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Today in Health & Wellness
HEALTH CONDITIONS

Impotence

Overview
Symptoms
Risk Factors
Commonly Prescribed Drugs
Treatment and Management
Doctors to Consult
Overview

Common name: Sexual dysfunction

A sexual dysfunction characterized by failure to attain an erection sufficient for sexual intercourse. It is common that every man is incapable of achieving an erection occasionally. It is only considered as erectile dysfunction when the problem is frequent.

Symptoms
  • Failure to achieve an erection completely.
  • Achieves erection but cannot sustain for intercourse.
  • Inconsistent erection.
  • Decrease in libido.
Risk Factors
  • Organic Erectile Dysfunction
    1. Heart diseases (may compromise blood flow to the penis).
    2. Nerve damage (e.g., spinal cord injury, stroke, diabetes)
    3. Hypogonadism (e.g., due to cancer treatment, pituitary disorders, obesity)
  • Psychologic Erectile Dysfunction
  • Primary causes includes depression, anxiety, malaise, sedation, hypothyroidism, Alzheimer disease and other mental disorders.
  • Social habits: Cigarette smoking, excessive alcohol intake, illicit drug use. Some medication (e.g. antidepressants and other antipsychotics, anticholinergics, antihypertensives).
  • Men older than 65 years old.
Commonly Prescribed Drugs
  • Phospodiesterase inhibitors (PDE-5 inhibitors): e.g. Sildenafil, tadalafil, vardenafil. Preferably taken 1 hour before sexual activity. Sildenafil, if possible take on an empty stomach or at least 2 hours before meals. Avoid taking sildenafil or vardenafil with a fatty meal.Use with caution in patients with heart disease. Should not be taken within 4 hours of an a-adrenergic antagonist. Contraindicated in patients taking nitrates.
  • Testosterone-Replacement Regimens: Acts by improving libido.
  • Alprostadil (Prostaglandin E1): Should not be used together with alprostadil due to risk of priapism.
  • Other treatment options
    • Vacuum erection devices (VEDs) Patient can use constriction bands or tension rings to lengthen the erection. Contraindicated in patients with sickle cell disease.
Treatment and Management
  • Surgery
    • Insertion of a penile prosthesis.
  • Communicate with your partner.
  • Quit smoking, and avoid or limit alcohol intake.
  • Get help for anxiety or depression.
  • Exercise regularly.
Home Remedies
Doctors to Consult
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