Erectile Dysfunction

Treatment

The first step in the treatment of ED includes the elimination or alteration of modifiable risk factors or causes, such as lifestyle or psychosocial factors including smoking, obesity, substance and alcohol abuse, and the alteration of prescription and over-the-counter medications if necessary.

Recommended treatment options for ED include the following medications:

• Oral erectogenic medications
• PDE-5 inhibitors. Sildenafil (Viagra) is an example. It works by blocking PDE-5 thereby allowing cGMP to have a longer effect, increasing penile blood flow and producing erection.
• Yohimbine
• Apomorphine
• Alpha adrenergic blockers

Vacuum constriction device therapy, which involves a mechanical device to increase penile blood flow and erection may also be recommended. Psychosexual therapy is also recommended so that any psychological causes for ED can be detected and therapy can be instituted. Individual psychotherapyor couples therapymay be helpful. These various treatment methods can be used alone or in combination.

If those therapies are unsuccessful, the following treatment options may be recommended:

• Intracavernous therapy (ICIT). This therapy involves injection of the penile structures with substances that promote blood flow and produce erection.
• Intraurethral therapy. Medications are inserted into the urethra and act to increase blood flow and muscle relaxation, allowing for erection.
• Penile prostheses. These are various devices inserted surgically into the penis to produce the erect state.
• Surgery. In rare cases, surgery may be used to correct a defect that interferes with penile erection.

Regardless of the therapy chosen, follow-up at regular intervals and good communication between the patient and the doctor is essential. Patients need to keep their doctors informed about adverse reactions, and patients need to be informed about drug interactions. The doctor may adjust the dosage of medication, or may substitute or add a therapeutic agent into the treatment, as necessary.

The patient and his sexual partner can work with their treatment team so that they are both well-informed about various treatment options and can maximize treatment results.

Content licensed from:

Author Info: Ralph Myerson M.D., The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Mental Disorders, 2003

This feature is for informational purposes only and should not be used to replace the care and information received from your healthcare provider. Please consult a healthcare professional with any health concerns you may have.