If you had to define erectile dysfunction, it can be described as ‘the inability to gain or maintain an erection during sexual performance’. Since erection, orgasm and ejaculation are three different neurological factors, many men find that orgasm is still possible even if the suffer from erectile issues like those caused by diabetes and ejaculation problems like those cause by prostate surgeries.
Several factors contribute in causing erectile dysfunction, be it psychological (neurological problem) or physiological (venous/blood flow problems).
Erectile difficulty can be a result of metabolic and endothelial risk factors that are found in Cardio-vascular diseases, obesity, hypercholesterolemia, diabetes and smoking etc. The young men can reduce their risk of getting erectile dysfunction by changing the above factors (i.e. stop smoking/losing weight/exercising).
How does erectile dysfunction happen?
The erection process is mostly dependent on the NO-cGMP pathway (i.e. nitric oxide cyclic guanoisne monophosphate). The two major sources of nitric oxide is from health endothelial lining and penile nerve endings which can be damaged by smoking, hypertension and hyperlipidmia etc. therefore men with such conditions have more risk of getting ED.
Such patients require high doses of PDE5 inhibitors such as Sildenafil Citrate or it’s variants like Generic Viagra, Tadafinil, Levitra, Cavarta etc, because PDE5 inhibitors are reliant on NO-cGMP triggered by arousal.
Men who are diagnosed with Parkinson disease, suffered brain injury, prostate/bladder/abdominal surgery have the risk of getting afflicted by neurological ED due to nerve damage.
What are the various ways ED can be treated by modern medicine?
Male reproductive organ rehabilitation
Penile rehabilitation is done to increase the erectile ability by use of device, drugs or in some cases both to protect and preserve the genital tissues and their function. After surgery (bladder/abdominal/prostate) the autonomic nerves that cause erection are often damaged and cause impotence. Therefore loss of oxygenation leads to loss of smooth muscle and increase in collagen within the corpora carvernosa.
Recovery post surgery erectile dysfunction can be mitigated through improved oxygenation with the use of vacuum erection device therapy/ use of PDE5 inhibitors and intracavernosal injections.
- PDE5 inhibitors
While using PDE5 inhibitor just post surgery may not take much effect, the drugs will be more effective as nerve re-growth start taking place (i.e. more than four years after surgery). PDE5 inhibitor such as Sildenafil Citrate is effective for daily use and is safe for some selective patients. Cost is a detrimental factor in using this method, cost-effective substitutes such as generic-Viagra, Suhagra, Kamagra etc are therefore become popular.
- Intracavernosal injections
Intracavernosal injections are used for maximizing erectile function by bypassing NO-cGMP process and relaxing the smooth penile muscles through cAMP pathway.
- Vacuum erection device therapy ( VEDT)
VEDT is a popular therapy for treating ED following surgical or radiation treatment for prostate cancer. As this therapy is not dependent on the condition of the nerves but rather than on vascular status, VED therapy is at least theoretically play a major role in prevention of venous occlusive dysfunction.