
If you are a man having difficulty maintaining
an erection during sexual intercourse, one of
the most important things you should know
is that you are not alone. Erectile dysfunction
(ED), sometimes also known as impotence, is
believed to affect around 40% of men at
some time in their lives. Usually it’s defined
as having difficulty getting or maintaining
an erection, or not having a hard enough
erection.
For some men it is a rare or occasional
problem, but for others it is ongoing. While it
can be upsetting for the man and their
partner, only 12% of men seek help – that’s
despite the fact that it is often easily treatable.
It s important to note that erectile
dysfunction can be an indicator of an
underlying cardiovascular condition, or of
diabetes, a prostate problem, or anxiety and
depression – all of which can be treated.
So the message is clear – erectile dysfunction
can usually be treated and treating it could
save your life as it may be an indicator of a
more serious underlying condition.
Causes
There are many conditions which are known
to cause erectile dysfunction, and the most
common ones include:
◗◗ Age. The incidence increases with age.
◗◗ High blood pressure, (hypertension).
◗◗ Diabetes.
◗◗ Heart disease.
◗◗ Prostate problems, including an enlarged
prostate or cancer.
◗◗ Anxiety.
◗◗ Vascular conditions such as penile arterial
disease.
◗◗ Depression.
◗◗ Penile trauma.
◗◗ Congenital disorders.
◗◗ Neurological diseases, including spinal
cord injury, multiple sclerosis, and
tumours.
◗◗ Psychosis.
◗◗ Relationship issues.
◗◗ Sexual abuse.
◗◗ Stroke.
◗◗ Thyroid disease.
◗◗ Major surgery.
◗◗ Kidney (renal) failure.
There are a number of other factors that
may contribute to a man’s predisposition
to the incidence of erectile dysfunction,
including:
◗◗ Smoking.
◗◗ Excessive alcohol consumption.
◗◗ Obesity.
◗◗ Sleep apnoea.
◗◗ Lack of sleep.
◗◗ Substance abuse, including illegal and
◗◗prescription drugs.
◗◗ Some medications.
◗◗
Symptoms
Symptoms of erectile dysfunction will vary
from man to man, depending on its frequency
and severity. Symptoms may include:
◗◗ Difficulty getting and maintaining an
erection,despite stimulation.
◗◗ Erections may not remain hard enough for
penetration for intercourse.
◗◗ Once penetration has taken place,
sometimes erections can not be maintained
to continue or complete sexual intercourse.
Erectile dysfunction can cause anxiety
about sexual performance and this can
exacerbate the problem.
Treatment options
For most men erectile dysfunction can be
treated so they can resume normal sexual
activity.
It is important to note that there are many
treatments on the market that claim to
address men’s sexual problems, but these
can be very costly and most over-the-counter
or postal order products are not scientifically
validated.
Treatments for erectile dysfunction fall into
three main categories
◗◗ Non-invasive
◗◗ Minimally-invasive
◗◗ Surgical
Sometimes these will be used in combination.
◗◗Non-invasive
treatments
These are the most popular treatments and
include oral medications, commonly Viagra,
Cialis or Levitra.
These medications work allowing the blood
that flows to the penis during an erection to
stay there longer, and in doing so, maintaining
the erection for longer.
It is estimated that medication works in
about 70% of patients, but it is not without
potential side effects which include facial
Reviewed by: Dr Michael Lowy, Sydney Men’s Health, Bondi Junction, NSW
flushing, headaches, indigestion and nasal
congestion.
People with heart problems must not
take erectile dysfunction medication without
consultation with their doctor, as it may
interact with existing heart medications.
Other non-invasive treatments include
counselling (as well as psychotherapy), and
hormone therapy, which may be particularly
effective for men with low testosterone levels.
Another treatment involves the use of
devices such as vacuum pumps. The pump
looks like a tube and is placed over the penis.
Air is pumped out of the cylinder, raising the
pressure that helps to draw blood into the
penis, causing it to enlarge. A rubber ring is
then placed around the base of the penis,
and this helps to maintain the erection.
Minimally-invasive treatments
Penile injections are the mainline treatment
of this approach, but these are not as scary
as they sound. This method was widely used
until oral medication was introduced, and it
remains a popular treatment for men who
have undergone prostate surgery or have
nerve damage. It is also useful for men who
can’t take oral medication because it is not
effective or it is not recommended.
Once a man learns to self-administer the
injection, it is generally easy to use and very
effective. The medication increases blood
flow, resulting in an erection within about 5
to 10 minutes that can last up to an hour.
However, it also has potential side effects,
including a painful erection that can last for
several hours.
This requires medical treatment to avoid
permanent penis damage. This side effect
is usually the result of injecting too much
medication, so care should always be
taken to follow the doctor’s prescription
instructions.
◗◗
Surgical treatments
Penile implants (also known as prostheses),
and less commonly, vascular surgery, are
possible surgical treatments for erectile
dysfunction. Penile implants are usually only
recommended after other treatments have
been tried and failed. It involves placing an
implant into the penis that can be manually
squeezed or pumped to create an erection.
Similarly, vascular surgery is also generally
a last resort treatment. The surgery aims to
repair restore blood flow to and from the
penis.
◗◗
Patient Handout
Sexual health
Causes | Symptoms | Treatment | Lifestyle & diet | Medicines | Support & resources
Erectile dysfunction
Generally erectile dysfunction can be treated
by your GP, but sometimes the problem
involves complexities that require referral to a
specialist or other allied health professionals,
such as:
◗◗ Endocrinologist. These specialists work
with patients who have a hormonal or
metabolic disorder such as diabetes.
◗◗ Urologist. If penile surgery is required you
are likely to be referred to this specialist.
◗◗Psychologist or counsellor specialising in
sexual disorders if there are psychological
issues involved.
Lifestyle and diet
Staying healthy and on top of diseases such
as diabetes, heart disease and high blood
pressure are the key to maintaining good
erectile function. Regular exercise, a low
cholesterol diet, avoiding excessive alcohol,
not smoking and maintaining a healthy weight
may help reduce the risk of developing
erectile.
Support and resources
Impotence Australia
(www.impotenceaustralia.com.au)
◗◗ Andrology Australia
(www.andrologyaustralia.org)
◗◗ Mensline Australia
(www.menslineaus.org.,au)
◗◗
ItsMyHealth.com.au
Reviewed by: Dr Michael Lowy, Sydney Men’s Health, Bondi Junction, NSW