Do you also have problems with erection during sex? (Erectile Dysfunction) Let's talk about this!

Erectile dysfunction is a topic that many people have, but it's a bit difficult to talk about. But it's a medically explainable condition. So knowing about it properly will help you cope with it. Let's talk about it openly and honestly.

What is Erectile Dysfunction?

Simply put, erectile dysfunction (ED) is the inability to get or maintain an erection that is hard enough for sexual intercourse. It can be considered a medical condition that affects the penis. Your thoughts and feelings have a big impact on this. Feeling relaxed, confident, and sexually aroused is essential to getting an erection. However, it is normal to have problems getting an erection sometimes. This can happen if you are feeling anxious, scared, worried, or tired. Drinking alcohol or using drugs can also affect this. It can also occur due to other medical conditions or as a side effect of certain medications or cancer treatments. If you are also having difficulty getting or maintaining an erection, it is best to see a doctor and talk about this. Often, ED can be the first sign of a serious underlying condition, such as heart disease . That's why it's important to talk to your doctor about it. Other names for ED include "Impotence" or "Impotence." But the most common term used today is "Erectile Dysfunction."

What are the main types of erectile dysfunction (ED)?

Doctors divide ED into several main types:

• Vascular ED (Vascular erectile dysfunction) : This is the most common type. It can be caused by a problem with the blood vessels that carry blood to the penis or a problem with the valves that help keep blood in the penis .
• Neurogenic ED (Neurogenic erectile dysfunction) : This condition is caused by a problem with the nerves that carry signals from the brain to the penis. It can be caused by an accident, pelvic surgery, radiation therapy , or stroke , spinal stenosis, multiple sclerosis (MS) , or other conditions .This can be caused by neurological diseases such as Multiple Sclerosis ( MS ).
• Hormonal erectile dysfunction (ED) : This is caused by a decrease in the hormone testosterone ( testosterone deficiency), or sometimes by thyroid problems.
• Psychogenic erectile dysfunction (ED) : ED can also be caused by psychological conditions that affect your thoughts, feelings, or behavior.

How common is this condition (ED)?

ED is one of the most common sexual problems men report to their doctors, especially as they age and other health problems increase.

At what age does ED usually occur?

Doctors and researchers say that ED affects more than 50% of men between the ages of 40 and 70. But the number could be much higher. Many men are too embarrassed and embarrassed to talk about it or seek treatment.

What are the symptoms of ED?

The following are some of the symptoms of ED:

• The penis only becomes erect sometimes before sexual intercourse.
• Even though the penis is erect before sexual intercourse, that erectness is lost during intercourse.
• Inability to fully erect the penis.
• Needing a lot of stimulation to stay alive.

What causes ED?

There are many factors that can cause ED. The main ones are those that affect these systems of yours:

• Circulatory system : This is the part of your body that carries blood throughout your body. Your penis needs a good blood supply to grow and stay healthy. It also has a system of valves that help keep the blood inside when it fills with blood. Sometimes these valves may not work properly.
• Nervous system : This includes your brain , spinal cord, and nerves . Together, these send electrical impulses that control your body's movements and sensations. This also applies to the functioning of your penis.
• Endocrine system : This includes the glands that produce and release hormones . Hormones control various functions in the body. The hormone testosterone helps to widen the channels that carry blood to the penis.

Some medical conditions and other causes that can affect ED include:

• Diabetes Mellitus and diabetic neuropathy
• High blood pressure (hypertension)
• High cholesterol (hyperlipidemia)
• Vascular disease
• Chronic kidney disease
• Atherosclerosis
• Peyronie's disease (a condition that causes a curvature of the penis)
• Low testosterone / testosterone deficiency
• Stroke
• Epilepsy

ED can also be caused by trauma to the penis and surrounding areas:

• Damage to the tissues of the penis (sometimes called a " penile fracture," but there is no bone in the penis, only the blood-filled chambers are damaged here)
• Injury to the pelvic bones (hips, sacrum, coccyx), bladder, prostate, and spinal cord.
• Pelvic cavity surgeries (e.g. prostate, colon, or bladder cancer surgeries).
• Radiation therapy .

