Sexual dysfunctions cover a very wide spectrum — from painful intercourse to loss of desire, from erectile disorders to anxiety and worry — and need to be evaluated comprehensively.
Erectile dysfunction or impotence, one of the most common sexual dysfunctions, is generally defined as the inability to achieve sufficient firmness and rigidity of the penis for sexual activity, or, even when achieved, its ending before satisfaction is reached. Up to 50% of men over the age of 40 may experience erectile dysfunction.
Besides affecting a man's quality of life because of the problem it creates in having sexual intercourse, erectile dysfunction can also be a symptom of other diseases. Erectile dysfunction can appear as the result of a cardiovascular disease in which not enough blood reaches the penis.
Your doctor can look at the underlying causes of erectile dysfunction and help you become aware of potentially life-threatening conditions and bring them under control with treatment.
Causes
There are many underlying medical and psychological causes of erectile failure. Some of them are as follows:
- Cardiovascular diseases such as atherosclerosis (hardening of the arteries), peripheral vascular disease, previous heart attack and hypertension
- Diseases such as diabetes, kidney failure, cirrhosis and high cholesterol
- Some neurological diseases such as epilepsy, stroke and MS
- Lung diseases such as COPD and sleep apnoea
- Thyroid diseases and endocrine diseases related to sex hormones
- Urological diseases such as Peyronie's disease (abnormalities in the tissue that gives the penis its shape)
- Psychological problems and psychiatric diseases such as depression, post-traumatic stress disorder and sexual performance anxiety
- Certain chemotherapy or radiotherapy procedures used in the treatment of some cancers
- Certain medications
- Certain operations
Symptoms
Erectile disorders generally appear in the following forms:
- Inability to achieve sufficient rigidity of the penis for sexual intercourse
- Achieving rigidity sufficient for intercourse but losing it before satisfaction
- Loss of penile rigidity before pleasure is achieved, due to premature ejaculation
Diagnostic Methods
Besides diagnosing erectile dysfunction, identifying the underlying cause is of great importance for its treatment. For this reason, after your medical history and examination, your doctor may request a series of tests according to the findings. Some of these can be listed as follows:
Blood and Urine Tests
To reveal some causes of erectile dysfunction, a blood count, tests related to cholesterol and diabetes, certain hormone tests and tests showing the condition of organs such as the kidneys and liver may be requested.
Colour Doppler
This test analyses blood flow through the blood vessels in the penis.
Ultrasound
This imaging test uses high-frequency sound waves to create an image of the organs. In erectile dysfunction, this test can show poor blood flow or abnormalities in the internal structure of the penis.
Biothesiometry
This test uses electromagnetic vibration to test the nerve function that produces an erection in response to stimulation.
NPT (Nocturnal Penile Tumescence) Test
In this test, also known as the night-time test, a special device placed around the penis can determine whether you have erections during sleep.
Treatment Methods for Erectile Dysfunction
Treatments for erectile dysfunction usually begin with treating the underlying problem. If your doctor identifies another disease as the cause of the erectile dysfunction, they may refer you to the relevant specialist. Your doctor may also start medication for the erectile problem.
In the treatment of erectile dysfunction, where surgical treatments are also among the options when necessary, your doctor may in some cases also recommend certain devices:
- Erection-assisting devices: vacuum pumps and other devices may be recommended to some patients.
- Penile implant: implants placed inside the penis by surgical methods.
