Erectile dysfunction - your choices

Reference Summary
Impotence is a common condition. A man who The third tube-like structure is the "corpus is impotent is persistently unable to achieve or spongiosum," located between the two corpora maintain an erection for satisfactory sexual The urethra is the tube through which urine and About 30 million men in the U.S. have erectile semen exit the body. It does not play a role in dysfunction or ED. Erectile dysfunction is the When the penis is flaccid (or not erect), the Most men experience erectile dysfunction corpora cavernosa are not filled with blood. during their sexual life. Professional help is needed when erectile dysfunction becomes a Sexual stimulation, both physical and mental, causes the brain, nerves, blood vessels, and hormones to send orders to relax the muscles This reference summary will explain the causes and treatment options for erectile dysfunction. It also discusses the ED oral medications As the muscles around the corpora cavernosa relax, the corpora cavernosa fill up with blood. When the corpora cavernosa trap the blood, they expand and the penis becomes firm and This is a cross section of an erect penis. Three main tube-like structures can be seen. Two of these are long tubes known as "corpora After orgasm, the blood empties from the cavernosa," one on each side of the penis. corpora cavernosa through the veins of the penis. The penis becomes soft or flaccid. Testosterone is a sex hormone secreted by the testicles, and is important in regulating the frequency and magnitude of a penile erection. The younger the patient, the easier it is to achieve and keep an erection. Erectile dysfunction is more common among older men. However, erectile dysfunction is not an inevitable consequence of aging. About 1 in 4 men above the age of 65 are affected by erectile dysfunction. This document is a summary of what appears on screen in X-Plain. It is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. 1995-2005, The Patient Education Institute, Inc. [www.X-Plain.com] Symptoms and Their Causes
A man who has erectile dysfunction is persistently unable to achieve or maintain an erection for satisfactory sexual intercourse. Erectile dysfunction can be caused by many disorders. It can be caused by medications, psychological factors, or physical factors. Medications are a leading cause of erectile dysfunction. Some medications taken for depression or high blood. pressure could cause erectile dysfunction Physical impotence is caused by a disease, psychological. A man's failure to achieve an erection could have originated from his abuse of alcohol, cigarettes, or recreational drugs. If the man continues to fear not being able to have an erection, he may develop persistent psychological impotence. Stress and other psychological factors can cause erectile dysfunction. When erectile dysfunction is caused by psychological factors, • cholesterol deposits in the blood vessels, the male can achieve spontaneous erections when sleeping or early in the morning before going to the bathroom but cannot achieve an erection when making love. Marital or job stress, alcohol or drug abuse, Examples of injuries that can cause erectile performance anxiety, financial problems, and other factors can all play a role in starting, maintaining, or worsening erectile dysfunction. Examples of surgeries that can cause erectile dysfunction are: This document is a summary of what appears on screen in X-Plain. It is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. 1995-2005, The Patient Education Institute, Inc. [www.X-Plain.com] • surgical removal of the prostate gland, If erectile dysfunction is caused by psychological reasons, counseling or sex body to control body functions. The lack or excess of hormones could also cause erectile There are several other treatment options that your doctor can recommend. These include oral medications such as Viagra®, Levitra®, Diagnosis
and Cialis®. Other treatment options include Your doctor will evaluate your condition in order urethral suppositories, injections in the penis, to determine the specific cause of erectile dysfunction. He or she will prescribe the best treatment for you. Viagra, Levitra, and Cialis are oral medication cleared by the Food and Drug Administration The evaluation usually includes a medical (FDA), for treating erectile dysfunction. The history, a detailed sexual history, a physical usage of these drugs is explained in the next examination, and other basic tests. The doctor tries first to determine if the causes are psychological or physical. In one medical treatment option, the patient pushes a urethral suppository into the urethra If no erection can be achieved during sexual with a special applicator. The medication activity, special devices can be fixed on the dissolves in the urethra and is absorbed into the base of the penis at bedtime to monitor whether penis. After about 5 minutes, an erection is If that test shows that an erection has occurred, This treatment helps many men achieve an there is a good chance that the erectile dysfunction could be caused by psychological factors. Another treatment option for erectile dysfunction is the use of a vacuum pump and a tension ring. Treatment Options For Erectile Dysfunction
A plastic tube is placed over the penis and the The treatment of erectile dysfunction depends patient uses the pump to draw blood into the on the cause or causes. For instance, if the penis by removing air from the cylinder. In most erectile dysfunction is caused by medications patients, an erection is produced in one to two A rubber constriction ring is then placed at the If erectile dysfunction is caused by severe base of the penis to keep the blood in the penis clinical depression, antidepressant drugs may and maintain the erection. The vacuum tube is In very rare cases, erectile dysfunction is The ring should be taken off within 30 minutes or in case of pain, severe discoloration, or replacement therapy could help in these cases. cooling of the penis. Leaving the ring in place The use of pills or injections usually will restore This document is a summary of what appears on screen in X-Plain. It is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. 