Erectile Dysfunction
Can erectile dysfunction be cured? All the information about the causes, symptoms, and treatments for erection problems.
Symptoms and Causes
Erectile dysfunction, commonly known as impotence, occurs when an erection firm enough for complete penetration and sexual satisfaction cannot be achieved. It is only a concern when it happens continuously over time.
The causes of impotence can be physical, psychological, or the result of another pathology. Treatments must consider the origin of erectile dysfunction in order to cure it.
Depending on its characteristics, erectile dysfunction is classified into three types:
- Impotence coeundi: Also known as sexual impotence, where an erection is weak and prevents intercourse.
- Impotence erigerandi: An erection does not occur.
- Impotence generandi: This is actually male infertility since penetration is still possible.
As a consequence of erectile dysfunction, men may experience stress, depression, lack of self-confidence, or relationship problems.
Symptoms
The most common symptoms of impotence include:
- Difficulty achieving an erection.
- Weak or incomplete erections.
- Easily losing the erection, for example, when changing positions.
- Reaching orgasm faster than usual or when the erection is not yet complete.
- Decrease in the frequency of spontaneous morning erections.
Causes
There are many causes of erectile dysfunction since it can originate from any of the systems involved in erection: endocrine, nervous, muscular, vascular, cerebral, or emotional.
Physical factors influencing impotence can include:
- Vascular: High cholesterol, smoking, obesity, excessive alcohol and drug use, or heart disease. Additionally, surgeries for prostate cancer or other pelvic surgeries can also be significant causes of erectile dysfunction.
- Neurological: Parkinson’s disease, multiple sclerosis, strokes, tumors, spinal cord injuries, etc.
- Hormonal: Low testosterone (hypogonadism), increased prolactin, thyroid-related diseases, etc.
- Anatomical or structural: Penile curvature (Peyronie’s disease), micropenis, traumatic penile injury, etc.
Some psychological factors that cause erectile dysfunction include:
- Stress.
- Depression.
- Relationship problems.
- Fear of failure (performance anxiety).
Risk Factors
The main factors that increase the risk of impotence are:
- Age, as the likelihood increases over the years.
- Having any of the previously described physical or psychological conditions.
- Certain surgical, pharmacological, or radiotherapy treatments.
Complications
Erectile dysfunction often causes self-esteem issues, anxiety, stress, difficulty maintaining relationships, sexual dissatisfaction, and infertility.
Prevention
Although erectile dysfunction is sometimes unavoidable, it is advisable to:
- Maintain a healthy diet.
- Avoid harmful substances such as tobacco, alcohol, and drugs.
- Control conditions like diabetes, stress, or anxiety.
- Exercise regularly.
Which Doctor Treats Erectile Dysfunction?
Urologists are the specialists who diagnose and treat erectile dysfunction. Additionally, psychologists, smoking cessation specialists, cardiologists, neurologists, and endocrinologists may intervene to address underlying conditions.
Diagnosis
To diagnose impotence, specialists study the patient’s medical history, listen to the symptoms, and perform a physical examination. When determining the underlying condition causing erectile dysfunction, additional tests may be conducted, including:
- Blood and urine tests to assess overall health and detect high cholesterol, diabetes, heart disease, or hormonal imbalances (low testosterone levels or high prolactin).
- Penile ultrasound to observe its condition, especially to check for blood flow problems.
- Psychological evaluation to assess relationship status, family and work factors, socioeconomic status, and more.
- Neurophysiological studies in some cases to investigate a possible neurogenic origin.
Treatment
Erectile dysfunction treatment must be personalized and focus on curing the underlying cause. The most effective treatments typically include:
Medication Therapy:
- Oral: These usually enhance the natural erection process but do not trigger it.
- Injectable or intraurethral: These promote an erection that lasts up to 60 minutes.
Psychological Therapy: Addresses mental causes of impotence, such as stress or anxiety.
Vacuum or Penile Pump: Creates an erection using a device that removes air around the penis, facilitating blood flow for an erection, which is maintained with a ring placed at the base.
Surgery: The least common approach. Implants are placed on both sides of the penis (penile prosthesis) to help maintain an erection when inflated.
