Erectile Dysfunction is a pervasive condition that has afflicted many men. It is the physical disability that also adversely affects mental health and overall quality of life. Many men seek professional advice as they look for treatment for erectile dysfunction.

How does Erection happen?

Visual, olfactory, and spinal reflexes work together to generate the stimuli that increase the blood flow in penile arteries. It also causes smooth muscle relaxation by the production of Nitric oxide under the action of testosterone. Complex ?? I know, right !! Erectile dysfunction medicines work on one or the other step of this mechanism, and your ED doctor can tell you where does the problem lie.

Is ED Curable?

As frightening as the name might sound, ED can be reversed or cured by treating its etiological factor. The interplay of causative factors include:

  • Cardiovascular diseases
  • Urinary tract infection
  • Prostate enlargement
  • Kidney disorders
  • Stress, anxiety, and depression
  • Neurological disorders or nerve injuries

Erectile dysfunction is an alert signal of the major underlying disease.

Treating Erectile Dysfunction

ED can be treated via invasive and non-invasive methods. However, non-invasive methods are mostly preferred by patients.

  • Transform your Style of Living- Give yourself a break. Take a week off from your busy routine and indulge in your favourite things. Spend quality time with your loved ones. A refreshing change can sometimes fix your ED. Eating the right food and exercising regularly will keep you high on energy and improve your stamina. Quitting smoking and limiting alcohol intake will prevent progression, and all these lifestyle modifications can help to regress ED.
  • Loosen up your mind- Stress is the most common reason for ED. Seek professional counselling from the therapist. Couple counselling is also helpful in these cases. Meditation and breathing exercises can relieve stress. The onset of ED sometimes aggravates the stress. Your doctor can put you on anti-depressants if he sees early signs of depression.
  • Prescribed Drugs- PDE-5 inhibitors like Tadalafil, Sildenafil, Vardenafil have approved drugs that maintain the flaccid state of penile muscles for up to 4 hours. They are taken before intercourse or as directed by your doctor. These can cause side-effects on overdose and prolonged usage. The other drugs used in combinations are Dopamine agonists, Adenylate cyclase activators that have shown a remarkable effect in patients where PDE-5 inhibitors were ineffective. Testosterone replacement therapy is useful if a low level of testosterone is detected in the blood. If a person is not able to take oral medicines, suppositories are readily available, to be inserted in the penile urethra.
  • Topicals and Injectables – Intracavernosal or intraurethral injections are gaining a lot of attention due to their efficacy and fewer side-effects. They are the ideal choice for moderate-severe cases of Erectile dysfunction with vasculogenic aetiology. The injections have fine needles that cause minor discomfort.
  • Chemoprevention- An upcoming strategy, still under trial mainly for patients with uncontrolled diabetes. This combination therapy includes free radical scavengers, NO substrates, rho-kinase inhibitors that are under development.

The medical management includes the therapies to treat ED along with the underlying disorder.

  • Vacuum-assisted Erectile Devices- An automated device that creates a vacuum to draw all the blood into the penis and a band is placed to keep the penis erect. These devices can be challenging to use and depend on the individual’s compliance, but their success rate is 90%. In the cases of prostate removal, these devices have assisted the erectile function.
  • Prosthetic replacement- Surgically placed penile implants have shown maximum benefit to the person, and they have achieved higher satisfaction than any other oral medication. A person undergoing implants is extensively counselled about post-surgical complications and expectations.
  • Reconstructive Surgery- Reconstruction of the penile arteries is done to improve the blood flow and restore erectile function.
  • Novel therapies: The forthcoming techniques for the treatment of Erectile dysfunction are:
  1. Low-intensity Shockwave therapy- This therapy will promote the growth of newer blood vessels.
  2. Stem-cell Therapy- Regeneration of neural function that can help with Erection.
  3. Platelet-Rich plasma- Promote growth factors that induce healing and formation of new blood vessels.
  4. External penile prosthesis- It is strapped around the patient’s waist and helps in penetrative intercourse. However, this device can get perceived as inappropriate or embarrassing.

Erectile dysfunction is a complex interaction of several causative factors. Your primary caregiver or your family doctor can help you diagnose the related cause and any underlying condition that requires immediate medical attention.

Medically reviewed by Rishabh Verma, RP