Dr. Deepak Gupta

If a survey is done for the most common male sexual problem, the outcome would be erectile dysfunction. Commonly referred to as ED, it is a major problem for the male but it can be treated in simple ways.
By definition, ED is the repeated inability of a male to achieve and/or maintain an erection for a healthy and satisfying sexual relationship. The key word here is “repeated” as a quicker erection or softer erection is very common in many men, which could be a one-off instance and caused by transient factors like stress or lack of sleep. When this happens repeatedly, then it needs attention.

Symtoms: Erectile dysfunction is when:

1. Erection is too soft, not allowing for sufficient penetration and prolonged intercourse
2. Erection duration is very short
3. There is difficulty in arousal

Risk factors: ED has been noted to be commonly seen in people, who have following behaviours:

1. Smoking
2. Obesity
3. Advanced age (>60 years)
4. Excessive alcohol abuse
5. Sedentary lifestyle with no exercise
6. History of diabetes
7. Hypertension
8. Atherosclerosis
9. History of groin surgical procedures for prostate, bladder, etc.

Causes: ED has both physiological and psychological reasons.

• Most common psychological reasons are strained relationships, performance anxiety, and other life stressors.
• Physical causes include reduced hormone levels and other chronic medical conditions like obesity, diabetes, and hypertension.

Diagnosis: While ED is easy to diagnose medically, the truth is that not many would be forthcoming for a diagnosis. Given that this issue could be a jolt to the “manhood,” it is often not brought out in the open for discussion. Once that is done, the following steps can help in diagnosis.

1. Medical history and specifically sexual history
2. Check for genital abnormalities
3. Blood testosterone levels
4. Other vitals including blood pressure, sugar, and cholesterol levels to identify overall health

Management:

1. Sexual counseling involving the couple. Once they open up and get comfortable, the problem vanishes. Performance anxiety which is a major cause is taken care of, and ED is no longer an issue. Aligning the couple’s expectations also is very essential.
2. Hormone supplements, both locally applied and taken into the system, help to a great extent
3. Lifestyle changes like quitting smoking, moderating alcohol abuse, healthy eating habits, and moving away from sedentary lifestyle helps treat ED
4. Medicines like Viagra are very useful for occasional cases of erectile dysfunction

As a last resort, there are advanced options like pumps, vacuum devices, implants, and surgical options, and implants. These are often not required, as in most cases, sexual counseling and hormone therapy help in managing ED. If you wish to discuss about any specific problem, you can ask a free question.