It affects many men—however, only a few talk about it. Erectile dysfunction is one of the most commonly diagnosed sexual dysfunctions in males. In many years of human existence, the erect penis has been attributed to male fertility and sexual prowess. Men with this condition are socially discriminated against –an unfortunate occurrence that causes sexual anxiety and damps a patient’s willingness to present at the doctor’s clinic for treatment. Topics bordering on sexual health are considered sensitive and are preferred by many to be managed in professional secrecy.
Erectile dysfunction is simply the inability to achieve and maintain a penile erection for a period sufficient enough for sexual satisfaction. Once it happens recurrently, a confirmed diagnosis is made, and the clinician makes frantic efforts to ascertain the possible cause in a patient. Erectile dysfunction might be very tricky to manage for a clinician. Starting from the first appointment with the patient, the doctor struggles to understand the patient’s comfort level in discussing erectile dysfunction. With recent technological advancements and treatments, erectile dysfunction has become treatable even by online doctors today.
Diagnosing Erectile Dysfunction
On establishing a professional relationship, the doctor then proceeds to ascertain the remote cause of this condition. Most importantly, clerking questions are directed at determining which stage of the erection process is affected by this condition. Questions asked are important to understand exactly if a patient cannot achieve an erection or the erection attained is ineffective for penetration. By extension, the doctor can also understand if the erection lasts until orgasm is reached or whether ejaculation occurs with sexual satisfaction.
A complete medical history is also expected to be reviewed. This necessary to examine the presence of any disease condition or comorbidities implicated in the onset of erectile dysfunction. Cardiovascular diseases, diabetes mellitus, and obesity are leading risk factors for erectile dysfunction. Recently, new clinical evidence emerged, suggesting that people who had survived different forms of childhood cancers are at risk of developing erectile dysfunction at a point in their lifetime.
Medical Review of Erectile Dysfunction
In a publication update on the management modalities for erectile dysfunction, the American Urology Association stressed the need for a comprehensive review of medical, sexual, surgical, and psychosocial history in the treatment of erectile dysfunction. A positive history of previous prostate surgery, trauma, and pelvic surgery definitely helps the doctor understand the condition and formulate a better therapy plan for the patient.
Medication history can also be reviewed. All supplements, vitamins, herbal formulations, and prescription medications administered within a specific time period preceding the onset of erectile dysfunction should be reviewed for a possible cause. Medical history is particularly important in an elderly patient who is currently managed with multiple drugs for different disease conditions.
Causes of Erectile Dysfunction
Clinical researches have verified that the causes of this condition are multifactorial. In many cases, the exact cause of this sexual impairment might not be known. In other cases, however, there exist at least two possible causes of this condition in a patient. Judging from validated researches, classification of the leading causes of erectile dysfunction in males include:
- Organic Causes
In erectile dysfunction caused by organic factors, the patients notice a range of symptoms that progresses steadily in severity over months or years –from difficulty to sustain an erection to total failure in achieving an erection. This in sharp contrast to dysfunction caused by psychogenic factors. Generally, organic erectile dysfunction is caused by physical problems, which the patients might have noticed to be directly linked with the inability to achieve or maintain the penile erection. Organic causes of erectile dysfunction can be vascular, neurogenic, or drug-related.
Subclinical perineal trauma is a leading vascular disorder causing organic erectile dysfunction. Physical activities that can temporarily occlude penile vessels –including Bicycling –can cause trauma to the penile vessels. In 2012, the report of clinical research focused on examining the incidence of erectile dysfunction in young surgically treated patients with lumbar spine disease was published. Research results suggest that about 34% of men under 50 who underwent surgical decompression of the lower spine experienced erectile dysfunction.
- Drug-Related Causes
Erectile dysfunction has long been documented as a side effect of some medications. Many antidepressants, anxiolytics, neuroleptics, and non-steroidal anti-inflammatory drugs have a side effect warning of their possibility of causing erectile dysfunction. Selective serotonin receptor inhibitors are another drug class notorious for this side effect. Neuroleptics are indicated in the treatment of schizophrenia and other psychotic disorders.
All varieties of these drug class increase prolactin levels in males –an action that have been linked to the onset of erectile dysfunction in many psychotic patients. Antiepileptic, on the other hand, induces changes in the level of reproductive hormones in males. This action has been reportedly linked to the onset of erectile dysfunction in patients managed with these drugs.
- Psychogenic Causes
Unlike in organic ED, where the symptoms develop over time, psychogenic erectile dysfunction is sudden in onset. Patients with this form of erectile dysfunction might experience difficulty in achieving penile erection after psychological trauma. In some cases, the patient might experience erectile dysfunction with a partner and not with another –this explains why psychogenic erectile dysfunction is commonly referred to as ‘Selective Erectile Dysfunction.’
Anxiety, guilt, depression, stress, and conflicts about sexual issues are considered the leading causes of psychogenic erectile dysfunction. Many patients suffering from this condition can achieve penile erection during self-stimulation but total erectile failure during sexual intercourse. In some patients, adequate medical history, physical and laboratory examinations might be required to correctly differentiate between psychogenic and organic erectile dysfunction as symptoms can sometimes be confusing.
Treating Erectile Dysfunction
As it stands, there are different treatment modalities for erectile dysfunction; however, the desired therapy aim is the same –increasing penile blood flow and improving sexual satisfaction. Online ED treatment is becoming increasingly popular. Aided by telemedicine, online doctor services offer online ED treatment plans to patients in the comfort of their homes.
This means patients can avoid driving long distances to the hospital or wait for long hours in a queue before seeing a doctor. A patient can simply book an appointment online with an online doctor service. The online doctor can make a diagnosis and issue an online prescription. Telemedicine is advancing healthcare delivery and, at the same time, reducing the cost of assessing expert medical care.