Erectile Dysfunction – Hard To Get, Easier To Cure

Introduction

Erectile dysfunction (ED), formerly known as impotence, should not be considered taboo. The best way to seek help is by being open about it with your partner and discussing it frankly with your health care provider. The symptoms of this condition can be subtle, with one’s partner being the first to notice them. Around half of all men can have ED at some point in their lives (1).

In medical terminology, ED is defined as the failure to achieve or maintain a penile erection satisfactory for sexual intercourse which is being encountered for more than six months (2). It is commonly associated with increasing age and other medical conditions. There is a lot more that comes under the ED umbrella; a softer erection, decreased length of the penis, early or delayed ejaculation, less sensation, or having a decreased desire to have sex are included (3).

This article intends to give an overview of the causes and risk factors of ED as well as inform readers about the management of this very intimate condition.

Causes and risk factors of ED

Sexual arousal is not as simple as it seems. It involves the interplay of emotions, the brain, sexual thoughts, sexual hormones, nerves, blood vessels, and muscles of the penis. If any of these don’t work in sync with the others, it can lead to dysfunction and hint towards a medical condition. Even though ED increases with age, one can remain optimistic as men can stay sexually active late into their 80s.

The causes of ED can be organic or psychogenic. Organic causes occur when there is insufficient blood flowing to the penis. Conditions affecting the circulation of blood include aging, heart disease, high blood pressure, hardened arteries (aka atherosclerosis), high cholesterol, obesity, high blood sugar, and smoking. There are many other organic causes that might affect the muscles of the penis and its nerve supply. Hormonal imbalance can also lead to ED; low testosterone elevated estrogen or even diseases of the thyroid gland. Medications have also been implicated in ED, with drugs for cancer, antidepressants, anti-ulcer, tranquilizers, and diuretics being leading culprits (4, 5).

The satisfactory sexual performance involves the interplay of the mind and body to work congruously. Some psychogenic causes include worry about one’s own sexual performance, low self-esteem, depression, anxiety, having an emotional conflict or not being attracted to your partner, experiencing stress at home or at work, and feeling any form of guilt.

Effects on the patient and the partner

The Sexual Dysfunction Association, through a survey in the past, found that 62% of participants felt that ED reduced their self-esteem, with 29% reporting conflicts in their relationships and 21% reporting that their relationship had ended as a direct consequence. This is very frightening. ED can create a social stigma and men with ED feel hesitant confiding in others or even approaching physicians for help. Their partners might think they are not attractive enough or worse, that the man is having an affair with someone.

Management of ED

ED, whilst devastating to those experiencing it, can be managed. It starts with opening up to your partner and then seeks medical help. The doctor will do a complete exam and then advise lifestyle modifications, personal counseling and if needed, medication or tests. At this point, men with this condition can become desperate, being susceptible to try ANYTHING to resolve their condition. Lifestyle modifications to manage ED include maintaining a normal sugar level and blood pressure reading, exercise, reducing weight, coping with mental stress, and avoiding smoking or recreational drugs. Self-medicating with over-the-counter therapies and supplements can be disastrous. As an example, an ED patient with a heart condition obtaining over-the-counter Viagra from an unregistered or unregulated online site can potentially jeopardize his own health as it can lead to a heart attack.

The most common medicine to treat ED is a class of drugs called oral phosphodiesterase-5 (PDE-5) inhibitors. These include drugs like Tadalafil, Sildenafil (commonly known as Viagra), and Vardenafil. We at KamaHealth offer these ED medications in a wide range of dosages as they have been proven to have a clinical efficacy and safety profile of 76% (6). The most common side effects include headache, indigestion, nasal congestion, and mild changes in vision. These drugs should be used responsibly in patients currently taking blood pressure pills. Other second-line treatments include Alprostadil, testosterone replacement, penile pumps, or implants which are used in select cases where the previously mentioned treatments fail.

Kama Health provides a prescription referral service connecting patients with licensed Canadian pharmacies who are fully authorized by the relevant provincial regulatory authorities. For your safety, always use legitimate sources instead of risking your health with substandard products from unauthorized sellers. We at Kama Health know how devastating ED can be for the lives of you and your loved one. You are not alone and we will help you overcome this barrier in living a happy and satisfied life, being easily intimate with your partner as you were before.

References

1. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. The Journal of urology. 1994;151(1):54-61.
2. Muneer A, Kalsi J, Nazareth I, Arya M. Erectile dysfunction. Bmj. 2014;348.
3. Sharma A, Sharma R. Erectile Dysfunction: The Male Stigma. International Journal of Surgery and Medicine. 2019;5(3):172-8.
4. Eaton C, Liu Y, Mittleman M, Miner M, Glasser D, Rimm EB. A retrospective study of the relationship between biomarkers of atherosclerosis and erectile dysfunction in 988 men. International journal of impotence research. 2007;19(2):218-25.
5. Wu FC, Tajar A, Beynon JM, Pye SR, Silman AJ, Finn JD, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. New England Journal of Medicine. 2010;363(2):123-35.
6. Goldstein I, Tseng L-J, Creanga D, Stecher V, Kaminetsky JC. Efficacy and safety of sildenafil by age in men with erectile dysfunction. The journal of sexual medicine. 2016;13(5):852-9.