Erectile dysfunction or impotence is an inability of a man to develop or maintain an erection of the penis that is sufficient enough to pursue sexual activity. This condition has different causes. Hence, it is important to note that treatment options are usually based on the underlying causes of impotence.
Common Treatments for Erectile Dysfunction
1. Psychological Intervention
Some cases of erectile dysfunction are due to underlying psychological causes such as stress, anxiety, and depression, as well as a feeling of guilt, low self-esteem, and indifference. These cases are collectively called psychological impotence.
The common workaround is to seek help from a licensed psychologist, especially if the underlying cause is due to stress, anxiety, or depression. Experts specializing in sex therapy and couple counseling can provide more specific intervention, particularly if impotence is due to lack of confidence or relationship problems.
2. Medication Using PDE5 Inhibitor
A class of drugs called PDE5 inhibitors which include sildenafil or Viagra, vardenafil or Levitra, and tadalafil or Cialis are prescribed when the cause of erectile dysfunction is organic, such as in the case of diabetes mellitus or cardiovascular problems that restrict blood flow in the penis. These drugs work by blocking the degenerative action of cGMP-specific phosphodiesterase type 5 or PDE5 in the smooth muscle cells lining the blood vessels supplying the corpus cavernosum of the penis.
Nonetheless, these PEDE5 inhibitors treat erectile dysfunction by relaxing the muscles and boosting blood flow in the penis, thus making erection easier to maintain. Men with previous episodes of heart attack, stroke, or irregular heart rate within the past six months should consult first with a doctor.
3. Medication Using Alprostadil
Prostaglandin E1 or alprostadil is a naturally occurring prostaglandin that is also prescribed and used to treat erectile dysfunction. It works by expanding the blood vessels and boosting the blood flow throughout the body, including the penis. When used as a treatment for erectile dysfunction, it is administered through direct injection into the penis or as a suppository inserted into the opening tip of the penis.
Take note that alprostadil is a prescription drug and improper use can permanently damage the penis. Side effects include bleeding at the site of injection and prolonged erection. It is also important to tell a doctor first about any history or existing cases of penile infection, penile curvature or any other defect, painful erection or priapism, Peyronie’s disease, and conditions that cause blood to thicken, among others.
4. Vacuum Constriction Device
A vacuum constriction device, otherwise known as vacuum erection device or penis pump, is an external pump that creates negative pressure to draw blood into the penis and cause it to expand. These devices are relatively safe and are used to treat erectile dysfunction due to reduced blood flow to the penis, diabetes, side effects of surgery for prostate or colon cancer, and psychological causes.
However, there are devices or pumps in the market that are not medically approved. Most of these pumps are used for penis enlargement. Because some of them do not have a limit on maximum pressure, they can reach dangerous pressure levels while in use, thus potentially damaging penis tissue.
5. Penile Prosthesis or Implants
Psychological interventions, medication, and pumps are first-line treatments for erectile dysfunction. However, if all of these fail, one of the two last resort options is the use of penile prosthesis or implants. This option involves a procedure in which devices that are either malleable or inflatable are inserted into the penis.
The procedure is considerably simple. It is an outpatient procedure that only takes about an hour. However, the patient cannot engage in sexual intercourse within six weeks after the operation. The most common type of penile prosthesis is a hydraulic, inflatable prosthesis that allows control over the erection, thus making it more natural than prosthesis based on malleable rods.
6. Vascular Reconstructive Surgery
Another last resort for treating erectile dysfunction is vascular reconstructive surgery. This procedure generally involves bypassing blocked arteries to improve the flow of blood to the penis. To be specific, the procedure involves taking an artery from a muscle in the abdomen and transferring it in the penis to create a new path for blood to flow.
Because of its difficulty and cost, doctors rarely recommend this surgery. In addition, vascular reconstructive surgery is not an absolute treatment for erectile dysfunction because of its low success rate and the fact that it does not seem to work well over time.