1995-2005, The Patient Education Institute, Inc. [www.X-Plain.com] longer than 30 minutes could cause damage to A malleable implant consists of two rods that are inserted into the corpora cavernosa of the penis. The rods may either be positioned up for Another treatment option for erectile dysfunction intercourse or down for everyday activities. is injections of special medications by the patient himself directly in the penis. This may This is a simple implant and is easy to use. It has few parts and is durable. However, the patient will always have a rigid penis. Through a small needle, a special medication that allows the blood to be trapped in the Another type of implant consists of self- corpora cavernosa may be injected directly in contained inflatable cylinders. To produce an the penis five to fifteen minutes before erection, the patient pumps the top of the intercourse. This usually gives an erection that cylinders to force fluid into the cylinders making can last up to one hour. The injection is given the penis stiffer. To make the penis soft again, This is a simple implant and is easy to use. Another type of implant is more complex mechanically. However, it allows the implant to be pumped into a more solid erection. It can then be deflated. Prior to intercourse, the patient inflates the device by squeezing the pump. The pump can be placed in the scrotum. This implant is slightly more complex to place If you and your doctor choose this option, you Viagra, Levitra, & Cialis
will be taught how to administer the injections A man achieves an erection when the muscles of the penis relax, allowing blood to flow and pool in the corpora cavernosa of the penis. If none of the previous treatments are helpful or practical, surgery may be recommended. Viagra, Levitra, and Cialis are medications that work by relaxing the smooth muscles of the The most common surgical alternative to help penis allowing the corpora cavernosa to fill with erectile dysfunction is to place an implant inside Viagra, Levitra, and Cialis vary in how they are taken, when they begin to work and how long recommended if the blood vessels of the penis their effect last. There are also differences in their side effects, which are explained in the There are several types of implants to choose next section. Your doctor will tell you when to from. These implants differ in the manner they are operated, how natural the erection feels, the Remember that for all of these 3 medications to possibility of mechanical malfunction. The work, sexual stimulation is necessary. These following is a brief description of some implants. medications do not cause an erection if there is This document is a summary of what appears on screen in X-Plain. It is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. 1995-2005, The Patient Education Institute, Inc. [www.X-Plain.com] no sexual stimulation. The sexual stimulation Side Effects
• All 3 medications may produce headache Most patients are satisfied with the improved quality of the erection and with the ability to maintain the erection for satisfactory sexual intercourse. These medications do not increase flushing, stuffy nose and upset stomach. the libido (sex drive) and do not affect the orgasm. • Viagra may produce diarrhea and a blue- History
Viagra was approved in 1998. Levitra and
Cialis were approved in 2003. The longer a medicine has been in use, the more we know Your doctor will discuss with you the dosage of about its side effects. In general, all 3 these medications as well as their side effects medications are effective in a majority of patients. The rate of improvement also depends on the cause of the erectile Contraindications
Viagra, Levitra, and Cialis may be very dangerous when taking with other medications. Dosage
Your physician will tell you what medications All 3 medications are available in different dosages. Your doctor may need to adjust your dosage level for the medication to work or to decrease the side effects. Viagra, Levitra and Cialis should not be taken with nitrate medications. They may increase the Viagra is better taken without food on an empty stomach. Levitra and Cialis can be taken with pressure in patients with hypertension and heart disease such as angina. The use of these medications with nitrates can Viagra works 30 to 60 minutes after it is taken. cause a lower than expected blood pressure. So does Levitra. Cialis works 30 minutes after This extra lowering of blood pressure could potentially be fatal and therefore contraindicates the use of Viagra, Levitra, and Cialis. The How Long They Last
patient and his physician should look for Viagra lasts up to 4 hours. Levitra lasts four another treatment option for erectile dysfunction hours too. Cialis on the other hand can last from 24 to 36 hours, which is why it is called "Le weekender". This is one of the major reasons that you should inform all of your doctors about the use of ED When we say "an erection may occur up to 4 medications prior to starting any new drugs. hours after taking the oral ED medication", it does NOT mean that the erection will last for 4 Patients who share their prescribed ED pills hours! It means it can occur any time within 4 with their friends may endanger the lives of their friends who may be taking medications that are not compatible with the pill they are given. This document is a summary of what appears on screen in X-Plain. It is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. 1995-2005, The Patient Education Institute, Inc. [www.X-Plain.com] The dosage of your ED medication may need to be adjusted when taken with other medications. Make sure to tell all of your doctors and pharmacists about all the medications you use. If you have had a heart attack, a stroke, a serious abnormal heart beat in the last six months; do not take Viagra, Levitra, or Cialis. Check with your doctor. If you have any side effect, you should let your doctor know. He or she may want to adjust your dosage. It also is very important to remember that Viagra, Levitra, and Cialis do NOT protect against sexually transmitted diseases such as AIDS. Viagra, Levitra and Cialis do NOT prevent conception or pregnancy. Erectile dysfunction is a common condition. Thanks to recent advances in medicine and pharmacology, there are many ways to treat it. Many men experience improvement in erectile function after taking Viagra, Levitra, or Cialis. Check with your doctor if Viagra, Levitra, or Cialis are acceptable for you. He or she will tell you what medications you can and cannot take with your prescription. Knowing about your ED treatment options, the benefits, and the risks and complications associated with these options will help you make a more informed choice. This document is a summary of what appears on screen in X-Plain. It is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. 1995-2005, The Patient Education Institute, Inc. [www.X-Plain.com]

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