Erectile dysfunction (ED, commonly known as impotence) is a chronic disease that affects both physiology and psychology. Its treatment needs to comprehensively consider social factors such as education level, social background, and family status.
The general principles of treatment are safe, effective, simple, and economical, in line with the preferences of patients and spouses. To enable patients to obtain a satisfactory sex life through individualized comprehensive treatment.
If you think you have ED, the best first step is to consult your doctor. The treatment you need depends on what’s causing it.
Basic Treatment For ED
Your doctor may tell you to make some daily adjustments. Expect to hear something like:
Improve Lifestyle: Lifestyle adjustment is an important part of ED treatment and should be carried out before or at the same time as ED treatment. Especially for patients with cardiovascular disease or metabolic disease (such as diabetes, high blood pressure, etc.).
Treatment of Underlying Disease: For patients with clear underlying diseases, such as cardiovascular disease, diabetes, hyperlipidemia, depression, etc., should be treated prior to or concurrently with ED.
Psychological Counseling: People with ED are more likely to experience psychological problems such as decreased well-being and decreased self-confidence and self-esteem. Patient education, counseling, psychological counseling, and treatment are helpful for the recovery of sexual function.
Sex Life Guidance: Sex life is an important part of quality of life. Face this problem together with your partner and properly increase your interest in sex life. Properly increase the frequency of sexual life under psychological or drug treatment, and gradually learn the skills of sexual life.
The latest research shows that good living habits, such as smoking cessation, moderate aerobic exercise, reasonable diet, weight control and regular life, can not only improve blood vessel function, be beneficial to erectile function, but also benefit overall health.
Drug Treatment For ED
Due to large individual differences, there is no absolute best, fastest, and most effective medication. In addition to commonly used over-the-counter drugs, you should choose the most appropriate drug based on your personal situation under the guidance of a doctor.
Oral medications are the simplest and most acceptable first-line treatment for ED.
Phosphodiesterase 5 (PDE-5) Inhibitor Therapy
This type of drug is currently the first choice for clinical treatment of ED, and the effective rate of ED treatment is about 80%. Commonly used drugs are sildenafil, tadalafil, vardenafil, avanafil and so on.
Taking such drugs does not automatically produce an erection, it needs to work under the premise of sexual stimulation.
PDE-5 is not an aphrodisiac, so men with normal erections do not need the assistance of such drugs. Side effects include headache, flushing, indigestion, nasal congestion, dizziness, abnormal vision, back pain, and myalgia.
These drugs are not suitable for all patients and may be less effective, for example, after prostate surgery or if you have diabetes. If the patient is taking nitrate drugs, or has heart disease or heart failure, low blood pressure, etc., consult a doctor before taking these drugs.
Androgen Therapy
Some men suffer from ED, which can be caused by low androgen levels. In such cases, hormone replacement therapy is the mainstay of treatment.
After supplementing with androgen, it can increase libido and improve erectile function. The androgens used for ED treatment mainly include testosterone undecanoate capsules, injections and patches.
Other Medications
Hyperprolactinemia can be treated with dopamine antagonists after exclusion of pituitary tumors. In addition, clinically used drugs include drugs that act on the central nervous system (such as apomorphine, trazodone) and drugs that act on the local area (such as yohimbine and phentolamine), but these drugs are not routinely used now.
For patients who do not respond to oral medications, doctors may recommend intracavernosal injection therapy, which has an effective rate of up to 85%.
Currently, commonly used drugs include alprostadil, papaverine, phentolamine, and multiple drug combinations. A transurethral administration of prostaglandin E1 can effectively treat ED, and the satisfaction rate of sexual intercourse erection can reach 30%~65.9%. This therapy can be used as another option for patients who do not receive injections.
Physiotherapy – Vacuum Devices
Vacuum erection device is a physical therapy method that uses negative pressure to attract blood flow into the cavernous body of the penis, thereby promoting penile erection.
In line with the principles of ED treatment, it can be used for penis rehabilitation. It is suitable for patients with ED caused by vascular disease, diabetes, prostatectomy, pelvic fracture, urethral rupture and spinal cord injury.
It can also be used for patients who cannot tolerate PDE-5 inhibitors or fail to treat PDE-5 inhibitors. The elderly population can obtain the same curative effect as the general population.
Vacuum erection devices are hollow tubes that have manual or battery power. The tube is put over the penis, and the air in the tube is sucked out using a pump. Draws blood into the penis by creating a vacuum. Once erect, a tension ring is placed around the base of the penis to maintain engorgement. Then remove the sleeve.
The erection usually lasts long enough for intercourse that the tension ring is removed after intercourse. Note that the tension ring should not be placed for more than 30 minutes, otherwise ischemic injury to the penis may occur.
Possible side effects include penile bruising, ejaculation restriction, etc., and the incidence rate is less than 30%.
Physicians may choose a specific model to suit needs based on the patient’s own circumstances. Additionally, the way it is used in penile rehabilitation has changed in recent years. Perform functional exercises of the penis (erection-weakness-erection) through repeated negative pressure suction.
