Erectile Dysfunction (Impotence)

Erectile Dysfunction
Body Parts: Reproductive Site
Medical Subjects: Men's Health

What Is Erectile Dysfunction?

What is erectile dysfunction?

Erectile dysfunction, also known as "impotence", means that the penis can't erect, or the erection time is very short, so that it can't get satisfactory sex life.  According to this concept, erectile dysfunction can be diagnosed if the erection hardness of the penis is not enough to penetrate the vagina, or the erection maintenance time is not enough to complete sexual intercourse satisfactorily.

Why does the penis become erect?

Under normal circumstances, the arterial blood flowing into the penis is in balance with the venous blood flowing out. During sexual excitement, the smooth muscles of the penile cavernous body relax, the penile arteries expand, the arterial blood flow increases and the venous return is blocked, so the penis becomes erect. After erection, the pressure in the cavernous body increases, the inflow of arterial blood is significantly reduced, and the outflow of venous blood is correspondingly reduced, maintaining a balanced state and maintaining the complex hemodynamic process of erection.

Are there many people suffering from erectile dysfunction?

Studies have shown that the incidence of erectile dysfunction among men aged 40 to 70 is 52% (including mild 17.2%, moderate 25.2%, and severe 9.6%), and the incidence increases with age.


What Is The Cause Of Erectile Dysfunction?

Erectile dysfunction is divided into organic, psychological, and mixed according to the cause, most of which are mixed.

  • Organic erectile dysfunction: The causes include congenital penile dysplasia, penile vascular or neuropathy, and pathological changes in the structure of the penile cavernous body. According to different causes, organic erectile dysfunction can be subdivided into vascular, neurological, anatomical, endocrine, drug-induced, and traumatic erectile dysfunction.
  • Psychological erectile dysfunction: related to psychological disorders.
  • Mixed erectile dysfunction: both organic and psychological factors exist.

What are the risk factors for erectile dysfunction?

The risk factors for erectile dysfunction are:

  • Age, physical diseases, such as cardiovascular disease, diabetes, and neurogenic diseases.
  • Psychological factors, such as schizophrenia, depression, etc.
  • Drug factors, such as a variety of antihypertensive drugs, cardiovascular drugs, antidepressants, etc.
  • Trauma, surgery and other iatrogenic diseases. Such as spinal cord and pelvic trauma, damage to the blood vessels and nerves of the penis in the lower abdomen and perineal surgery.
  • Bad lifestyle, such as smoking, alcohol abuse, drug abuse, obesity, staying up late, etc.
  • In addition, poor sexual experience, cultural background, religious beliefs, family social factors, and spouse’s sexual response can also cause erectile dysfunction.

Can erectile dysfunction be inherited?

Although there is no accurate data to prove whether erectile dysfunction is hereditary, some hereditary diseases that can lead to erectile dysfunction can indeed increase the incidence of erectile dysfunction in families. From this point of view, erectile dysfunction does have some genetic characteristics.


What Are The Symptoms Of Erectile Dysfunction?

The clinical manifestations of patients with erectile dysfunction mainly include: the penis cannot be erected during intercourse, or the penis can be erected but not hard enough, or the penis can be erected hard but not lasting enough.

What are the types of erectile dysfunction?

  • Classified by time: Divided into primary and secondary erectile dysfunction.
  • Classification by degree: According to the International Erectile Function Evaluation Index, it is divided into light, moderate, and severe. According to the hardness of the erection, it is divided into grades Ⅰ, Ⅱ, Ⅲ, and Ⅳ.
  • According to whether it is combined with other sexual dysfunction classification: divided into simple and compound erectile dysfunction.
  • Classified by cause: Erectile dysfunction caused by mental, metabolic, endocrine, vascular, neurological, drug and other causes.

What are the hazards of erectile dysfunction to patients?

The main hazards of erectile dysfunction to patients are as follows:

  • Produce anxiety and depression.
  • Lead to sexual avoidance.
  • Cause psychological barriers.
  • Cause the couple's relationship to break up.
  • Affect the health of patients.

Will erectile dysfunction affect fertility?

Generally speaking, erectile dysfunction does not directly affect the quality of semen, but if the erectile dysfunction causes difficulty in intercourse and the semen cannot be injected into the female body, it will have an impact on fertility.


How Is Erectile Dysfunction Diagnosed?

