Erectile dysfunction is the inability to get and keep an erection that stays firm enough for sex. In a study of 729 men aged 30 and above in Singapore, 51.3% of respondents (374) reported some degree of erectile dysfunction. This indicates that ED is prevalent among Singaporean men. But this problem Isn’t particular to just Singapore. Even in the U.S ., erectile dysfunction affects 30 million men. In fact, ED tops the chart of the most common sex problem reported by men.
ED happens when
- There is limited or no blood flow in the penis.
- Nerves are damaged.
- One is affected by stress or other psychological issues.
- There is an underlying health problem. In this instance, ED can be an early sign of a more serious illness like heart disease, diabetes, or high blood pressure.
The first step to getting the best treatment for ED is to know the root cause of the problem.
A correct diagnosis goes a long way to treating any ED problems effectively and helps your overall health. More importantly, it helps with the early identification of what could be a fatal problem, thus preventing avoidable deaths.
Generally speaking, your heart health and sexual health go hand-in-hand. What’s good for your heart is ultimately good for your sexual health.
How do you know you have ED?
As with every other thing we do, the erection begins in the brain. Something we see, smell, feel, hear, think or read about triggers your nerves to send messages to the blood vessels in your penis. The muscles of the erectile tissues relax to allow blood flow in, filling the empty spaces.
The pressure that comes from the flowing blood expands the penis, making it hard and erect.
When the blood flow stops, blood leaves the erectile tissue, the spaces collapse, and the tissue condenses. This turn of events leads to a flaccid or soft penis. In this state, the arteries are relaxed and contracted. Blood flow has lowered to its usual rate and volume.
Someone suffering from ED may have a disconnect somewhere going through the process of getting an erection. The following may have occurred.
- There may not be a stimulus from the brain
- The nerves to the penis may not function well
- The blood flow to the penis may be insufficient
You know you have ED when you experience these things.
- Reduced or lack of sex drive
- Soft erections/trouble getting an erection
- Trouble maintaining an erection
Other related issues include,
- Anxiety
- Low self-esteem
- Depression
- Premature ejaculation
Causes of ED
There are two causes of ED: physical and psychological causes.
Physical
Some physical causes of ED include:
Diabetes: damages the nerve and artery that are responsible for achieving an erection. About 50% of men with diabetes experience ED.
Vascular disease: atherosclerosis (clogged blood vessels), high blood pressure, and high cholesterol are diseases that restrict blood flow to the penis. Vascular disease is responsible for physical-related causes of ED 70% of the time.
Kidney disease: Kidney diseases can affect sexual health because of the way it alters hormones, nerve functions, blood circulation, and energy levels. Chemical changes caused by kidney disease can reduce sex drive and stamina.
Neurological diseases: The nervous system and brain play a major role in achieving and maintaining an erection. Stroke and Parkinson’s disease are examples of ailments that affect the nervous system interrupting the transmission of nerve messages from the brain to the penis.
Medications and treatments: Some cancer treatments can lead to erectile problems. Likewise, some prescription medications can cause ED.
Certain Surgeries or injuries that affect the pelvic area or spinal cord, low testosterone, sleep disorder, and tobacco use can also cause ED.
Emotional and psychological causes of ED include
- Depression
- Anxiety
- Stress at home or work that may include money issues and marital troubles
- Overly worrying about sex performance after experiencing it a few times
- Fear of intimacy
Treatment options for ED
Your doctor will first evaluate you for any underlying physical and psychological conditions, which will help guide treatment. Diagnosis techniques range from physical examination to lab tests (scan, blood tests, and X-rays). Your doctor might refer you to a specialist like a urologist or sex therapist. Your health professional will also ask you about your health history, lifestyle, questions around stress and your emotional state, and other Ed-related questions. Try not to feel embarrassed talking about your ED experience with them. Also, be honest with your answers, as this can lead to diagnosing you appropriately. The following treatments may be prescribed after diagnosis.
