Erectile Dysfunction

WHAT YOU SHOULD KNOW IN DIAGNOSING ERECTILE DYSFUNCTION

WHAT IS ERECTILE DYSFUNCTION (ED)? 
Most men have problems with erections from time to time.  But some men have erectile dysfunction, or ED.  When you have ED, it is hard to get or keep an erection that's firm enough for sex.  ED can be caused when health problems prevent good blood flow or damage nerves in the penis.  ED can also be caused by stress or emotional reasons, or by a combination of health and emotional reasons.  ED can be an early warning of a more serious illness.  Heart disease, high blood pressure and high blood sugar can all cause ED.  Finding and treating the cause(s) of your ED can improve your overall health and well-being.

HOW IS ED DIAGNOSED?
Finding the cause of your ED will help your health care provider find the best treatment choices for you.  Most health care providers will ask you about your health and about the history of your erection problem.  They may also give you a physical exam and order lab tests.

Health and ED History:  Questions about your health history can help find diseases that may lead to ED.  It can also find medicine or drug use that can cause ED.  Cutting back on or changing certain meds can often improve ED.  Your health care provider will also ask if you smoke or drink because that can affect erections.  Asking questions about your history of ED can help your provider find out whether your problems are with sexual desire, erection, ejaculation, or orgasm (climax).

Physical Exam:  A physical exam checks overall health and includes a check of your penis.  Both can give clues to the cause of ED.

Lab Tests:  To test for diseases that cause ED, your health care provider may order blood tests and collect a urine sample.

Stress and Emotional Health:  Your health care provider may ask you questions about feelings such as depression or worry.  They may also ask about problems in your relationship with a partner.  All of these can make ED worse.  Some health care providers may ask if it is okay to talk to your sexual partner, also.

WHAT WILL YOUR HEALTH CARE PROVIDER ASK?

To help your health care provider find the best way to treat your ED, be ready to answer a number of questions.  Some of these questions will be personal and may seem embarrassing.  Honest answers will help find the cause and best treatment for your ED.

QUESTIONS ABOUT YOUR ED?

•How long have you had these symptoms?  Did they start slowly or all at once?

•Do you wake up with an erection?  How about in the evening?

•If you do have erections, how firm are they?  Is penetration difficult?

•Do your erections change at different times such as when entering a partner, during stimulation by mouth or with masturbation?

•Do you have problems with sex drive, arousal, ejaculation, or orgasm (climax)?

•What effect is this problem having on your enjoyment of sex?

•What effect is this problem having on your relationship if you are in one?

QUESTIONS ABOUT HEALTH PROBLEMS:

•What health problems do you have?

•What medicines do you take?

•Do you smoke, drink, or use other drugs?  If so, how much?

•Did you have any prior history of surgery or radiation therapy, especially in the pelvic area?

•Do you have urinary problems?

QUESTIONS ABOUT STRESS AND EMOTIONAL HEALTH:

•How is your relationship with your partner?  Has anything changed lately?

•How satisfied are you with your sex life?  Has anything changed lately?

•Are you under a lot of stress most of the time?  Or has anything especially upsetting happened to you?

•Do you have any mental illnesses or depression?  Are you taking any medications for depression or anxiety?

The good news for many men is that ED can be prevented or treated safely. I f you have ED, there is hope.  There is help.  Talk to your health care provider about ED prevention and treatment choices.

ERECTILE DYSFUNCTION WHAT YOU SHOULD KNOW

WHAT IS ERECTILE DYSFUNCTION (ED)?

ED affects as many as 30 million men.  Most men have problems with erections from time to time.  In some men, these problems are regular and more severe.  ED, or erectile dysfunction, is when it is hard to get or keep an erection that's firm enough for sex.

WHAT CAUSES ED?

While ED becomes more common as men age, growing old is not the cause of the problem.  ED can be an early sign of a more serious health problem.  Finding and treating the cause(s) of your ED can improve your overall health and well-being.

ED can result from health or emotional problems, or from both combined.  Reduced blood flow or harm to nerves in the penis can result in erection problems.  These can be caused by heart disease, high blood pressure, high blood sugars, surgery, injuries and even smoking.  Some medicine, as well as alcohol or other drugs may also cause erection problems.  Emotional (depression, stress or worry) or relationship problems can cause or worsen ED.

HOW IS ED TREATED?

To improve erection problems, your health care provider may need to treat the root causes.  Your provider may ask you to change certain habits, such as stopping smoking, drug or alcohol use.  Treating emotional problems, such as relationship conflicts, depression or performance anxiety can also help. Cutting back on or changing certain meds can often improve ED. Do not stop taking your medicine or change any meds without talking to your health care provider first.  If a blood test shows low testosterone levels (lowT), testosterone replacement therapy (TRT) may help.  However, if a blood test shows you have normal testosterone levels, adding TRT will not help your erection problems.

Other treatment choices are:

•Oral drugs, known as PDE-5 inhibitors.  These drugs relax muscle cells in the penis and increase blood flow.  (These are the drugs you see often on TV and internet ads.)

•A vacuum erection device pulls blood into the penis, causing an erection.  An elastic ring is then slipped onto the base of the penis.  This holds the blood in the penis (and keeps it hard) for up to 30 minutes.

•Self-injection therapy.  By injecting this medication into the penis with a very fine needle, an erection is created.

•Intraurethral therapy.  Patients place a tiny medicated pellet of the drug alprostadil into their urethra.  (The urethra is the tube that carries urine out of the body).  This causes an erection.

•A urologist can surgically implant one of two types of penile prostheses.

Ask your doctor which treatment is right for you.  Dietary supplements (often called "herbal remedies") for ED are popular but may not be safe or even work.  Unlike prescription drugs, they do not have to be proven to work.  Check with your health care provider to see if one of these treatment choices will work for you.

QUESTIONS TO ASK YOUR HEALTH CARE PROVIDER

•What is ed?

•What causes ED?

•Can ED be prevented?

•Can you help me or do I need to see a specialist in ED?  If so, how can I find the right one for me?

•Will I need to have tests to find out what is causing my ED?

•Would you explain each test and why you are recommending them?

•What types of treatment are available for ED?

•Are there side effects from treatment?

•What are the pros and cons of each type of treatment?

•What treatment do you recommend for me and why?

•What happens if the first treatment doesn't help?

•Are there any lifestyle changes I can make that could help my symptoms