The diagnosis of erectile dysfunction mainly includes the following aspects:

Clinical manifestations and symptom assessment, with specific assessment as follows:

  • Past sexual life history, including penile erection status, occurrence and development of erectile dysfunction, diagnosis process, sexual life with partner, mental and psychological family status.
  • Past health conditions and previous diseases, including concomitant diseases, history of surgery or trauma, history of drug use, etc.
  • Living conditions: including bad living habits and special hobbies, etc.
  • Erectile function evaluation index table, erectile hardness evaluation results.

Physical examination:

  • Such as development, penis size, deformity, testicles are normal, and nervous system examination, etc.
  • Assessment of the cardiovascular system.
  • Psychological assessment.

Laboratory examination:

Such as blood routine, urine routine, blood sugar, liver and kidney function, blood lipids and related hormone levels.

What special tests are needed for erectile dysfunction?

The recommended special examinations include: nighttime penile erection monitoring, audio-visual stimulation of erection testing, penile cavernous injection test of vasoactive drugs, penile color Doppler ultrasound examination, etc.

According to the needs of the condition, penile cavernography, selective pudendal arteriography, vascular function assessment, and neuroelectrophysiological examination can also be selected.


What Are The Preventive Measures For Erectile Dysfunction?

Discover and treat correctable causes, improve living habits, and control risk factors related to erectile dysfunction.

  • Quit smoking, physical exercise and weight loss, low-fat and high-fiber diet.
  • Control accompanying diseases, such as coronary heart disease, hypertension, diabetes, hyperlipidemia, metabolic syndrome, etc.
  • Regular sex can help improve erectile function.
  • Provide psychological counseling and education for patients with mental disorders, and adopt necessary treatments.
  • Early treatment of mild erectile dysfunction with drugs such as sildenafil.

What is the prevention goal of erectile dysfunction?

  • For men with erectile dysfunction risk factors but normal erectile function, control the risk factors to reduce the possibility of erectile dysfunction.
  • For men with erectile dysfunction, active treatment can achieve the rehabilitation of erectile function and improve the quality of sexual life.

How Is Erectile Dysfunction Treated?

Is erectile dysfunction an "incurable disease"?

Different patients have different causes and severity of illness, but even for severe patients, it is not impossible to cure erectile dysfunction as long as they are treated according to a reasonable course of treatment. However, this process needs a certain amount of time and patience, and it is unrealistic to expect the best results in the shortest time.

In short, as long as doctors and patients cooperate closely and establish a good atmosphere of mutual trust and communication, the treatment of erectile dysfunction will get good results.

What are the basic treatment principles for erectile dysfunction?

The treatment principles of erectile dysfunction mainly include the following aspects:

  • Definite diagnosis: detailed medical history, comprehensive physical examination and necessary laboratory examinations, etc.
  • Correction of reversible causative factors: modification or discontinuation of medications that may lead to erectile dysfunction, correction of possibly related bad habits, hormone replacement therapy, and surgical intervention if necessary.
  • Treat basic diseases such as diabetes, hypertension, and hyperlipidemia.
  • Evaluation and education: including psychological counseling and sexual guidance, discussion and evaluation with patients and their sexual partners. Depending on the patient's condition, different treatment options were selected, such as oral medication, injection of vasoactive drugs through the urethra or cavernous body, and surgical prosthesis implantation.

What is the sexual psychotherapy for erectile dysfunction?

Compared with normal people, patients with erectile dysfunction are more likely to have psychological problems such as decreased happiness, decreased self-confidence and self-esteem. Patient education or consultation may restore good sexual function. If the patient has obvious psychological problems, psychological counseling or treatment should be carried out, and some patients may need adjuvant drug treatment.

When communicating with patients, we should try our best to establish mutual trust and a good relationship, so that patients can honestly state their condition. At the same time, it is necessary to be good at discovering the emotional symptoms of patients. When there are obvious emotional abnormalities, depressive disorders or other mental illnesses are suspected, the patients should be comforted and the patients should be recommended to the psychiatric department for consultation.

Elderly patients often have many complicated factors, such as age, concomitant diseases, medication, partner relationship, physical condition, sex life expectancy, psychosocial factors, etc., which require collaborative diagnosis and treatment by other professional doctors.

Can erectile dysfunction heal itself without treatment?

It varies from person to person. The causes of erectile dysfunction are complex and the severity of symptoms varies. Therefore, patients with erectile dysfunction need to go to a regular hospital for active treatment instead of waiting for self-recovery. In addition, treatment needs to be continuous, not intermittent, and at the same time maintaining an optimistic attitude.

