ED - Erectile Dysfunction
What are the facts about Erectile Dysfunction?
Erectile dysfunction (ED) is the inability to get and keep an erection firm enough for sexual satisfaction or sexual performance. The causes of the condition can vary and include stress-related psychological factors as well as physical and biological factors involving blood flow and nerves.
Most men have experienced an occasional problem with erection, and it isn’t necessarily a cause for concern. But frequent or persistent ED not only causes stress, affects your self-confidence, and causes relationship problems, but it also can be a sign of an underlying health condition, sometimes a serious one.
Conclusive evidence indicates that ED is a risk marker for a number of medical conditions that, if left untreated, reduce quality and length of life.1 ED can negatively affect mental health, relationships, and your general well-being. Consequently, the presence of ED provides an opportunity to address multiple issues that affect your overall health.
- Trouble getting an erection
- Trouble keeping an erection
- Reduced sexual desire
- The need for a thorough medical check-up
Sexuality is a uniquely complex part of being human.
No other aspect of human functioning involves so many components of a person's sense of self.1 The goals of treatment for ED are pretty universal: restoring or enhancing sexual function, improving overall health, and optimizing quality of life and well-being for a man and his partner. But every man who struggles with ED is unique. He has individual symptoms, his own degree of distress, associated health conditions, and his partner's concerns, in addition to his personal sociocultural, educational, and religious components.
Shared decision making is the cornerstone of patient-centered care in the treatment and management of ED.1
The process of sharing makes it possible to include these individual patient factors in the treatment process. The physician shares Information about the best available choices for diagnostic procedures and treatments. The patient is able to express his personal preferences and values that ultimately lead to an informed choice aligned with those preferences and values.
To be effective, the process requires commitments by both physician and patient. The physician’s commitment requires that he/she be cognizant of those social, cultural, religious, educational, and other factors that impact treatment selection for the patient. The physician must communicate objectively and clearly regarding the patient's condition and the available diagnostic and treatment options and make sure the patient understands completely
The patient's commitment includes the willingness to absorb information, ask questions, and clearly express his and his partner's preferences and values. The sharing of information and personal commitment to the process result in mutual responsibility that creates a respectful collaboration and decision regarding diagnostic and treatment plans.
Treating Erectile Dysfunction
It is essential that the patient is informed and understanding of all options for first-line treatments that are not medically contraindicated. Included in that information are the risks, benefits, and burdens associated with those options.
Determining an appropriate plan requires that the patient and his urology specialist navigate all of these issues in order to arrive at the best treatment choice. The patient and the physician (along with the patient’s partner if possible) together determine the best treatment options based on a discussion of the risks, benefits, burdens and desired outcome.
It is justifiable for a patient to begin with any type of treatment he chooses, regardless of invasiveness or reversibility. Some patients choose to start with the least invasive option. Some patients choose to forego treatment. Regardless, it is a fully-informed decision for the patient to make. The urology specialist's role is to make sure that the patient and his partner have a complete understanding of the benefits and risks/burdens of the various strategies available.
There are numerous approaches to treating ED, all dependent on the cause, the treatment options most suitable, and the preferences and values identified in the shared decision-making process with the physician.
Some of the most common are:
- Medications that relax smooth muscle and improve blood flow to the penis
- Vacuum pumps that stimulate an erection by using low-pressure
- Surgical penile implants that can be bendable or inflatable
- Increased activity or an approved exercise plan that helps to reduce stress and improve circulation
- Psychological counseling that addresses depression, anxiety and relationship issues
- Lifestyle changes that improve chances of successful treatment, like losing weight, stopping smoking, and reducing alcohol intake
Risk Factors Associated with ED
All men, regardless of their decision to treat ED, should request information about, and screening for, possible underlying medical issues that may contribute to erectile dysfunction. Many are overlooked, independent risk factors for poor health, reduced quality of life, and decreased life span.
Hypertension is frequently associated with ED and often contributes to its development. Approximately 35% of men with hypertension have some degree of ED.
Dyslipidemia refers to an abnormal amount of lipids (e.g. triglycerides, cholesterol and/or fat phospholipids) in the blood. Elevated levels of total cholesterol and low-density lipoprotein cholesterol are important risk factors for coronary heart disease and stroke, and are also significantly correlated with moderate to severe ED.
Diabetes Mellitus may be previously undiagnosed but brought to light by a diagnosis of ED, one of the most common complications of diabetes mellitus. This relationship highlights the importance of screening men with ED for diabetes-related risk factors.
Heart Disease and Stroke have a documented link to ED, regardless of other risk factors. In a study published June 11, 2018, in Circulation, a journal of the American Heart Association, researchers found that men with ED were nearly twice as likely to experience heart attacks, cardiac arrests, sudden cardiac death and fatal or non-fatal strokes than those without ED.2
Other risk factors commonly associated with ED include depression, smoking, premature ejaculation, lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH), and other causes of voiding dysfunction, such as overactive bladder. These connections underscore the importance of assessing the overall health of patients with ED.
Don't let Erectile Dysfunction damage your sexuality.
Contact Dr. Paul Kenworthy today for a specialty consultation.
Patients are our #1 Priority
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