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Monday, July 18, 2016


Impotence can be a concern outside of sex

Talking about sex, especially erectile dysfunction, can be embarrassing. However, doctors advise that engaging in clear communication about a problem like erectile dysfunction is the only means of effective treatment.

Erectile dysfunction, also known as impotence, is the inability to get and keep an erection. Erection trouble every so often is not a cause for concern. ED is characterized as an ongoing problem for a patient. ED does not just affect one’s sex life but can also affect confidence, contribute to depression and stress and cause riffs in a relationship.

ED can also be a concern outside of sex and mental/emotional health. It is sometimes a symptom for another health problem or a risk factor for another health problem, such as heart disease.

A good place to start talking about possible ED is with a family doctor/primary care provider. Most specialists require a referral from a PCP, anyway, and your PCP will have a strong knowledge of your medical history. Talk to your PCP if you have consistent trouble getting an erection, keeping an erection, and/or experiencing sexual desire. Other symptoms in addition to ED should also be noted, as they could be related.

There’s no one reason for ED to occur.

Male sexual desire comes from a variety of places, including the brain, hormones, emotions, nerves, muscles and blood vessels. ED can be linked to one or more than one of these areas. Both physical and psychological health can contribute to ED. Common physical causes of ED include heart disease, high blood pressure, high cholesterol, diabetes, obesity, alcoholism, tobacco use, certain prescription medications, sleep disorders (such as sleep apnea), prostate cancer/enlarged prostate treatments, and recent surgeries or injuries. Many of these physical causes are common for American men. Heart disease, for example, is the leading cause of death for men in America. According to the Centers for Disease Control and Prevention, in 2013 one in four men in the United States died from heart disease. It’s also key to understand relationships between these physical concerns. For example, if you’re obese, there’s a higher chance that you’ll have a disease such as heart disease, high blood pressure, high cholesterol or Type 2 diabetes. There’s also a higher chance that you’ll suffer from a sleep disorder like sleep apnea if you’re obese.

Psychological contributions to ED include depression, anxiety, stress and relationship problems. According to the Anxiety and Depression Association of America, anxiety disorders are the most common mental illness in the United States. According to the National Institute of Mental Health, about 18 percent of the population suffers from anxiety disorders.

Following a visit with your PCP, you may be referred to a urologist or an endocrinologist, depending on the root of your ED. Before visiting your doctor, be sure to ask what you need to do leading up to your appointment. For example, you may need to fast if you’re having blood work completed. Be sure to write down all symptoms you’re experiencing, not just ED, as symptoms can be related. Make a list of all medications and any key personal information that could be contributing. Are you experiencing more stress than usual at work? This could be a factor. Taking your partner to the appointment, if possible, can be helpful. Your doctor will more than likely only perform a physical exam and ask questions to diagnose and plan treatment for ED. Additional tests, such as blood tests, urine tests and an ultrasound, may also be necessary, depending on symptoms and cause of ED.

Treatment varies based on the cause and severity of ED. Oral medications are successful for many. The Mayo Clinic recommends taking time with these medications: “These medications might not fix your erectile dysfunction immediately. You might need to work with your doctor to find the right medication and dosage for you.” Before trying any over-the-counter or herbal treatments, be sure to talk with your doctor.

Other medications include self-injections, alprostadil intraurethral (Muse) therapy and testosterone replacement.

Medications are not effective or appropriate for every case. Other forms of treatment include penis pumps, penile implants and blood vessel surgery. Psychological counseling may be appropriate if ED is moreso related to a psychological problem.

Ways to help ED in addition to medication, surgery or therapy include lifestyle changes such as physical activity and weight loss. Quitting smoking and receiving treatment for alcohol or other substance abuse will also help. Marriage counseling or couple’s therapy may be helpful, too.

Because ED can be caused by a variety of factors, be open and honest with your doctor when discussing your symptoms. This will help you receive the best form of individualized treatment.


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