Medical History
Your doctor will ask general questions about your health, as well as specific questions about your erection problems and your relationship with your partner. Bring a list of all the medications you take, or bring them with you to show to your doctor. Tell your doctor about any surgery you have had.
Your doctor will ask about habits like alcohol use, smoking, and exercise.
Your doctor might ask you questions like
- How do you rate your confidence that you can get and keep an erection?
- When you have erections with sexual stimulation, how often are your erections hard enough for penetration?
- During sexual intercourse, how often are you able to maintain your erection after you have penetrated (entered) your partner?
- When you attempt sexual intercourse, how often is it satisfactory for you?
- How would you rate your level of sexual desire?
- How often are you able to reach climax and have an ejaculation?
- Do you have an erection when you wake up in the morning?
The answers to these questions will help your doctor understand the problem.
Physical Exam
A physical exam can help your doctor find the cause of your ED. As part of the exam, the doctor will examine your testes and penis, take your blood pressure, and check your reflexes. A blood sample will be taken to test for diabetes, cholesterol level, and other conditions that may be associated with ED.
Source: National Kidney and Urologic Diseases Information Clearinghouse
Working with other FDA components, the division’s Internet and Health Fraud Team led an Internet survey in which more than one-third of purchased “dietary supplements” claiming to spur sexual enhancement or treat ED contained undisclosed prescription drug ingredients or similar substances.
Six of the 17 products contained sildenafil (the active ingredient in Viagra) or a substance similar to either sildenafil or vardenafil. Vardenafil is the active ingredient in Levitra, another FDA-approved prescription drug that treats ED.
Mark Hirsch, a medical team Leader in CDER’s Division of Reproductive and Urologic Products, says this undisclosed presence of prescription drug ingredients—and similar compounds known as analogs of the drugs—can lead to serious side effects in users.
Source: FDA Consumer Health Information
Lifestyle changes—including exercising more, quitting smoking, losing weight, and cutting back on alcohol—may solve the problem. If you have made these changes and still have erection problems, your doctor can offer a number of other treatments. Treatment may include
- Counseling. Even though most cases of ED have a physical cause, counseling can help couples deal with the emotional effects.
- Oral medication. Your doctor may prescribe a pill to treat ED. Current brands include Viagra, Levitra, and Cialis. These drugs work by increasing blood flow to the penis. Do not take any of these drugs if you are taking nitrates, a type of heart medicine.
- Injection. Medicines injected into the shaft of the penis or inserted into the tip of the penis usually cause an erection within minutes.
- Vacuum device. A vacuum tube inserted over the penis can create an erection. As air is pumped out of the tube, the penis expands and blood flows into it. After the tube is removed, a specially designed rubber band is placed at the base of the penis to keep the blood from flowing out.
- Penile implant. If other options fail, a surgeon can implant a device into the penis that inflates or can be straightened to create an erection.
Source: National Kidney and Urologic Diseases
Men looking online for “dietary supplements” to treat erectile dysfunction (ED) or enhance their sexual performance should beware: these products may contain prescription drugs or other undisclosed ingredients that can be harmful.
“The number of these problematic products available on the Internet appears to be increasing,” says Michael Levy, director of the Food and Drug Administration’s (FDA) Division of New Drugs and Labeling Compliance. The division is part of the Office of Compliance (OOC) in the agency’s Center for Drug Evaluation and Research (CDER).
Many consumers perceive these products as completely safe because they are often sold with labeling, suggesting that they are all-natural alternatives to prescription drug products that have been approved by FDA for treating ED.
But these products may be laced with potentially hazardous ingredients that aren’t noted on the label.
Since 2004, FDA has become aware of several such “dietary supplements”
Source: FDA Consumer Health Information
Talking about ED can be difficult. You might use a phrase like “I’ve been having problems in the bedroom” or “I’ve been having erection problems.” Remember that a healthy sex life is part of a healthy life. Don’t feel embarrassed about seeking help. ED is a medical problem, and your doctor treats medical problems every day.
If the interaction with your doctor doesn’t put you at ease, ask for a referral to another doctor. Your doctor may send you to a urologist-a doctor who specializes in sexual and urologic problems.
Your partner may want to come with you to see the doctor. Many doctors say ED is easier to treat when both partners are involved.
To find the cause of your ED, your doctor will take a complete medical history and do a physical examination.
Source: National Kidney and Urologic Diseases Information Clearinghouse
Many different conditions can lead to ED. Most of the causes of ED are health problems requiring treatment to help prevent more serious complications than ED:
- High blood pressure and high cholesterol can injure the arteries that supply blood to the penis.
- Diabetes injures blood vessels and the nerves that control erections.
- Alcohol and drug abuse can cause ED by damaging blood vessels and deadening the nerves that control erections.
- Some prescription drugs such as some antidepressants or some high blood pressure medicines can cause ED. Your doctor may be able to change your drug treatment. Never stop taking a prescribed drug without talking to your doctor.
- Unhealthy habits like smoking, overeating, and avoiding exercise can also contribute to ED.
- Anything that’s bad for your heart is also bad for your sexual health.
- An injury to the spinal cord can cause ED by interfering with nerve signals.
- Treatments for prostate cancer, including radiation and prostate removal, can damage the nerves that control erections.
- Diseases that affect the nerves, like multiple sclerosis, can also lead to erection problems.
- A small number of ED cases result from a reduced level of the male hormone testosterone.
- Doctors used to believe that most cases of ED resulted from mental or emotional problems. We now know that most ED has a physical cause. But depression and worry or anxiety can still cause ED. And ED from physical causes can lead to depression and worry, making physical ED worse.
- A person should not assume that ED is part of the normal process of aging. There is quite likely an underlying cause.
Source: National Kidney and Urologic Diseases Information Clearinghouse
Points to Remember about Erectile Dysfunction
- Erectile dysfunction (ED) is the repeated inability to get or keep an erection firm enough for sexual intercourse.
- ED affects 15 to 30 million American men.
- ED usually has a physical cause.
- ED is treatable at all ages.
- Treatments include psychotherapy, drug therapy, vacuum devices, and surgery.
Hormones, blood vessels, nerves, and muscles must all work together to make an erection. Your brain starts an erection by sending nerve signals to the penis when it senses sexual stimulation. Touching may cause this arousal. Another trigger may be something you see or hear. It may be a sexual thought or dream.
Your brain starts an erection by sending nerve signals to the penis.
The nerve signals cause the muscles within the penis to relax and let blood flow into the spongy tissue within the penis. Blood collects in this tissue like water filling a sponge. The penis becomes larger and firmer, like an inflated balloon. The veins then get shut off to keep blood from flowing out.
After climax, or after the sexual arousal has passed, the veins open back up and blood flows back into the body.
Healthy blood vessels are needed for an erection.
Source: National Kidney and Urologic Diseases Information Clearinghouse
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