While ED is not life threatening, the condition may result in withdrawal from sexual intimacy, reduced quality of life, decreased working productivity, and increased healthcare utilization. Patterns of care may shift away from surgical and device therapies provided by urologists and toward pharmacologic treatments and/or multidisciplinary approaches. With men increasingly seeking to preserve sexual function and quality of life as they age, the treatment of ED will take on even greater importance in the years to come.
“Porn-induced ED is not caused by a low libido or an organic problem in the blood vessels or nerves of the penis. Twenty percent under age 35 say they need to watch more and more, or more extreme porn to get the same level of arousal to get an erection. And in those who feel they need to watch more to get the same level of arousal to get an erection [they] also watch more and have a higher addiction score,” wrote De Win, who was assisted by Tim Jacobs, MD, also of the University of Antwerp. .
Alprostadil is an FDA-approved erectile dysfunction drug that can be injected directly into the penis to trigger an automatic erection. "Penile injection is the most effective type of ED treatment for men who can't take oral treatment," says Nelson Bennett, MD, a urologist at the Lahey Clinic in Burlington, Mass. In fact, it has an 85 percent success rate. Possible side effects include a burning sensation and priapism, an erection that lasts more than four hours and requires medical treatment.
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Conditions like vascular disease, surgery, diabetes, and medications are some of the top causes of erectile dysfunction. If you suffer from ED, schedule an evaluation with your doctor and get the help you need
Men with diabetes, radical prostatectomy, and other complicating factors may still benefit from treatment with a phosphodiesterase type-5 inhibitor such as Viagra. Patients who fail a trial of PDE5 inhibitor should be informed of the benefits and risks of other therapies. This of a different PDE5 inhibitor is unlikely to have a profound effect on sexual function and someone who fails a first drug trial, but should be considered in selected cases. Second-line therapies include intra-urethral suppositories, intra-cavernous drug injection, vacuum-constriction devices, and penile prosthesis. Medicated Urethral System for Erection (MUSE). MUSE is an intra-urethral suppository of alprostadil, of vaso-active drug that relaxes smooth muscle in the penis and induces penile erection. Although not as effective as intra-cavernosal penile injection, MUSE is a less invasive treatment option. An initial trial dose of intra-urethral alprostadil should be administered under healthcare provider supervision due to the risk of fainting. The cost of intra-urethral suppositories is high with respect to the overall success and therefore should be used judiciously.
Public enemy number two is alcohol. Yep, brewers droop is real. Alcohol interferes with your ability to achieve an erection and lessens your ability to ejaculate. But the effects last longer than the hangover. A study published in the New England Journal of Medicine revealed that “erectile failure” is significantly higher in men who drink more than 3 units of alcohol every day. And a separate study found that 61% of people dependent on alcohol suffered from sexual dysfunction, most commonly erectile problems or reduced sexual desire.
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Niacin, or vitamin B3, is a natural vasodilator that helps to improve blood flow. Taking 250 milligrams of niacin three times daily may help men with erectile dysfunction to achieve and maintain an erection. Plus, niacin is also known to help improve brain function, improve diabetes symptoms and lower the risk of cardiovascular disease — all health conditions that commonly contribute to erectile dysfunction.
Call your doctor right away if you take one of these medications and have a prolonged erection that lasts 4 hours or longer. This condition may cause permanent impotence if not treated.
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It is likely to improve ED management and benefit a large number of men, particularly in terms of recognising ED as a sentinel of vascular disease.
A separate study of men ages 25-45 examined the effect of taking both L-arginine and pycnogenol together for ED treatment. Pycnogenol is the name for certain chemicals taken from a French pine tree. Men were given L-arginine for one month; nothing happened in the study.
A complete medical, sexual, and drug history can provide clues as to the cause of ED and help in planning an effective treatment. Lifestyle changes, such as weight loss and avoidance of alcohol, nicotine, and recreational drugs, may be effective in reversing ED. There are several prescription medications (Viagra, Cialis, Levitra) that increase the ability to achieve an erection after sexual stimulation. There are also two forms of alprostadil, an injection (Caverject) and a urethral pellet (Muse), which will cause an automatic erection without sexual stimulation. A vacuum pump, penile implant, and surgery are options if other treatments are not effective.