Erectile dysfunction (ED), sometimes also referred to as impotence, means
you can’t get an erection. It may also mean you aren’t happy
with the size, hardness, or longevity of your erections.
Each year, between 15–30 million men are diagnosed with erectile
dysfunction (ED). This condition is caused by a number of contributing
factors and results in an inability to achieve or maintain an erection.
Also known as impotence, this health issue can be caused by physical factors
brought on by old age or psychological factors such as stress or anxiety.
No matter the reason for erectile dysfunction, men should know it is treatable.
West Jefferson Medical Center helps more and more men seeking treatment
each year.
What causes ED?
In the past, ED was often considered a psychological problem. However,
it’s now understood that, for many men, ED has a physiologic cause.
There are a variety of different types of and causes of ED. Some of the
most common include:
Premature ejaculation
Performance anxiety
Depression (some antidepressants can cause erection problems, too)
Organic impotence, involving the hardening of arteries or veins in the penis
Diabetes
Nervous system conditions, including multiple sclerosis, stroke, or spinal
cord injuries
Medicine-induced impotence (blood pressure medicine, anti-anxiety and antidepressant
medicines, glaucoma eye drops, and cancer chemotherapy medicines are just
some of the many medications that can cause ED)
Hormone-induced impotence, due to issues with the amount of hormones the
body is producing
Low-testosterone, atype of hormone-induced importance that is linked to ED
Lifestyle choices, including smoking, excessive alcohol use, being overweight,
and not getting enough exercise
Treating ED
The best treatment for ED often depends on what’s causing it. Our
urology team at West Jefferson Medical Center can determine the cause of your ED with diagnostic tests and physical
and mental health exams. Then, we’ll explain your treatment options
and the benefits and risks of each.
Common treatments for ED include:
Lifestyle changes: Drinking less alcohol, quitting smoking, losing weight, and exercising
may help with ED. Some studies have found that any amount of exercise
(moderate, vigorous, or less intense) can reduce the risk of ED.
Therapy: Going to therapy to help reduce stress and anxiety can treat ED for some people.
Medication: Taking some oral prescription medications can treat ED by increasing
blood flow, so an erection results from sexual stimulation. Common medicines
include Viagra, Adcirca, Cialis, Levitra, Staxyn, and Stendra. It’s
also helpful to review your current medications to see if ED is a side effect.
Testosterone replacement therapy: Getting testosterone replacement therapy can help balance your testosterone
levels, which may help with ED. There are a few ways to get testosterone
replacement therapy:
Apply prescription gel to the skin.
Adhere testosterone transdermal patches to the skin. Wear these patches
during a defined period and replace them every 24 hours.
Inject Depo®-Testosterone into your butt muscle about once or twice per month.
Penis pump device: Using a vacuum device (called a penis pump) can help pull blood into
the penis and lead to an erection. A tension ring around the base of the
penis then helps you keep an erection.
Injection therapy: Self-injecting intracavernosal injections directly into the penis can
help with ED.
Surgery for penile implants: Getting
surgery to add penile implants to both sides of the penis may help treat ED. There are two types of penile implants:
Inflatable implant: Two or three pieces are placed inside the penis, scrotum,
and abdomen. The implant inflates to create an erection.
Semirigid rods: Devices that stay firm are inserted into the penis.
If you have ED and are looking for the right treatment option, our urology
team at West Jefferson Medical Center is ready to support you.
This common condition impacts many men over the age of 45, but many don’t
realize treatment is available.
Understanding low testosterone
Testosterone is a male sex hormone that helps maintain sex drive, reproductive
function, muscle mass, adequate red blood cell levels, and more. Low testosterone
(also known as male hypogonadism) is a condition where the testicles (aka
testes or gonads) don’t make enough testosterone for the body to
function properly. Normal total testosterone level in men is > 300 ng/ml.
There are many potential causes for low testosterone levels, including
certain medications, metabolic disorders, chronic illness, and more. However,
testosterone levels also naturally begin declining around age 30, and
continue to drop throughout a man’s life.
Low testosterone affects millions of men in the U.S., with the prevalence
increasing by age. However, it’s estimated that only 5% of affected
men seek and receive treatment.
Know the symptoms; ask for support
Men may fail to get treatment for low testosterone for a variety of reasons,
including not understanding the symptoms, or being embarrassed to talk
about them with a healthcare provider. It’s important to remember
that opening up is the first step to feeling better!
