Alarcon Urology specialists answer the 10 most common questions about erectile dysfunction, ED treatment and male impotence.
If you think you may be suffering from erectile dysfunction, it is probably a scary time in your life. You probably have many questions about what this condition means for you and your partner. Rather than face this common issue on your own, schedule an appointment with a skilled urologist immediately to get your questions answered.
In the meantime, see the frequently asked questions below to learn more about what erectile dysfunction is, what causes it, how to treat it, and more. At the very bottom of the page, you’ll find a glossary of terms for reference.
Thankfully, with the right therapy, support and attitude, ED can be effectively managed.
Contact the Alarcon Urology Center today and ask about our simple 5 question form called the IIEF (International Index of Erectile Function).
What is erectile dysfunction (ED)?
Erectile dysfunction, or ED, is defined as the inability to achieve and sustain an adequate erection for satisfactory sexual intercourse. ED itself is not a disease, but rather a symptom of another health issue.
Erectile dysfunction affects more than half all men between the ages of 40 and 70.
What causes ED?
The causes of erectile dysfunction are many. Sometimes disorders such as diabetes, high blood pressure, heart and vascular disease, nerve damage and depression can lead to problems maintaining an erection. Stress, alcohol consumption, smoking, weight gain and side effects from other medications may also be to blame. You should always discuss male sexual dysfunction with your doctor to get properly diagnosed.
How does a man get an erection?
To achieve an erection, a complicated process must occur involving the body’s central nervous system, hormones, psychological factors, blood flow and circulation, and the penis itself. If any stage of this complex process is disrupted, erectile dysfunction can occur.
- Sexual stimulation – by touch, smell or visual stimuli – triggers the brain and nerve centers at the base of the spine, where nerve fibers connect to the penis and regulate blood circulation.
- The nerve center release chemicals that cause the smooth muscle in the penis to relax, which allows greater blood flow into the penile region. This increased blood flow causes the penis to become rigid and full, resulting in an erection.
- Veins in the penis which normally allow the drainage of blood are compressed and blocked off as the erection bodies grow.
- After ejaculation, the smooth muscle in the erection bodies begin to regain tone and allow blood to flow into the penis, and the venous channels open to drain the excess blood. The erect penis loses its firmness and becomes flaccid again. This process is called “detumescence.”
What’s the difference between erectile dysfunction and impotence?
From a medical perspective, the terms “erectile dysfunction” and “male impotence” are used interchangeable. They are simply two ways to describe the same issue. Problems achieving and maintaining an erection can cause significant psychological and emotional stress in men, which begins a cycle of anxiety that further prevents normal sexual activity.
Erectile dysfunction is not to be confused with premature ejaculation. Premature ejaculation is a disorder where the entire erection and ejaculation process happens very quickly – sometimes in just a few seconds or minutes. This condition can leave both sexual partners dissatisfied and should be treated if it begins to interfere with an individual’s relationship.
How is ED treated?
If you have problems achieving or maintaining an erection, you should talk with your doctor first and foremost. If you are diagnosed with erectile dysfunction, your recommended treatment will depend on what is causing it. For instance, some men are able to reduce or eliminate impotency with simple lifestyle changes such as losing weight, drinking less, or quitting cigarettes. If another medication is causing the problem, your doctor may reduce your dosage or prescribe a different drug entirely.
Is ED a normal part of aging?
Simply put, no. While erectile dysfunction is indeed a common problem among men at some point in their lives, it is not something they should accept as a normal part of getting older.
It may be true that older men require more sexual stimulation during intercourse; however, men at any age should still be able to achieve an erection and enjoy sex.
Are medications like Viagra effective at treating ED? What are the side effects?
For many men who experience problems with erectile dysfunction, prescription drugs like Viagra (sildenafil citrate), Cialis (vardenafil) and Levitra (tadalafil) are the first place they turn to treat their symptoms. ED medications work by blocking an enzyme primarily found in the penis that breaks down erection-causing chemicals produced during sexual stimulation. By preventing these enzymes from working, Viagra and other impotence medications help arousals last longer and support erectile function. Generally speaking, these drugs work successfully for 65-70% of impotent men. Note: Viagra and most other ED medication does not effect erections in non-impotent men, only in those who have true medical issues due to erectile dysfunction. These are not aphrodisiacs (sexual stimulants) and require sexual stimuli in order to work.