Oral pills
These ED medications are also known as phosphodiesterase type-5 inhibitors and work to increase blood flow to the penis. Examples include Viagra, Levitra, Cialis, and Stendra. These pills are best utilized when taken about an hour or two before having sex. Always consult with your health care provider before using any of these PDE5 inhibitors. Ofnoah.com is one of the leading viagra sellers in Singapore. They have a policy that “ED doesn’t discriminate, and neither do we. We also know you value privacy, so we’ve made everything discreet, from login to delivery.”
The most common side effects are mild and do not last for long. Some common side effects are:
- Nasal congestion
- Headache
- flushed skin
- Muscle aches
- Indigestion
Testosterone Therapy
Low testosterone may not always be the cause of ED. But in cases where testosterone drops and affects the libido by lowering sex drive, testosterone therapy may be administered to fix erection problems. Sometimes this therapy is given in addition to ED pills.
Penile Injections/self-injection (Alprostadil)
Alprostadil is a good option if you have erectile dysfunction (ED). Doctors prescribe this when oral pills do not work. It boosts blood flow in the body and into the penis by expanding blood vessels. It is done by inserting a needle into your penis and injecting the medicine. This method helps your penis become firm and maintains the erection as long as sex lasts. Since it is to be administered by you, you’ll receive self-injection lessons from the doctor to guide you. If possible, give yourself the first shot in the presence of your doctor before trying to do it on your own.
Alprostadil can also be used as a suppository by placing it into the tiny hole at the tip (the urethra) of the penis. This method is called Intraurethral (IU) Therapy. A common side effect of IU therapy includes a burning sensation in the penis. It is not as effective as the injection and produces an erection in 30%-40% of men with ED.
Vacuum constriction Devices
A penis pump is a plastic tube with an attached pump that helps a man get an erection plus a band or ring that helps him maintain the erection. ED resulting from anxiety is mostly treated in this manner. People with poor insufficient blood flow to the penis, excess blood flow out of the penis or damaged nerves can be treated with this method.
It is used by sliding your penis into the pump and sealing the pump with your groin’s skin. Next, you manually pump the air out of the cylinder (or pump using a battery). This creates space in the muscles, allowing blood flow and causing the penis to engorge and stay erect. After achieving an erection, remove the pump but leave the band at the base of the penis as it blocks the blood from draining. That way, you can maintain an erection until sex is over (it can last for up to 30 minutes). You may need to apply a water-based lubricant on your penis before using a penis pump to avoid irritation. Lubricants will also help to create an airtight seal and aid the penis’ entry.
Penile Implants
Penile implants are devices placed inside the penis to allow men with erectile dysfunction (ED) to get an erection. There are two types that both involve surgery – semi-rigid and inflatable. A penile implant is usually a last resort when other methods do not work.
Semi-rigid: silicone rods are implanted in the penis. These rods are always firm. To get an erection, bend the penis away from the body.
Inflatable: (can be inflated and deflated)
Inflatable cylinders are placed in the penis. These cylinders are linked to a valve and a fluid reservoir that is placed inside the scrotum. To get an erection, you need to pump fluids from the reservoir, using the valve, into the cylinders in the penis. A penile implant does not change anything about your sexual feelings and feels natural. Side effects could include infection and implant problems.
Exercises
Since cardiovascular health helps your sexual health, good doses of exercise will improve your heart health and sexual performance. Pelvic floor exercises, anaerobic exercise, and aerobic exercises can improve sexual health. Kegels, weight lifting, and swimming fall under these various categories. Exercises can help with the following, which impacts sexual performance in a good way.
- Reduces high blood pressure
- Improves testosterone level
- Lowers risk of obesity
- Regulates blood sugar
- Improves stamina
Psychotherapy
Sex therapy can also help with ED. It involves working with a therapist to help you change your sexual behavior. Your therapist will recommend gradual steps you can take to help make your sex life better. It works to treat emotional causes of ED like performance anxiety or other emotion-related problems that lead to discontinuing medical treatments.
Your choice of treatment will always depend on what may have caused ED. Your doctor is always the best person to advise what treatment(s) is/are best for you. However, it’s equally okay to be aware of what these various treatments involve, as this will help you decide which one to accept. Don’t hesitate to ask all the questions to clear your doubts about any treatment recommended to you.
