Erectile Dysfunction
About erectile dysfunction
An erection is a complex interaction between the muscles, nerves, and blood supply of the genital region. Erectile dysfunction occurs when you are unable to obtain or maintain an erection for sufficient sexual intercourse.
Most men will experience difficulty getting or maintaining an erection at some point in their lives. Around 1 in 5 men over age 40 experience erection problems, and around 1 in 10 cannot develop an erection at all.
At Paradigm Urology, erectile dysfunction concerns are managed by Dr. Tony Makris. Dr. Makris is a specialist urologic surgeon with extensive experience in managing male sexual health concerns.
What causes erectile dysfunction?
Erectile dysfunction can be influenced by a variety of physical and psychological causes. It’s sometimes a combination of both and does not always have a clear cause.
Factors that may impact it include:
- Some drugs (prescription and recreational)
- Alcohol intake
- Tobacco use
- Heart conditions (such as atherosclerosis or high cholesterol)
- Obesity
- Diabetes
- Sleep disorders
- Depression or anxiety
- Stress
- Physical injury
- Hormonal conditions (such as a lack of thyroid hormone or testosterone)
How is erectile dysfunction diagnosed?
A physical exam and a few questions about your medical history are often all that’s needed to diagnose erectile dysfunction and recommend a treatment. If initial treatments fail or your doctor suspects an underlying cause, you may be referred to a specialist for further tests. These may include:
Blood tests
These may check for low testosterone levels or signs of heart disease.
Urine tests
These can check for abnormalities other health conditions.
Ultrasound
This uses sound waves to create an image, which may be used to check blood flow and internal bodily structures.
Psychological exam
You may be referred to a mental health professional if depression or anxiety contribute to your erectile dysfunction.
How is erectile dysfunction treated?
The goal of erectile dysfunction treatment is to help you achieve an erection predictably and long enough for sufficient sexual intercourse. What works best in this regard is different for everyone, and Dr. Makris will help you find an ideal option. This may include:
Medications and/or supplements
Medications like Viagra work by blocking certain enzymes, allowing more blood to flow into the penis.
Counselling
If erectile dysfunction is due to a social or psychological cause, a psychologist or sex therapist may be able to help. These specialists can help you develop psychologically to promote a fulfilling sex life.
Penile injections
Penile injections consist of medications which are injected directly into the penis to cause an erection. Your specialist will guide you on how to do this at home.
Penile implants/prosthetics
Malleable (one part) and inflatable (two or three part) implants are available. The user positions or inflates the device to create an erection, which can be disengaged after intercourse. If this approach is recommended, Dr. Makris will explain your options and help you select an appropriate option.
Vacuum pump
A vacuum pump can be used to help produce and maintain an erection. The pump creates an erection by drawing blood into the penis, which is then kept in place using a penile constriction ring. Dr. Makris can advise on correct fitting and options which may help you.
Pelvic floor exercises
Research strongly indicates that training the pelvic floor muscles can assist in both erectile dysfunction and premature ejaculation. This method also has the benefit of not producing additional side effects. At Paradigm Urology we have Shani Clark, a physiotherapist with a special interest in pelvic floor physiotherapy, who can you introduce and assist you with pelvic floor rehabilitation.
Penis procedures
Paradigm Urology performs a range of procedures including:
- Intracavernosal injections
- Surgery for Peyronie's disease
- Penile prosthesis surgery
- Alternative injections therapies: platelet rich plasma (P-Shot, O-Shot)