Treatment of Erectile Dysfunction

Erectile dysfunction (ED), along with premature ejaculation, is the most common sexual disorder that occurs in men, and regardless of age, it is not considered a normal occurrence.

Of course, age and general health status have an additional impact on its presence. In everyday practice, healthcare providers should discuss sexual issues with their patients because they can be predictors of other health conditions.

ED is defined as the inability to achieve an erection sufficient for regular sexual activity, lasting continuously for more than 3 months. Any difficulty in this area is usually perceived by men as an acknowledgment of their weakness and inability, leading them to question their masculinity. Statistically, occasional ED issues affect one in ten men aged 18-40, one in three men up to the age of 70, and in older age, one in two men.

ED appears in various forms:

• As a constant and complete inability to achieve an erection
• As the inability to achieve an erection hard enough for successful penetration
• As the inability to maintain an erection long enough for a successful sexual intercourse
• Loss of sexual desire

The process of erection begins in the brain (state of arousal), and the subsequent process involves blood vessels, nerves, and smooth muscle of the penis.

Accordingly, the causes of ED can be:

• Vascular
• Neurogenic
• Hormonal
• Penile injury/disease
• Depression
• Anxiety
• Psychosocial issues
• Psychological distress

Cardiovascular disease, atherosclerosis, high cholesterol, high blood pressure, diabetes, obesity, metabolic syndrome, neurological diseases (Parkinson’s, multiple sclerosis), smoking, Peyronie’s disease, treatment of cancer and other prostate diseases, sleep disorders, alcoholism, pelvic surgeries, hormonal disorders (hypogonadism, hypothyroidism, hyperthyroidism, hyperprolactinemia), chronic liver disease, and chronic kidney failure are the most common causes of ED.

How is erectile dysfunction treated?

Before starting therapy for erectile dysfunction (ED), it is recommended to gather anamnesis regarding the presence of erectile issues. These issues may be related to an underlying condition, and accordingly, therapy for ED should be prescribed. Since ED can manifest before the symptoms of cardiovascular diseases (due to the smaller diameter of the penile arteries and thus earlier occlusion compared to coronary arteries), it is essential to recognize the cause-and-effect relationship and conduct diagnostics and treatment.

According to literature:

• Diabetes increases the likelihood of ED by 4.1 times
• Prostate diseases increase it by 2.9 times
• Peripheral vascular disease by 2.6 times
• Heart disease by 1.8 times
• Hypertension by 1.6 times
• Hyperlipidemia by 1.6 times
• Depression by 1.8 times

Medications taken for other conditions can cause disruptions in all aspects of ED, from the absence of sexual desire to arousal and the ability to achieve orgasm or ejaculation. In this way, the positive effects of medications for primary diseases can negatively impact ED.

Sexuality and the quality of sexual life are important aspects of life. A simple question, “Do you have any sexual problems?” can change the current practice of avoiding discussions on this topic.

Why Should Erectile Dysfunction Be Treated?

Erectile dysfunction (ED) should be treated because it restores a normal sexual life. Treatment helps the patient’s partner to once again enjoy sexual relationships. Studies have shown that individuals who have regular sexual intercourse tend to have better physical and mental well-being. It improves both the quality of life and relationships.

Erectile dysfunction is not just a physical disorder; it also affects a man’s mental state and his relationships with others. ED deteriorates the quality of life and the relationship with a partner. Additionally, it can lead to the discovery of other health issues,
as research has shown that erectile dysfunction can be an early sign of diabetes and cardiovascular diseases.

In any case, the complexity of sexual issues lies in their multifactorial nature, combining both organic and psychogenic effects. The responses are individual, tied to each patient, and depend on a precise medical history, sometimes even a partner’s medical history, and an analysis of all symptoms. In this way, we piece together the parts of the puzzle, offering a wide range of therapeutic options.

Preparation for treatment

The assessment for erectile dysfunction (ED) involves several steps and may be conducted in collaboration with a family doctor, sexual therapist, cardiologist, endocrinologist, or a male reproductive health specialist, such as a urologist.

Here’s what the typical evaluation for ED treatment looks like:

1. Discussion of Symptoms and Medical History

The doctor will ask about your symptoms, such as difficulty achieving or maintaining an erection, their frequency, and duration. They will also inquire about your general medical history, including any existing health conditions, medications you take, and any past traumas or surgeries in the genital area.

2. Physical Examination

The doctor may perform a physical examination to identify potential physical causes of impotence. This could involve examining the genitals, measuring blood pressure, and checking other parts of the body that may be related to ED, such as the heart and blood vessels.

3. Laboratory Tests

The doctor may request laboratory tests to check hormone levels, prolactin, or blood sugar. These tests can help detect hormonal imbalances or other health issues that may contribute to erectile dysfunction.

4. Additional Tests

In some cases, the doctor may recommend additional tests to assess blood flow to the genital area. This could include an ultrasound or Doppler examination of the penis, testing for the presence of involuntary nocturnal erections, or other specialized tests to determine the cause of ED.

After these evaluations are conducted, the doctor will discuss treatment options for erectile dysfunction. Depending on the results and the identified cause, recommendations may include lifestyle changes, psychological therapy, medication, or other therapies.

It’s important to note that each assessment is tailored to the individual’s needs, and the specifics of the examination will depend on the doctor’s expertise and the clinical practice.

Treatment

After the examination and diagnostic procedures, individualized therapeutic modalities are initiated, which may include medication and/or injection therapy, shockwave therapy, consultations about psychotherapeutic approaches, and advice on other possible forms of treatment.

Cost of Erectile Dysfunction Treatment

You can check the current price list for the cost of the procedure. Contact us by phone at +385 1 5005 970 or email info@sinteza.hr for more information. For direct appointment reservations, click on the link.

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