Erectile Dysfunction

How is erectile dysfunction treated?

Treatment options may include :

• Lifestyle changes such as quitting smoking, reducing alcohol consumption, losing excess weight, and increasing physical activity may help some men regain sexual function.
  
• Cutting back on or replacing medicines that could be causing ED.
• Psychotherapy: techniques that decrease anxiety associated with intercourse can be taught, sometimes together with the help of the partner.
  

• Oral medication

• Oral drugs called phosphodiesterase type 5 (PDE₅) inhibitors enhance the effects of nitric oxide, a chemical that relaxes smooth muscles in the penis during sexual stimulation and allows increased blood flow in the penis. Men who take nitrate-based drugs such as nitroglycerin pills for heart problems should not use any of these drugs prior to consulting with a cardiologist because the combination can cause a sudden drop in blood pressure.
  
• Locally injected drugs
• Drugs such as prostaglandin E1 are injected into the shaft of the penis to relax the smooth muscles of the corpora cavernosa, causing it to become engorged with blood. Patients using such medications should be warned about persistent erection, known as priapism, which requires emergency treatment.
  

• Vacuum erection devices: Mechanical vacuum devices cause an erection by creating a partial vacuum, which draws blood into the corpora cavernosa, engorging and expanding the penis. An elastic ring is moved from the end of the cylinder to the base of the penis as the cylinder is removed to maintain the erection. At the end of the erection, the ring must be removed to allow for blood circulation though the penis.

• Surgery

• Penile implant: Implanted devices, known as prostheses, can restore erection in many men with ED. The implants may be malleable implants or inflatable implants. Once a man has either a malleable or inflatable implant, he must use the device to have an erection, and they are very effective with high satisfaction rates.  Possible problems with implants include mechanical breakdown and infection, although the incidents of mechanical problems have decreased in recent years because of technological advances.
  

Extracorporeal Shock Wave Therapy (ESWT)