Some types of drugs:

ED can occur as a side effect of many medications. The most common medications that cause ED are:

• Antidepressants
• Anxiety-reducing medications (anxiolytics)
• Blood pressure medications
• Diuretics
• Antihistamines ( medicines for allergies)
• Chemotherapy drugs
• Parkinson 's disease drugs
• Prostate cancer drugs
• Antiarrhythmics (medicines for heart rhythm disorders)
• Sedatives
• Muscle relaxants
• Antiseizure medications (medicines given for conditions such as epilepsy)

Other drugs and addictive substances:

These addictive substances can also cause ED:

• Alcohol
• Amphetamines
• Barbiturates
• Cocaine
• Marijuana
• Methadone
• Nicotine (contained in tobacco)
• Opioids (a class of painkillers)

These substances affect your central nervous system, reducing its function. They can also cause severe damage to blood vessels and lead to permanent ED.

Mental and emotional states:

• Depression
• Anxiety
• Stress
• Fear of having sex or being intimate (genophobia)
• Low self-esteem

Consider that one or more of these factors could be contributing to your ED. That's why it's important to talk to a doctor to find out the exact cause.

What is the main cause of ED?

Often, the main cause of ED is conditions that interfere with the blood supply to the penis.

Who is most affected by ED?

You may be at increased risk of developing ED if you:

• If you are 40 years old or older.
• If you have diabetes .
• If the Body Mass Index (BMI) is greater than 25 (obesity).
• If you have depression .
• If you are not very physically active.
• If you smoke .

How is ED diagnosed?

A doctor can diagnose ED and find out what's causing it. He or she will review your medical history and perform a physical exam. He or she will also ask you questions about your personal and sexual life. You may feel a little embarrassed or uncomfortable asking these questions. However, it's important to be honest to find the cause quickly. The doctor may ask questions like:

• Are you currently taking any medications (prescribed, over-the-counter, herbal, dietary supplements, drugs)?
• Have you ever been told by a doctor that you have depression or anxiety ?
• Do you often feel stressed ?
• Are you having problems in your family life or relationships?
• How often can you stimulate your penis?
• How stiff is it when it comes to life?
• How long can you stay alive?
• Are you losing your vitality because you ejaculate faster than you expect?
• When did you first notice symptoms of ED?
• What exactly happened when ED symptoms first appeared?
• Does your penis feel erect when you wake up at night or in the morning?
• What sexual positions do you often engage in?

The doctor may also ask to speak with your sexual partner. He or she may also be able to provide additional information about possible causes. The doctor may then recommend various tests to confirm the diagnosis and pinpoint the cause.

What tests are used to diagnose ED?

This will depend on the doctor's suspicions. Tests may include:

• Blood tests: Complete Blood Count (CBC) , Lipid panel (looks at cholesterol levels), Liver function tests, Kidney function tests, Thyroid tests , Testosterone test .
• Urinalysis .
• Penile Doppler ultrasound (to see how blood flows to the penis).
• Tests to see if the penis responds to nerve impulses (penile biothesiometry) .
• Injection of drugs that temporarily stimulate the penis (vasoactive injection) .
• Magnetic Resonance Angiogram (MRA) (to obtain detailed images of blood vessels).

Before performing these tests, the doctor will explain them to you and answer your questions. If you feel uncomfortable, you have the right to refuse the test at any time.

What are the best treatments for ED?

