Erectile Dysfunction

Erectile Dysfunction Evaluation at Southland Urology

Erectile dysfunction (ED), also known as impotence, is a common condition where a man has consistent trouble getting or maintaining an erection firm enough for sexual activity. It can be caused by physical factors, such as issues with blood flow, or psychological factors like stress and anxiety. While ED is more common with age, it’s not considered a normal part of aging and can often be a warning sign for other underlying health conditions.

Understanding Erectile Dysfunction

Erectile dysfunction (ED), also known as impotence, is a common male sexual health issue characterized by the persistent inability to achieve or maintain an erection firm enough for satisfactory sexual performance. While it’s not unusual to have occasional erection problems, ongoing issues should be addressed as they can cause stress, impact relationships, and may signal an underlying health condition. The process of getting an erection is complex, involving the brain, hormones, nerves, blood vessels, and muscles, and a problem with any of these components can lead to ED.

At Southland Urology, our urologists are highly trained and experienced in treating patients with erectile dysfunction. Call our urology clinic at (714) 870-5970 to schedule an appointment today!

Causes and Types of ED

ED can be caused by a wide range of factors, which are often categorized into two main types: organic (physical) and psychogenic (psychological).

Organic Causes: The most common type of ED is organic, often related to physical conditions that affect blood flow, nerves, or hormones. These include:

• Vascular Issues: The most frequent cause, where conditions like heart disease, high blood pressure (hypertension), high cholesterol, and atherosclerosis (hardening of the arteries) reduce blood flow to the penis. ED can often be an early warning sign of cardiovascular disease.
• Neurological Conditions: Problems with the nervous system can prevent signals from the brain from reaching the penis. This can be caused by conditions such as multiple sclerosis, Parkinson’s disease, or nerve damage from surgery or injury.
• Hormonal Imbalances: Low testosterone levels (hypogonadism) can contribute to ED, although it is rarely the sole cause. Other hormonal issues, like those involving the thyroid, can also play a role.
• Other Physical Factors: These can include diabetes, obesity, Peyronie’s disease (a condition causing a curved penis), and side effects from certain medications (e.g., antidepressants, blood pressure drugs). Lifestyle factors like smoking, excessive alcohol consumption, and drug use can also contribute.

Psychogenic Causes: Psychological factors can also interfere with sexual arousal and performance. Common causes include:

• Mental Health Conditions: Stress, anxiety, depression, and relationship problems are often significant contributors to ED. Performance anxiety, in particular, can create a cycle of worry that makes it difficult to achieve an erection.
• Emotional Trauma: A history of sexual trauma or abuse can also lead to ED.

Diagnosis of ED

To determine the underlying cause of ED, a healthcare provider will typically conduct a comprehensive evaluation. This usually begins with a detailed discussion of your medical, sexual, and mental health history. They may ask about the frequency and quality of your erections, as well as any other symptoms you are experiencing.

A physical exam will be performed to check for any physical abnormalities in the genitals and to assess overall health. Depending on the findings, additional tests may be ordered, such as:

• Blood and Urine Tests: These can help identify underlying conditions like diabetes, kidney disease, or hormonal issues.
• Ultrasound: A Doppler ultrasound of the penis can be used to check blood flow and detect any vascular problems.
• Nocturnal Penile Tumescence (NPT) Test: This at-home test monitors erections during sleep to distinguish between physical and psychological causes of ED.

Treatment Options

Fortunately, a wide range of effective treatments for ED are available. Treatment is tailored to the individual and depends on the underlying cause.

Lifestyle Changes: For many, improving overall health can significantly reduce ED symptoms. This includes:

• Quitting smoking
• Limiting alcohol consumption
• Maintaining a healthy weight
• Regular exercise
• Managing stress and anxiety

Medications: Oral medications called phosphodiesterase-5 (PDE5) inhibitors are often the first-line treatment. These drugs, such as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra), work by increasing blood flow to the penis. Other medications may include injectable or intraurethral therapies.

Devices and Surgery: If medications are not effective, other options may be considered, including:

• Vacuum Erection Devices (VEDs): These devices use a plastic cylinder and a pump to create a vacuum that draws blood into the penis, creating an erection.
• Penile Implants: A surgical procedure to place a device inside the penis to allow for a reliable, on-demand erection. This is considered the closest option to a cure for ED.

In addition to these medical treatments, counseling and therapy can be very helpful, especially if psychological factors are contributing to ED.