Surgical Treatment For ED
When the patient is ineffective in drug treatment or other treatment, it is recommended that the patient take surgical treatment, including the following aspects:
Penile Vascular Surgery
Including penile vein leak surgery, penile artery reconstruction surgery, etc. At present, the effect of surgical treatment of penile vein leakage is not ideal, so it should be used with caution. Penile artery reconstruction surgery requires strict selection of patients with surgical indications.
Penile Prosthesis Implant Surgery
By surgically placing a penile prosthesis into the cavernous body of the penis, the patient can independently control the timing and hardness of the erection. Penile prosthesis can be divided into three types: semi-rigid, 2-piece and 3-piece. Penile prosthesis implantation is an effective means of treating ED, with a success rate of more than 90%.
Satisfaction of surgical patients is about 86%, partner satisfaction is about 83%. It is the most satisfactory treatment method among all ED treatment methods.
In the 2018 edition of the American Urological Guidelines, it is proposed that the penile prosthesis implantation surgery can be performed after the patient and his family members agree to negotiate and discuss the plan in detail with the doctor.
Chinese Medicine For ED
ED is described in traditional Chinese medicine as penis flaccidity but not lifting, lifting but not firm or firm but not long, unable to achieve satisfactory sex life. Chinese medicine can act on the whole body through multi-target, multi-system and multi-part, mild, slow and long-lasting, and improve systemic symptoms. And many traditional Chinese medicines have androgen-like effects, which can improve libido while treating ED.
At present, there are many kinds of Chinese patent medicines for treating impotence on the market, which are mainly suitable for psychological ED and mild and moderate organic ED.
Acupuncture Treatment
Acupuncture. This ancient Chinese practice involves placing very thin needles in certain parts of the body. It is believed to enhance the body’s ability to heal itself. It has helped some men. But more research is needed to prove it works.
In the specific treatment, it is necessary to treat according to syndrome differentiation, remind patients and their families not to listen to folk prescriptions at will. Chinese medicine treatment needs to go to a formal medical institution, and be diagnosed and treated by a practicing Chinese medicine doctor.
Stem Cell Therapy
As a new technology, stem cell therapy has made some progress in the treatment of ED. However, there are few clinical applications, and most of them are still in the research stage.
It can repair the damaged cavernous blood vessels and nerves. One of the reasons may be that growth factors and other cytokines secreted by stem cells have the ability to repair vascular endothelium, nerves, and smooth muscles. Of course, more mechanisms need to be clarified through research.
Low Energy Extracorporeal Shockwave Therapy (LESWT)
In an initial randomized double-blind controlled study, LESWT had a positive effect on both short-term clinical and physiological effects in ED patients responding to PDE-5 inhibitors.
Subsequent clinical data suggest that it may be effective for mild to moderate ED. However, due to the limited research data at present, it is not yet possible to give a clear evaluation of LESWT.
Home Care For ED
Consciously cultivate a tacit understanding with your spouse, improve your mental state together, and restore your confidence in your sexual life. Eliminate the tension before sex, get a good sex experience and help form a virtuous circle.
Pay attention to the cleanliness of the perineum to avoid further aggravation of anxiety and tension from the occurrence of diseases.
Daily Life Management
Smoking and drinking are independent risk factors for ED. Therefore, quitting smoking and drinking is very necessary. Men can also experience ED when they are overworked or physically weak.
Therefore, ED patients should improve their physical fitness, avoid overwork, ensure adequate sleep, and actively exercise to enhance their physical fitness. Meal conditioning includes the following aspects:
High-quality protein: Some animal foods themselves contain some sex hormones, which can promote sexual desire.
Appropriate intake of fat: If men eat less fat, their libido will also decrease.
Supplement vitamins and trace elements: Vitamin C has a positive effect on the recovery of sexual function.
Daily Condition Monitoring
Planned behavioral therapy can be administered at home by oneself. Self-test and record erection time, erection hardness and erection maintenance time, etc., and observe the recovery situation. Regular visits to the hospital for review and scale assessment.
Takeaway
Most men with erectile dysfunction get better with treatment. After targeted treatment of their own psychological factors and organic diseases, most patients will have a more satisfactory sex life. Due to dissatisfaction with the curative effect, some patients will turn to believe in folk remedies and inappropriate surgical treatment, which may aggravate the disease.
ED will cause greater psychological pressure on men and their partners, resulting in disharmony in the relationship between husband and wife. For single men, the negativity is even greater.
Compared with normal men, ED patients have lower self-esteem and self-confidence, and are accompanied by anxiety in sexual life. When the patient is in an anxious situation for a long time, the sexual function will decline and even further aggravate ED.
Therefore, patients should have a correct understanding of the disease and carry out standardized and programmed diagnosis and treatment. Ensuring an optimistic attitude and properly handling the relationship between husband and wife are of great benefit to the disease.
Understand relevant knowledge, treat impotence correctly, and treat it under the guidance of a doctor and the cooperation of your partner.