The first step in treating ED is to find the underlying cause. Your doctor can help you choose the best treatment for you. Treatment options may include:

• Cardiovascular exercise : Vigorous cardiovascular exercise (such as brisk walking, jogging, swimming, cycling, jumping rope) for 45 minutes at least three days a week can help improve some mild ED conditions.
• Quitting smoking: People with mild ED may see improvement within a few months of quitting smoking.
• Talking to a sex therapist .
• Pills that increase blood flow to the penis: Sildenafil (Viagra®) , vardenafil (Levitra®) , tadalafil (Cialis®) or avanafil (Stendra®) . These pills start working within about an hour.
• Penile low-intensity focused shockwave therapy (LiSWT) :This is a non-invasive treatment that uses sound waves to improve blood circulation. It can take about two months to see results.
• Medications injected directly into the penis: alprostadil (Caverject®) , papaverine (Papacon®) , phentolamine (Regitine®) , or a combination of these medications. These injections start working within 10 minutes.
• Vacuum constriction device / penis pump : These give results almost immediately after use.
• Testosterone replacement therapy: This is available in gels, injections, patches, and pills. This treatment starts working within four weeks.
• Penile implant procedure : In this procedure, a surgeon inserts a device into the penis to augment it. This device does not affect sensation, urination, or ejaculation.

Will ED get better on its own?

ED will not automatically improve without making changes to your lifestyle or receiving some treatment.

Can ED be prevented?

Some lifestyle changes can reduce the risk of ED:

• Lower your cholesterol levels.
• Be physically active, especially cardio exercises like running, jogging, and cycling.
• Maintain a healthy weight that suits you.
• Get good quality sleep.
• Eat healthy foods (fruits, vegetables, whole grains) that are low in saturated fat.
• Quit smoking.
• Reduce or stop drinking alcohol.

If I have ED, what should I expect?

There is hope for ED. It is a highly treatable condition. Although there is no complete cure for some causes, there are many treatment options that can help you maintain and improve your erection for sexual intercourse.

When should I see a doctor?

If you suspect you have ED, see your primary care physician or a urologist . They can diagnose ED, find the cause, and recommend the best treatment for you.

When should I go to an Emergency Treatment Unit (ETU) ?

If you are taking medication for ED and have a painful erection that lasts more than two to four hours, go to the nearest emergency room immediately. This could be a sign of a condition called priapism . If left untreated, it can cause permanent damage to the penis.

What questions should I ask the doctor?

• Is it normal to have ED?
• How do you know if I have ED?
• What is the cause of my ED?
• What ED treatment option do you recommend for me?
• Can ED cause other conditions that affect my sexual health?
• Can I get pregnant even if I have ED?
• Can you recommend a sex therapist?
• Can you recommend a support group for people with ED?
• Am I suitable for a penile implant procedure ?

How does it feel when you can't get an erection?

ED can make you feel a variety of emotions. You may feel ashamed, angry, guilty, worried, resentful, or like you're not good enough. If this continues, it can lead to serious mental health conditions like anxiety and depression . But you don't have to live with these feelings. ED is common, and it doesn't make you feel worthless. There are doctors who can help you.

What do I do if my partner has ED?

ED is a sensitive topic for many people. If your partner has ED, these tips can help you support them:

• Encourage open communication: Let her know that you care about her feelings and well-being. Find a time when she won't feel uncomfortable and that you can talk.
• Remind him that he's not alone: ​​ED is common, and there are treatments. Therapists and support groups can help him understand his feelings and cope with them.
• Encourage healthy habits: Focus on the benefits of regular exercise, a healthy diet, and reducing the things that can cause ED (alcohol, smoking).
• Be informed: If you have accurate, up-to-date information about ED and its treatments, your partner will feel empowered.
• Offer to go with him to his doctor's appointments: You can help him ask questions, take notes, and provide the doctor with information that will help with the diagnosis. If he prefers to see a doctor alone, respect that privacy.
• Express your love and affection in other ways: Sex is not the only thing that increases intimacy between two people. Holding hands, stroking each other's backs, spending time together, kissing, writing notes, being patient, and being a good listener are all ways you can show your love for your partner.

The most important things to remember (Take-Home Message)

ED is a common condition that affects many men, especially as they get older. It can cause embarrassment, low self-esteem, and other serious psychological problems. But you don't need to be ashamed or worried about having ED. It could be your body's way of telling you that "something isn't right."

The most important thing is to talk openly with a doctor about your symptoms and how they are affecting your life. Your doctor can then diagnose your ED, find the cause, and recommend the best treatment for you. Don't be afraid or embarrassed to seek medical advice. You are not alone!

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