Erectile Dysfunction: Causes, Treatments, and Solutions

Q: Erectile Dysfunction: Causes, Treatments, and Solutions

Y Der： Hello, I also believe it is a problem related to venous return. <br>However, a detailed examination is generally required to make a definitive diagnosis before considering surgical treatment. <br>Currently, larger hospitals in the country have specialized tests for sexual

Erectile dysfunction

Hello, every time I have intercourse with my wife, I achieve a normal erection, but when I try to change positions, I quickly lose my erection.
For instance, whenever I stand up to change positions, it goes soft immediately, but it remains firm when lying down.
I've tried this many times, and it happens consistently.
Sometimes, even when I watch adult films, the same issue occurs; I can maintain an erection while sitting, but it goes soft as soon as I stand up.
This problem has been troubling me for a year.
I visited a doctor who suggested that I might have venous leakage.
If that's the case, what should I do? I've also tried taking Viagra, but the issue persists.
The doctor prescribed me some medications for blood circulation, and I've been taking them for two months, but there hasn't been much improvement.
I asked him if surgery would resolve the issue, but he said the success rate isn't guaranteed and advised me to try medication since I'm still young.
However, he didn't specify how long I should continue taking the medication.
I'm really distressed.
Are there any other methods that could help me recover quickly?

A De, 30~39 year old female. Ask Date: 2005/10/27

Dr. Xu Weikai reply Urology

Y Der: Hello, I also believe it is a problem related to venous return.
However, a detailed examination is generally required to make a definitive diagnosis before considering surgical treatment.
Currently, larger hospitals in the country have specialized tests for sexual function, and the success rates are very high.
If surgery is not desired, there were alternative methods in the past that could be tried, such as penile rings and vacuum erection devices, but with advancements in medicine, these are less commonly recommended now.
Department of Urology, Taitung Hospital, Ministry of Health and Welfare, Director Hsu Wei-Kai.

Reply Date: 2005/10/27

More Info

Erectile dysfunction (ED) is a common condition that affects many men at various stages of life. It is characterized by the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Understanding the underlying causes, available treatments, and potential solutions is crucial for managing this condition effectively.

Causes of Erectile Dysfunction
ED can arise from a variety of physical and psychological factors. Physically, it may be related to:
1. Vascular Issues: Conditions such as atherosclerosis (hardening of the arteries) can restrict blood flow to the penis, making it difficult to achieve an erection. Venous leakage, where blood flows into the penis but leaks out, can also contribute to ED.

2. Neurological Disorders: Conditions like multiple sclerosis or Parkinson's disease can affect nerve signals from the brain to the penis.

3. Hormonal Imbalances: Low testosterone levels can impact sexual desire and erectile function.

4. Chronic Diseases: Diabetes, hypertension, and obesity are known risk factors for ED.

5. Medications: Certain medications, particularly those for high blood pressure, depression, and anxiety, can have side effects that include erectile dysfunction.

Psychological factors also play a significant role, including:
1. Anxiety and Stress: Performance anxiety or stress related to work or personal life can lead to temporary or chronic ED.

2. Depression: Mental health issues can diminish libido and affect sexual performance.

3. Relationship Issues: Problems with a partner can contribute to sexual dysfunction.

Treatments for Erectile Dysfunction
Given the multifactorial nature of ED, treatment options vary widely:
1. Lifestyle Changes: Improving diet, exercising regularly, quitting smoking, and reducing alcohol intake can enhance overall health and improve erectile function.

2. Medications: Phosphodiesterase type 5 inhibitors (PDE5 inhibitors) such as Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil) are commonly prescribed. These medications enhance the effects of nitric oxide, which relaxes muscles in the penis and increases blood flow.

3. Hormonal Therapy: If low testosterone is identified, hormone replacement therapy may be considered.

4. Vacuum Erection Devices: These devices create a vacuum around the penis, drawing blood into it and causing an erection.

5. Penile Injections: Medications can be injected directly into the penis to induce an erection.

6. Surgery: In cases where other treatments fail, surgical options such as penile implants or vascular surgery may be considered.

Addressing Your Specific Concerns
From your description, it seems that you experience erectile firmness when lying down but have difficulty maintaining an erection when changing positions, particularly when standing. This could be indicative of venous leakage or other vascular issues, as suggested by your physician.
Since you have already tried PDE5 inhibitors like Viagra without success, it may be beneficial to explore further diagnostic tests, such as a penile Doppler ultrasound, to assess blood flow and identify any vascular issues. Additionally, discussing your concerns with a urologist who specializes in sexual medicine could provide more tailored options.

Regarding the medications you are currently taking for blood circulation, it is essential to maintain open communication with your healthcare provider about their effectiveness and any side effects you may experience. If you feel that your current treatment plan is not yielding results, don't hesitate to ask your doctor about alternative therapies or adjustments to your medication regimen.

Conclusion
Erectile dysfunction can be a complex issue, but it is important to remember that it is treatable. A thorough understanding of the underlying causes, along with a collaborative approach with your healthcare provider, can lead to effective management and improved sexual health. If you continue to experience difficulties, consider seeking a second opinion or exploring specialized clinics that focus on sexual health. Remember, you are not alone in this, and many men face similar challenges.

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