What are the common treatments for erectile dysfunction?

There are several commonly used treatment methods for erectile dysfunction:

  • Oral medication: such as sildenafil, tadalafil, etc.
  • Drug injection treatment of the penile cavernous body: such as papaverine, phentolamine and prostaglandin E1.
  • Vacuum negative pressure device: that is, an erection is induced by mechanical negative pressure.
  • Others: low-energy shock waves, penile erection device implantation, penile artery reconstruction or vein ligation, etc.

What are the influencing factors of the treatment effect of patients with erectile dysfunction?

Many factors, such as the cause of the patient's disease, the severity of the disease, and the compliance with the treatment plan, will affect the treatment effect.

What is viagra?

"Viagra" belongs to a class of drugs called PDE5 inhibitors, which are the drugs of choice for the treatment of erectile dysfunction. The drug "Viagra" is called Sildenafil, which is the world's first oral medication for erectile dysfunction.

Similar drugs include tadalafil, vardenafil, etc., with the same mechanism of action, but each has its own strengths. In general, it has high efficiency, safe clinical use, low incidence of side effects, mild side effects and most of them disappear on their own. Common side effects include mild headache, dizziness, facial flushing, indigestion, nasal congestion, abnormal vision, and myalgia.

Can Viagra drugs be taken for a long time?

Clinical observations have shown that long-term use of Viagra drugs is safe and will not cause increased side effects. Such drugs do not act on the central nervous system. There are no problems such as "addiction, dependence", and at the same time, they do not contain any Hormonal components, even if taken for a long time, will not cause adverse effects on the body's endocrine.

What are the precautions for patients with erectile dysfunction when taking Viagra drugs?

There are two ways to take these drugs:

  • One is to take it as needed, only one hour before sex. The recommended dose is sildenafil 50 or 100 mg, tadalafil 10 or 20 mg, and vardenafil 10 or 20 mg.
  • The second is to take it regularly, that is, whether you have sex or not, take it daily after reducing the dose. Tadalafil is metabolized slowly in the body and the drug concentration is maintained for a long time. Therefore, the method of taking 5 mg daily is representative.

After taking Viagra drugs, enough sexual stimulation is needed to be effective. Its use with nitrous acid drugs can cause a significant decrease in blood pressure and increase the possibility of severe cardiovascular disease. At the same time, sex life itself will increase the burden on the heart. Therefore, patients who have taken nitrous acid drugs and high-risk cardiovascular diseases are prohibited from using them.

In addition, elderly men often use α-receptor blockers to treat benign prostatic hyperplasia. Taking Viagra drugs at the same time may produce a synergistic antihypertensive effect. If combined use is required, the medication should be taken more than 4 hours apart.

Does the treatment of erectile dysfunction require a woman's participation?


In addition to its own factors in the occurrence of male erectile dysfunction, factors from the woman's side cannot be ignored. Factors such as the woman's non-cooperation and the woman's mockery can cause or even aggravate the symptoms of male erectile dysfunction.

What kind of help do patients with erectile dysfunction need from doctors and sexual partners?

  • Be good at listening to patients and empathize with patients emotionally.
  • Understand the patient's living habits and general hobbies, and guide the patient to choose an appropriate diet and lifestyle.
  • Choose appropriate inspection items.
  • Comprehensive treatment, inform possible curative effects and side effects.
  • Do a follow-up visit, listen patiently and analyze the effect of treatment.
  • Referral in time for poor results

What Are The Life Precautions For Patients With Erectile Dysfunction?

Patients with erectile dysfunction should develop good living habits, such as quitting smoking, physical exercise and weight loss, low-fat and high-fiber diet, regular sex life, etc.

In addition, patients also need to consider the control of physical diseases in their lives. If you have high blood pressure, you need to adopt a low-salt diet, if you have diabetes, you need to follow a diabetic diet.

Will erectile dysfunction be caused or aggravated by long-term cycling?

People who often ride bicycles don't have more erection problems than those who don't ride bicycles. Cycling does cause pressure on the blood vessels and nerves in the perineum, and various discomforts will occur if the pressure ischemia for a long time, such as local numbness and pain, but it does not mean that there will be erection problems.

Will patients with erectile dysfunction taking Viagra drugs affect fertility?

Will not.

A large number of existing studies have confirmed that such drugs have no significant effect on all indicators of male semen, that is, no medical evidence has been found to prove harmful, and there is even laboratory evidence showing that certain indicators of sperm are improved.

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