Erectile Dysfunction Diagnosis & Treatment
How is erectile dysfunction diagnosed?
Primarily, erectile dysfunction is a diagnosis that's made through patient history. For example, with psychogenic erectile dysfunction, a man has the ability to obtain erections when they wake up in the morning and by themselves. However, they're unable to perform adequately with a partner. Additionally, the diagnosis can be made through blood tests looking at hormone studies, that is, regarding testosterone. In many men, their testosterone levels are low enough to where it's a contributing factor to their erectile dysfunction issue. By correcting the testosterone deficiency, their erectile dysfunction may be eliminated or improved.
How is a psychologically based erectile dysfunction treated?
Psychogenically induced erectile dysfunction is best be handled through the use of a sex therapist. The sex therapist can explore issues of intimacy, fear of failure to perform adquately. Sometimes an individual with premature ejaculation can tremendously benefit from a sex therapist. Now, additionally, medications, if an individual does have premature ejaculation, can help in delaying the ejaculation, allowing them to feel more confident about their performance, can be administered and medications like phosphodiesterase inhibitors can allow for reliable, firm erections and allow the individual to on their own to work through any hang ups or any psychological obstacles that they need to overcome.
How are vacuum devices used to treat erectile dysfunction?
Vacuum devices are very effective in treating erectile dysfunction because what they do is they induce a mechanically induced erection. The erection is generated by the use of a vacuum through a cylinder that's applied directly onto the penis. The area is evacuated, the penis engorges with blood, and that blood is trapped into place with the use of a constriction band that's applied to the base of the penis. The vacuum is then quickly released, and the device is removed, allowing the erection to maintain itself for as long as the band is kept in place. The erection can be utilised up to thirty minutes.
What drug therapies are available to treat erectile dysfunction?
There are two categories of medications that can be utilised to treat erectile dysfunction. The first category includes testosterone which is for the men who are testosterone deficient. By correcting the deficiency, a man can improve his erectile quality. The second category is a class of medication called phosphodiesterase inhibitors. They are very commonly applied and are usually the first line of therapy. Approximately sixty to eighty percent of men respond effectively to the phosphodiesterase inhibitors.
How do "phosphodiesterase" or "PDE" inhibitors work?
Phosphodiesterase inhibitors are medications which are used in order to improve erectile quality, and they include Viagra, Cialis, and Levitra. The mechanism of action is such that it affects blood flow to the penis by increasing it, thereby inducing a more firm and reliable erection. Side effects of phosphodiesterase inhibitors may include headache, flushing, upset stomach, and rarely, visual changes where something the individual sees normally as being white can appear slightly blue tinted or tinged. That quickly dissipates and does not leave any long-lasting or adverse affects on the eye. Contraindications for the use of phosphodiesterase inhibitors are when people are concurrently taking nitroglycerin derivatives, for example people with cardiac conditions involving chest pain that require nitroglycerin.
Will phosphodiesterase inhibitors work right away?
Well, it depends on which drugs we're using. Phosphodiesterase inhibitors may work very quickly; as soon as fifteen or so minutes after taking the tablet for Viagra and for Levitra. However, it could take as long as two hours for the onset of activity with the drug Cialis. Other major differences include the duration of activity. So, for Levitra and Viagra the duration of activity may be as long as five or six hours, whereas with Cialis, although it takes longer to sort of kick in and start working, it can last up to thirty-six hours in many individuals.
What surgeries are available for erectile dysfunction?
Surgery for erectile dysfunction is, of course, considered a last resort. All of the other available therapies should be at least attempted before any of these surgical options are entertained. The first, more common, of the two operations that are available for most individuals include placement of a penile implant. There are one piece, two piece, and three piece implants. That is, the two and three piece being inflatable in nature and the one piece being malleable or bendable. The operation is done under a general anaesthetic and it takes approximately six weeks to recover. It's an uncomfortable procedure post-operatively and destroys the integrity of the penis in the sense that once you have an implant placed, you can no longer go back and utilize any of the other techniques for correcting or improving erectile dysfunction. Additionally, there is vascular bypass surgery, where an operation is performed to improve the blood flow to the penis. However, these particular operations are only performed in referral centres around the country, of which there are only a few, and the problem with those operations is that they are fraught with complications and frequently do not accomplish the goal of improving blood flow to the penis.
How does a penile implant work?
A penile implant comes in three different forms. There is a malleable variety. There is a two piece and three piece variety. The two piece and three piece varieties are inflatable. With the inflatable penile implants a small bulb-like object is implanted along with the prosthesis which is the pump, so to speak. This pump is squeezed approximately 5 to 6 times and the prosthesis enlarges and becomes firmer in nature. The malleable penile implant, on the other hand, is a bendable prosthesis which when ready for use for intercourse is bent into the erect position and when no longer needed for intercourse, is bent away so it can be put inside of the undergarments.
What is vascular surgery for erectile dysfunction?
Well, vascular surgery for erectile dysfunction includes a procedure to apply a graft, a blood vessel, which will bypass the diseased blood vessel (the one that has narrowed with cholesterol, plaques, or atherosclerosis) and allow for an improvement of blood flow to the penis. The problem with that procedure is that it is frequently difficult to accomplish the goal of adequate blood flow, even with doing a successful bypass graft, because veins are used instead of arteries. As a result, the brisk blood flow that is needed to provide the individual with a good erection cannot be accomplished through the vein graft that is utilised. The complication rate is also quite high. The vein grafts sometimes clot off, and frequently simply don't work.
Are there any effective alternative methods of treating erectile dysfunction?
There are effective supplements that can be utilised to improve erections. They include L-Arginine. It has been found that doses of approximately 1,500mg daily can actually, after two weeks of continuous use, improve the quality of a man's erection. Additionally, the drug or natural product called yohimbine has been shown to be effective in approximately 30% of men who take it as a supplement. The main drawback, however, of yohimbine is that men can develop hypertension or high blood pressure and can also develop a severe headache.
Which methods of treating erectile dysfunction are dangerous?
The problem with alternative medications for treating erectile dysfunction is that one doesn't really know the total ingredients in the products. There have been reports that have indicated that certain numbers of the available products have been tainted with products that have made their use unsafe to individuals.
