By definition, erectile dysfunction is the inability to achieve or maintain an erection sufficient for satisfying sexual activity. Many men turn to over-the-counter supplements or pills that they obtain online because it can be an embarrassing topic of conversation, especially for a seemingly healthy younger man. But in many cases, erectile dysfunction can be a red flag for a much more serious problem occurring inside the body.
Erectile Dysfunction Causes
There are several common erectile dysfunction causes and there are a lot of medical conditions that are associated with ED. For example, a man who is a smoker, has high blood pressure, or is diabetic has a greater likelihood of having ED given his underlying medical conditions. These conditions don’t cause erectile dysfunction themselves, but they do have something in common - they all effect the health of a man’s blood vessels. When the blood vessels are effected in some manner, due to damage or a decrease in blood flow from cardiovascular disease, we call this vasculogenic erectile dysfunction. Vasculogenic ED is one of the most common causes for ED in men. Click here to read about the CIMT test that we recommend as part of a workup.
Other common causes of erectile dysfunction are psychologic, hormonal, drug-induced, or neurologic. The psychologic component of ED that is most commonly seen in our practice stems from either too much stress in a man’s life, which doesn’t allow the body to relax enough to achieve an erection; or if a man isn’t performing as he expects his body to, he begins to second guess his performance ability which generates an internal stress that further perpetuates a loss of the erection.
Hormone levels are also very important in assessing why a man has developed ED. Testosterone, in particular, is an important hormone for men’s sexual health and it plays a role in stimulating the tissue of the penis become erect. Low testosterone symptoms can also include a decrease in sexual desire, libido, and a long list of other issues, Click the link to read more about if you should get your levels checked. Some common medications that might be prescribed for diseases such as high blood pressure or heart failure, such as beta-blockers, can decrease the ability to achieve an erection. There are also neurologic causes for erectile dysfunction, such as direct injury to the genital region or the spine, like a disc avulsion with nerve compression, or radical prostatectomy.
Erectile Dysfunction as a Red Flag
If a man is diagnosed with erectile dysfunction, regardless or his age, it warrants more than just a pill to help improve his sex life. Think of the canary in the coal mine. The most important question that our clinic likes to answer for a man though, is “Why do you, as an individual, have ED?” Given that the most common erectile dysfunction cause is vasculogenic, ultrasound can be a very important assessment tool to determine if a man has underlying cardiovascular disease. I have remarked to a few gentlemen who came in for evaluation that, “Your penis probably saved your life,” given the extent of cardiovascular disease seen on ultrasound exam. It’s important to find the root cause of erectile dysfunction and treat that at the same time; otherwise, it can be like ‘putting a bandaid on a wound that needs stitches.”
Erectile Dysfunction Treatment
Oral medications are safe for most men and are widely used to treat ED but are not suitable for men who take nitrates for chest pain, have heart failure, or low blood pressure. There are other medications that can be directly injected into the base or side of the penis that can cause an erection. Testosterone replacement therapy may also be an effective treatment for men who have erectile dysfunction complicated by low testosterone. In more severe cases, penile implants can be surgically placed to literally pump up the penis. There is some recent medical research which shows that moderate or high intensity aerobic exercise can be helpful to improve erectile dysfunction. And for some men, psychological counseling may be necessary is there is an underlying issue, such as stress, anxiety, or depression which can be treated. One of the newest technologies to the market is something called focused shockwave therapy which has been shown in research studies to improve erection quality.
Focused Shockwave Therapy for Erectile Dysfunction
If a man is diagnosed with vasculogenic erectile dysfunction, he might be a candidate for an off-label treatment called low-intensity extracorporeal focused shockwave therapy. This novel technology is something that’s been around since the 1980 but in the last decade or so, it has been researched in the realm of improving blood flow the penis to improve erectile dysfunction. There are two commonly used devices on the market but only one has been shown to be effective for improving erection quality in the medical research. Click the link to read more about Focused Shockwave Therapy and what else is out there.