For many people, to diagnose erectile dysfunction and prescribe a cure, a physical examination and answering questions (medical history) are all that a doctor needs. If you have chronic health conditions or your doctor believes that there may be an underlying condition, you may need more testing or a specialist consultation.
Testing of the underlying conditions may include:
Physical test. This may include scrutinizing your penis and testicles closely and testing sensation for your nerves.
Blood tests. A blood sample may be sent to a laboratory to check for signs of heart disease, diabetes, low levels of testosterone, and other conditions of health.
Urine tests (urinalysis). Urine tests are used to scan for symptoms of diabetes and other underlying health issues including blood tests.
Ultrasound. The examination is usually carried out in a laboratory by a professional. This requires the use of a wand-like tool (transducer) in the blood vessels supplying the penis. This generates a video image that will allow your doctor to see if you have issues with blood flow.
This procedure is sometimes performed to increase blood flow and create an erection in conjunction with an injection of medicine into the penis.
Psychological exam. Your doctor can ask questions for depression screening and other possible causes of erectile dysfunction psychologically.
The first thing the doctor will do is to guarantee that you get the right treatment for any problems of health that might exacerbate or worsen your erectile dysfunction.
You might have different treatment options depending on the cause and severity of your erectile dysfunction and any underlying health conditions. Your doctor can explain each treatment’s risks and benefits and will take your preferences into consideration. The interests of your partner may also play a role in your care choices.
Oral medications are a successful treatment for many people with erectile dysfunction. We include:
These four drugs improve the effects of nitric oxide— a natural chemical that your body produces to relax your penis muscles. In response to sexual stimulation, this increases blood flow and helps you to get an erection.
Using one of these tablets will not create an erection immediately. Next, sexual stimulation is needed to allow the penile nerves to release nitric oxide. Such drugs intensify the signal, allowing certain men to work normally. Oral erectile dysfunction drugs aren’t aphrodisiacs, aren’t going to cause excitement and aren’t needed in men getting normal erections.
The dosage of the drugs varies, how long they operate, and the side effects. Possible side effects include flushing, inflammation of the nose, vomiting, visual changes, back pain and upset stomach.
Your doctor will consider your particular situation in order to decide which prescription can work best. These medicines may not immediately treat your erectile dysfunction. You may need to consult with your doctor to find the right dosage and prescription for you.
Get your doctor’s OK before taking any erectile dysfunction medication, including over – the-counter supplements and herbal remedies. Erectile dysfunction drugs do not operate in all people and may be less effective under certain circumstances, such as after prostate surgery or diabetes. Additionally, certain drugs could be harmful if you:
- Take nitrate medications — commonly prescribed for chest pain (angina) — including nitroglycerin (Minitran, Nitro-Dur, Nitrostat, etc.), mononitrate isosorbide (Monoket) and dinitrate isosorbide (Dilatrate-SR, Isordil).
- Have heart disease or failure of the heart.
- Blood pressure is very low (hypotension)
Other medications for erectile dysfunction include:
Alprostadil self-injection. Use this procedure to inject alprostadil (Caverject Impulse, Edex) into the base or side of your penis using a fine needle. In some situations, drugs that are commonly used for other conditions are used either alone or in combination for penile injections. There are examples of papaverine, alprostadil and phentolamine. Such combination drugs are often referred to as bimix (including two medicines) or trimix (including three).
Each injection is administered to produce an erection that will last no more than an hour. Because the needle is very small, there is usually minor discomfort from the injection site.
Side effects may include moderate injection bleeding, prolonged erection (priapism) and, occasionally, injection site formation of fibrous tissue.
Alprostadil urethral suppository. Alprostadil intraurethral (Muse) therapy involves placing a small suppository of alprostadil in your penis in the urethra of the penis. When inject the suppository into your penile urethra, you use a special applicator.
Usually the erection begins within 10 minutes and lasts between 30 and 60 minutes if it is effective. Side effects may include discomfort, mild urethra bleeding, and fibrous tissue formation within your penis.
Testosterone replacement. Some men have erectile dysfunction that may be complicated by low testosterone hormone levels. In this case, as a first step or in combination with other therapies, testosterone replacement therapy may be recommended.
Penis pumps, surgery and implants
If in your case, medications are not effective or necessary, your doctor can prescribe a different treatment. Other treatments are as follows:
Penis pumps. A penis pump is a hollow tube with a hand-powered or battery-powered pump. The tube is placed on top of your penis and the pump is then used to draw the air inside the tube. This creates a vacuum that pulls your penis with blood.
You place a stress ring around the base of your penis once you get an erection to secure it in the blood and keep it tight. Then the vacuum tool is disabled.
Usually the erection lasts long enough to have sex for a couple. After the intercourse, you remove the tension ring. Penis swelling is a possible side effect, and the band will limit the ejaculation. You can feel cold to the touch of your penis.
Your doctor may suggest or prescribe a specific model if a penis pump is a good treatment option for you. That way, you can be confident a reliable supplier can make it appropriate for your needs.
Penile implants.This treatment involves inserting electrodes on both sides of the penis surgically. Such implants are either swollen or malevolent (bendable) plates. You can monitor when and how long you have an erection with inflatable devices. The malleable rods remain firm but bendable in your penis.
Until other approaches have been tested first, penile implants are typically not recommended. Implants have a high level of satisfaction among people who have tried more traditional therapies and have failed. There is a risk of complications, such as infection, as with any surgery.
Recent studies have found that exercise can improve erectile dysfunction, particularly moderate to vigorous aerobic activity. Nevertheless, in some men, including those with known heart disease or other major medical conditions, benefits may be less.
Even less strenuous, regular exercise might reduce the risk of erectile dysfunction. Increasing your level of activity might also further reduce your risk.
Discuss an exercise plan with your doctor.
If your erectile dysfunction is triggered by stress, anxiety, or depression — or the disorder creates stress and tension in your relationship — your doctor may recommend that you or your wife see a psychologist or counselor.
Check with your doctor to make sure it’s safe for you before you use any supplements— particularly if you have chronic health conditions. Many alternative products may be harmful, claiming to work for erectile dysfunction.
The Food and Drug Administration (FDA) issued warnings on several “herbal viagra” forms because they contain potentially harmful drugs that are not specified on the label. The dosages may also be unclear, or during the preparation they may have been contaminated.
Some of these drugs can interfere with prescription medicines and cause blood pressure to be dangerously low. Such goods are especially dangerous to men taking nitrates.
Lifestyle and home remedies
For many people, lifestyle choices are causing or worsening erectile dysfunction. Here are a few steps that could help:
If you’re smoking, quit. If you find it difficult to leave, get support. Try replacing cigarettes, such as over-the-counter gum or lozenges, or ask your doctor about a prescription drug that can help you stop.
Lose excess pounds. Overweight can cause erectile dysfunction — or deteriorate—.
Include in your daily routine physical activity. Exercise can help with underlying conditions that play a role in a number of ways in erectile dysfunction, including stress reduction, weight loss, and increased blood flow.
Get treatment for problems with alcohol or drugs Too much alcohol or taking other illegal drugs can directly exacerbate erectile dysfunction or cause long-term health problems.
Work through relationship issues. Try therapy for couples if you have trouble communicating with your partner or operating on your own through problems.