Here are the top symptoms to look out for:
Increased fatigue
Decreased libido (sex drive)
Erectile dysfunction
Loss of muscle mass
Decreased strength and exercise capabilities
Changes in cognitive ability
Depression, moodiness, and/or decreased sense of well-being
Treating low testosterone
If you have a condition, such as a sexual health condition, that causes
low testosterone, treatment with testosterone replacement therapy may
help. This type of treatment gives your body testosterone, balancing your
levels so you feel more like yourself.
There are a few ways to get testosterone replacement therapy:
Apply prescription gel to the skin.
Adhere testosterone transdermal patches to the skin. Wear these patches
during a defined period and replace them every 24 hours.
If you and your partner are struggling to get pregnant, we can help you
get to the bottom of it.
What is male infertility?
Male infertility refers to problems with the reproductive system that prevent
a man from having children. Men experiencing male infertility will struggle
to start a pregnancy with their partner. Male factor infertility is the
sole cause of problems conceiving in 20% of couples trying unsuccessfully
to conceive and is a contributing factor in at least 50% of couples trying
unsuccessfully to conceive.
Natural male reproduction depends on two key factors: having healthy sperm
that can fertilize the egg and having an erection and ejaculation so that
sperm can reach the egg in the first place. If you are experiencing problems
with either of these factors, it may suggest male infertility.
What causes male infertility?
Problems with fertility can be caused by a variety of conditions, in addition
to environmental and lifestyle factors. Some of the most common causes
of male infertility include:
Infections or inflammatory conditions
Hormone or pituitary gland problems
Immune problems that cause your body’s antibodies to attack your own sperm
Genetic diseases, such as cystic fibrosis or hemochromatosis
Structural problems or scar tissue that blocks the genital track and stops
the flow of semen
Issues with erectile dysfunction or premature ejaculation
Environmental and lifestyle factors, including heavy tobacco use, heavy
alcohol use, marijuana or steroid use, or exposure to toxins
Testing for male infertility
If you and your partner have been trying to become pregnant for one year
with no luck, your healthcare provider will recommend tests for both you
and your partner to find the cause of infertility.
Male infertility is diagnosed through a combination of exams and tests,
including:
Our urology team can work with you to create a personalized treatment plan
to manage your condition.
Understanding Peyronie’s disease
Peyronie’s disease is a rare type of erectile dysfunction (ED), or
a condition in which a person has difficulty getting or maintaining an
erection. Peyronie’s disease causes abnormal growth of scar tissue
or plaque on the connective tissue of the penis. This condition can result
in a curve, bend, or narrowing in the penis that can impact erection quality
and cause penile pain or difficulty with sexual activity.
The exact cause of Peyronie’s disease is unknown, but some research
suggests it can be caused by trauma or injury to the penis resulting in
scar tissue buildup. However, many cases occur without traumatic injury,
suggesting that genetic factors may be at play, too.
Diagnosing Peyronie’s disease
Some men with Peyronie’s disease get better on their own; however,
for others—particularly if the condition has been present for a
long time—direct, interventional treatment is required.
If you notice a curvature or change in the shape or length of your penis,
it’s important to talk to your doctor as soon as possible. Your
doctor will perform a physical exam to determine your condition and can
refer you to a urologist if needed.
While there is no cure for Peyronie’s disease, it can be managed
with treatment.
Treating Peyronie's disease
The best treatment for Peyronie’s disease depends on if the condition
is acute or chronic.
Acute Peyronie's disease
The acute phase of Peyronie’s disease happens early on and may last
a few weeks to a year or more. Common symptoms in the penis include:
Pain
Changes in length
Changes in curvature
Changes in deformity
Treatment for the acute phase usually involves penile traction therapy.
A device is used to stretch the penis for a defined period. The goal is
to prevent losing penis length and decrease curvature.
Other medical and injectable therapies also may help at the acute stage
of Peyronie’s disease.
Chronic Peyronie's disease
With the chronic stage of Peyronie’s disease, symptoms are stable.
There isn’t penis pain or changes in length, curvature, or deformity.
The chronic stage often happens about three to 12 months after initial symptoms.
There are several treatment options for the chronic phase:
Watchful waiting
Injection therapy
Traction therapy
Surgery
Sometimes, it’s helpful to use multiple treatment options. For example,
if you get injection therapy, you may get several injections over the
span of months. During this time, you also might do traction therapy and
take medicine by mouth.
If you have Peyronie’s disease or another sexual health condition, our
urology team at West Jefferson Medical Center is here to help. We’ll work with you to find the best treatment
for you, long-term.
