What is erectile dysfunction?
Erectile dysfunction is a persistent inability to attain and sustain an erection of sufficient rigidity and duration for satisfactory sexual intercourse. It is usually a subjective complaint.
It can lead to an unsatisfactory sex life, anxiety, low self-esteem, relationship problems and inability to have children.
What are the symptoms of erectile dysfunction?
Symptoms of erectile dysfunction include:
· Persistent inability to attain an erection
· Requiring a lot of stimulation to attain an erection
· Ability to attain an erection but persistent inability to maintain it during sexual intercourse
What causes erectile dysfunction?
Male sexual arousal is complex and involves many psychological and physical factors.
Psychological factors include reduced sexual desire, stress, relationship issues, anxiety, or depression. It can be normal to have occasional issues with erection in times of stress or low mood, but it should not be persistent.
Physical factors include:
· Cardiovascular conditions such as diabetes, high blood pressure, high cholesterol, heart disease, kidney disease, smoking, obesity, or lack of physical activity
· Neurological conditions such as stroke, spinal cord injury and Parkinson’s disease
· Endocrine conditions such as testosterone deficiency and thyroid problems
· Medications/Substances such as alcohol, narcotics, certain blood pressure medications, anti-depressants, anti-seizure medications, and chemotherapy drugs
· Penis/pelvic organ conditions such as Peyronie’s disease, penile fracture, and surgery or radiation to the pelvic region
How is erectile dysfunction investigated?
The doctor will take a history and examine you to diagnose the condition and elucidate possible causes.
If deemed necessary, some blood tests may be performed to check for conditions such as testosterone deficiency, diabetes, high cholesterol, thyroid issues, or kidney disease.
How is erectile dysfunction managed?
The most familiar treatment for erectile dysfunction would be medications to improve blood flow to the penis such as tadalafil (e.g. Cialis), sildenafil (e.g. Viagra) or vardenafil (e.g. Levitra).
However, treatment should be targeted at the underlying cause of the erectile dysfunction.
General lifestyle measures to adopt include regular exercise, avoiding tobacco and alcohol, having a healthy diet, getting sufficient rest, and managing stress.
If there are relationship issues or problems with intimacy, a psychologist, counsellor, or sex therapist might help.
Testosterone replacement therapy can be started for those who are deficient.
Adequate management of metabolic illnesses such as diabetes, high blood pressure and high cholesterol is important to enhance overall cardiovascular health and improve sexual function.
If the above measures are not sufficient to achieve optimal outcomes, a referral to a urologist can be made for consideration of other treatment modalities such as injections into the penis, vacuum constriction devices, penile implant surgery or vascular surgery.
How can we help at Oaklife Family Clinic?
At Oaklife Family Clinic, we are able to make the diagnosis of erectile dysfuction and investigate its causes. We are also able to advise on appropriate treatment options, including lifestyle measures and medications such as Cialis and Viagra.
We are able to manage underlying causes, such as testosterone deficiency, thyroid problems, diabetes, high blood pressure and high cholesterol. A referral to a urologist can also be arranged if necessary.
Written by Dr Lim Chong Soon Daniel on 19 January 2024.
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Disclaimer: this article is written for educational purposes and does not substitute for medical diagnosis and treatment.