ED medication like Viagra is linked to numerous side effects, including:
- Nasal congestion
- Visual disturbance (blurred vision, increased sensitivity to light, temporary green/blue color loss)
It is recommended that men with heart conditions who are taking nitrates such as nitroglycerine or isosorbide should avoid taking ED drugs. Always consult your doctor before taking Viagra, Levitra, Cialis or any other erectile dysfunction mediation.
What are penile implants?
For men who decide not to take ED drugs or those who don’t experience success from using these medications, other erectile dysfunction treatment options exist. One such option is getting a penile implant. There are two types implants available: semirigid and multi-component inflatable systems.
A semirigid (malleable) penile implant is a device that uses two cylinders inserted into the penis to provide enough rigidity for sexual penetration. These implants rarely break. A downside is the need for surgery to implant these devices and the damage to the body’s natural erectile mechanism when inserted.
Like the semirigid device, an inflatable prosthesis features two cylinders inserted into the penis. In addition, a pump is implanted in the scrotum to inflate the cylinders during sex and a reservoir is inserted within the cylinders or beneath the lower abdomen tissue. The inflatable penile implant typically functions for 7 to 10 years before a replacement may be needed.
While surgical placement of prosthesis devices in the penis should be considered a last resort after all other acceptable treatment options have been attempted, modern penile implant procedures have become a safe and effective form of treatment for ED.
Continue reading: Penile Implants: Overcoming Erectile Dysfunction Surgically
Is erectile dysfunction reversible?
A majority of the time, impotence is easily reversible. Since ED is not a natural side effect of aging, a skilled urologist can determine the underlying cause(s) and work with you to correct the physical or psychological factors preventing a suitable erection for sexual activity.
Other treatments for erectile dysfunction include:
- ED medication (Viagra, Cialis, Levitra)
- Vacuum device
- Counseling (for anxiety)
- Penile implants & penis pumps
Continue reading: The Full Range of ED Treatments
What if I am too embarrassed to talk about my problem?
If you suffer from erectile dysfunction, it’s understandable that you might feel embarrassed or uncomfortable with sharing such a private issue with others. However, it is very important that you talk to your doctor and partner about your problem.
Scheduling an appointment to talk about it with a urologist will begin the path to overcoming impotence and achieving sexual satisfaction once again.
Be prepared to answer any questions your doctor asks about your sex life, relationship, health habits, stress levels and other medications you may be taking.
Erectile Dysfunction: Glossary
Alprostadil: A type of medication known as a “vasodilator” which increases blood circulation by enlarging blood vessels.
Antibiotics: Any type of drug that attacks unnatural bacteria in the body in order to fight against infection.
Antidepressants: Medications prescribed by doctors to treat depression and its symptoms.
Anxiety: Overwhelming feelings of stress or apprehension.
Atherosclerosis: A thickening and hardening of the arteries, often caused by fat deposit buildup.
Avanafil: An erectile dysfunction drug used to increase blood flow to the penis.
Cavernosography: A procedure used to help doctors visualize a venous leak by injecting dye into the penis and running an X-ray.
Cialis: A pharmaceutical drug used to treat ED by increasing blood to the penis.
Clinical trial: An organized test of a new medical treatment, drug or device to determine its effectiveness and safety.
Corpora cavernosa: The two spongy changers located in the penis that fill up with blood to cause an erection.
Delayed ejaculation: When a man experiences a delayed ability to ejaculate during sexual intercourse or stimulation.
Depression: A chemical disorder resulting in feelings of chronic sadness, apathy, helplessness, hopelessness and thoughts of suicide.
Detumescence: The process in which blood flows out of an erect penis and it returns to being flaccid.
Diagnosis: The process by which a physician finds out what disease a patient is suffering from by examining their symptoms, their medical history, and their test results.
Duplex penis ultrasound: A test to determine penile blood flow by bouncing sound waves off tissue in the penis.
Dynamic infusion cavernosometry: A test to determine the seriousness of a vein leak by pumping fluid into the penis.
Ejaculation: The event that occurs at the end of an erection when sperm and other fluids are expelled from a man’s penis during sexual orgasm.
Erectile dysfunction (ED): The lack of ability to achieve or maintain a suitable erection for sexual satisfaction during intercourse.
Erection: When the penis is aroused and filled with blood, becoming rigid.
