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  • Dr P K Gupta

Erectile Dysfunction: What Are the Causes and Treatments?

“We must also not forget that some drugs can influence the quality of erections and their replacement with other drugs – under medical supervision – can reverse the situation”

What used to be called “sexual impotence” is now called erectile dysfunction (ED). By definition, erectile dysfunction is the inability to obtain and/or maintain a penile erection “sufficient for satisfactory sexual performance”.


Several studies show that up to 52% of men may have some degree – mild, moderate, or severe – of erectile dysfunction. ED greatly reduces the quality of life of many men and can also compromise the couple's relationship. Once a big taboo – even today it is still for some men –, ED is increasingly being discussed among men and their sexologists in Delhi.


From a didactic point of view, we can divide the causes of ED into two large groups: psychological and organic causes. The psychological disorder is usually recent, has an abrupt onset, and is not associated with organic risk factors. It is often intermittent, happening in certain situations, with certain partners, or in certain places. Many of the men report normal masturbation, but they do not get a satisfactory erection in sexual intercourse.


On the other hand, ED of organic cause is usually long-standing, with the quality of stiffness progressively decreasing over months and years, and is not intermittent. In general, it comes from vascular changes (arteries and veins) of the penis, changes in the innervation of the penis, or endocrinological factors (men with ED should always measure testosterone). It may also be due to some local diseases in the penis, such as the appearance of fibrosis.



Risk factors

Most of the time, organic ED is related to risk factors such as diabetes, high blood pressure, high cholesterol and triglycerides, obesity (the so-called Metabolic Syndrome), sedentary lifestyle, excessive alcohol, smoking, depression, etc. Changing habits and controlling these risk factors can improve erections in many men. We should also not forget that some drugs can influence the quality of erections and their replacement with other drugs – under medical supervision – can reverse the situation.


When the cause is psychological, only a good orientation can be enough to improve the situation, but many times we have to resort to brief sexual therapy, which is usually carried out between two to six months in order to reduce anxiety about sex and the called “performance fear”, which is the fear of entering into sexual intercourse and not getting an erection. Sometimes, we can combine drugs with sex therapy to facilitate an erection.


The first line erectile dysfunction treatment in Delhi today is oral drugs from the phosphodiesterase type 5 inhibitor family. They are erection facilitators and need desire and stimulation for an erection to occur. They should be taken about an hour before intercourse.


When these drugs do not work well, the second line of treatment is drugs that can be injected into the penis through a small syringe and needle. It is usually painless, and an erection occurs within 5 to 10 minutes. These are erection-inducing drugs. When these also do not work, we can resort to penile prosthesis implant surgery, whose objective is to provide adequate rigidity to the penis. Dentures can be malleable or inflatable.


A man with erectile dysfunction should see his sexologist doctor in Delhi to discuss the best treatment for his problem, its risks, contraindications, and side effects. Currently, erectile dysfunction is always treatable, but treatment must be individualized for each patient.

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