Care for these patients, who in many cases are emotional, demanding, and time consuming, may evoke feelings of frustration and anticipatory anxiety in the time-strapped urologist. Early in the encounter, the urologist must understand the patient’s psychosocial environment and establish a rapport and meaningful alliance with the patient and his family, if present (13). It is important to ensure that the doctor-patient interaction is informative and task oriented for greater patient buy-in and compliance with treatment (13,14). Affirm to the patient that regardless of the short time allotted for the visit that the doctor-patient relationship will endure even after the visit. This may be accomplished through a scheduled follow-up telephone call, electronic message, follow-up clinic visit, or a written letter. It may also be beneficial to refer the patient to a sex therapist or counselor though many young men will reject the idea that there is a psychosocial element to their ED and may refuse to consider therapy.
Cigarette smoking is a risk factor for ED, according to the 2014 Report of the U.S. Surgeon General. Excess weight can also contribute to erectile dysfunction. A 2004 Italian study found that one-third of their 110 obese study subjects were able to eliminate their erectile dysfunction problems by losing fifteen percent of their weight through diet and exercise.
Erectile dysfunction is when a man either can’t have an erection or can’t keep an erection long enough to have sex. For only 20% of men with ED, the cause is due to a psychological problem or disorder.2 When the cause of your ED is due to a physical condition, your ED is not a reflection on you or your sexual partner, since lack of arousal isn’t the problem.
"We used to think that ED in young men was 90 percent psychological, but we now know that most cases are caused by a combination of risk factors. Erectile function depends on hormones, blood supply, nerve function, and psychological health,” said Run Wang, MD, professor of urology at The University of Texas Health Science Center in Houston and director of sexual medicine at MD Anderson Cancer Center.
Erectile dysfunction (ED) generally affects men older than 65, but younger men can get it too. If it happens at a younger age, ED may be a warning sign of another health issue. If you have no obvious risk factors and no other health problems, like diabetes, your doctor will run laboratory tests and may order heart tests. The same process that affects the arteries in the penis affects the ones in your heart, too. If something is wrong and it is not diagnosed and treated, you have a fairly high risk over the next four to five years of having some type of cardiac event.
Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 9 Jan 2019), Cerner Multum™ (updated 14 Jan 2019), Wolters Kluwer™ (updated 7 Jan 2019) and others. Refer to our editorial policy for content sources and attributions.
Tadalafil (Cialis) is the third oral medicine approved by the U.S. FDA for the treatment of erectile dysfunction. Like sildenafil (Viagra) and vardenafil (Levitra), tadalafil inhibits PDE5 (as described earlier). Unlike the other PDE 5 inhibitors, patients should take tadalafil once daily and is approved for the treatment of BPH (benign enlargement of the prostate).
If the patient complains of loss of sensation on his penile shaft or glans, it is useful to perform hot and cold perception testing and/or additional vibratory sensory testing with biothesiometer. These are tests that can be performed quickly during the office visit and provide useful information about the function of the dorsal nerve of the penis (Table 3).
The symptoms of erectile dysfunction include difficulty achieving an erection, trouble maintaining an erection, and a reduced interest in sex. Because male sexual arousal is a fairly complex process, it can sometimes be difficult to identify a specific cause. Arousal starts in the brain but it also involves the nerves, muscles, and blood vessels and can be impacted by hormones and emotions. If a problem develops with any of these things, erectile dysfunction could be the consequence.
ED is easily and successfully treated! If your sex drive is unaffected, but you experience problems achieving or sustaining erection for a period of four to five weeks, you may have ED. Talk to your doctor immediately. Don’t delay—erectile dysfunction doesn’t “just go away!” Additionally, ED could be a sign of a serious, even life-threatening complication, such as congestive heart failure or kidney disease. Ignoring your ED because it’s embarrassing could jeopardize your health.