Glans: The tip, or head, of the penis.
Hematospermia: A condition in which a man experiences bloody ejaculation.
Impotence: see Erectile dysfunction
Intercavernous injection therapy: An erectile dysfunction medication that is directly injected into the penis.
Intraurethral therapy: An ED suppository medication that is directly inserted into the urethra.
Levitra: A pharmaceutical medication that treats impotence by increasing blood flow to the penis.
Libido: An individual’s sex drive, or desire for sexual activity.
Meatus: The small opening at the head of the penis where semen and urine are discharged.
MUSE: The brand name for alprostadil, an intraurethral penile suppository medication.
Nocturnal penile tumescence and rigidity testing: A test that monitors a man’s natural erections during sleep to determine whether erectile dysfunction causes are physical or psychological.
Orgasm: Climax caused by sexual activity or stimulation.
Penile biothesiometry: A test that determines penile sensitivity and nerve function by using electromagnetic vibrations.
Penile implant: An inflatable or malleable prosthesis placed in the penis through surgery, allowing a man to have an erection for sexual activity.
Penile injection: A type of erectile dysfunction medication that is injected directly into the penis.
Performance anxiety: A psychological condition wherein a man is unable to perform during sex due to anticipation of a problem.
Peyronie’s disease: A disease that occurs when hardened plaque or scar tissue forms on the corpora cavernosa and reduces flexibility of the penis, resulting in pain and causing the penis to bend uncomfortably during an erection.
Premature ejaculation: A condition in which a man ejaculates very quickly – often in a few minutes or even seconds – sooner than desired.
Priapism: A persistent and painful erection that lasts from several hours to multiple days.
Promescent: A type of medication that reduces sensitivity of the penis; used for treating premature ejaculation.
Prosthesis: A manmade reproduction of a natural body part.
Retrograde ejaculation: When a man’s ejaculate, upon orgasm, is forced back into the bladder and prostate.
Scrotum: A term for the sac of skin around the testicles.
Semen: The sperm-containing fluid that is ejaculated through the penis when a man achieves sexual orgasm.
Seminal vesicles: Pouches near the base of the bladder that produce a fluid made of sugar, enzymes and nutrients to allow the sperm to move freely. A majority of a man’s ejaculate contains seminal fluid.
Shaft (of the penis): Contains long, thin cylinders that are made up of spongy tissue which expand with blood to cause erections.
Sildenafil: see Viagra
Sperm: Male reproductive cells.
Stendra: see Avanafil
Suppository: A form of medication that is created to dissolve at body temperature and is deposited in a body cavity other than the mouth.
Tadalafil: see Cialis
Testicles: Located in the scrotum, the testicles are a part of the male reproductive system that manufacture sperm, testosterone and other male hormones.
Transurethral therapy: A type of erectile dysfunction treatment taken through the urethra.
Tunica albuginea: A tough, thick membrane protecting the corpora cavernosa and testicles.
Urethra: The tube in the penis that leads from the bladder to the meatus to discharge urine.
Urologist: A doctor who specializes in the diagnoses and treatment of conditions in men’s and women’s urinary system, as well as male sexual health.
Vacuum constriction device: A device designed to increase blood flow into the penis and cause an erection by creating a vacuum.
Vardenafil: see Levitra
Vas deferens: A long tube which transports mature sperm to the urethra right before an orgasm; the body part cut during a vasectomy as a form of birth control for men.
Vasoactive injection: A procedure that causes the blood vessels in the shaft of the penis to dilate through an injection.
Venous leak: A condition in which the veins in the penis are unable to prevent blood from flowing out of the penis during an erection, thus causing erectile dysfunction to occur.
Venous ligation: A surgical treatment intended to allow an adequate amount of blood into the penis for erection by tying, clipping or removing veins.
Erectile Dysfunction – Further Reading
- Questions & Answers about Erectile Dysfunction
- Medications & Devices in ED Treatments
- Treating Erectile Dysfunction with Penile Implant (Penile Prosthesis)
- Causes and Treatment for Male Impotence
- Coloplast Alpha One Penile Implant Surgery
- A Four-Minute Video Can Save Your (Sex) Life
- Erectile Dysfunction Overview
- Profile: A Man Who Chose A Penile Implant
- Overcoming Erectile Dysfunction Surgically
- Exercise and Men Sexual Health
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