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Impotence (Erectile dysfunction) - Treatment

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of erectile dysfunction.

Alternative Names

Treatment:

Many physical and psychological situations can cause erectile dysfunction, and brief periods of impotence are normal. Every man experiences erectile dysfunction from time to time. Nevertheless, if the problem is persistent, men should seek professional help, particularly since erectile dysfunction is usually treatable and may also be a symptom of an underlying health problem. It is important to treat any medical condition that may be causing erectile dysfunction.

Treatment Choices

Drug therapy with PDE5 inhibitors is the main treatment for erectile dysfunction. Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) are the three PDE5 inhibitor drugs approved for treatment erectile dysfunction. In general, if a man is a candidate for PDE5 inhibitor therapy and is satisfied with the results, no further treatment is necessary.

PDE5 inhibitors are not safe or effective for all men. Men who cannot or choose not to take the drugs may have other options, including:

Medications inserted or injected into the penis
Vacuum devices
Surgery (limited to rare cases)

Ultimately, how successful the medical treatment is and how well it is accepted depends, in large part, on the man's expectations and how he and his partner both adapt to the procedure.

Psychotherapies. Some form of psychological, behavioral, or sexual therapy may be recommended for certain patients.

Lifestyle Changes. No matter what the treatment, embarking on a healthy lifestyle is the first and critical step for restoring and maintaining erectile function.

Resources

www.niddk.nih.gov -- National Kidney and Urologic Diseases Information
www.auanet.org -- American Urologic Association
www.urologyhealth.org -- Urology Health

References

Babaei AR, Safarinejad MR, Kolahi AA. Penile revascularization for erectile dysfunction: a systematic review and meta-analysis of effectiveness and complications. Urol J. 2009 Winter;6(1):1-7

Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, et al. Testosterone therapy in adult men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2006 Jun;91(6):1995-2010. Epub 2006 May 23.

Boloña ER, Uraga MV, Haddad RM, Tracz MJ, Sideras K, Kennedy CC, et al. Testosterone use in men with sexual dysfunction: a systematic review and meta-analysis of randomized placebo-controlled trials. Mayo Clin Proc. 2007 Jan;82(1):20-8.

Lindau ST, Schumm LP, Laumann EO, Levinson W, O'Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007 Aug 23;357(8):762-74.

McVary, K. T.. Clinical practice. Erectile dysfunction. N Engl J Med. 2007 Dec; 357(24): 2472-81.

Melnik T, Soares BG, Nasselo AG. Psychosocial interventions for erectile dysfunction. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004825.

Miles CL, Candy B, Jones L, Williams R, Tookman A, King M. Interventions for sexual dysfunction following treatments for cancer. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005540.

Müller A, Mulhall JP. Cardiovascular disease, metabolic syndrome and erectile dysfunction. Curr Opin Urol. 2006 Nov;16(6):435-43.

Nehra A. Erectile dysfunction and cardiovascular disease: efficacy and safety ofphosphodiesterase type 5 inhibitors in men with both conditions. Mayo Clin Proc. 2009 Feb;84(2):139-48.

Saad F, Grahl AS, Aversa A, Yassin AA, Kadioglu A, Moncada I, et al. Effects of testosterone on erectile function: implications for the therapy of erectile dysfunction. BJU Int. 2007 May;99(5):988-92. Epub 2007 Feb 19.

Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007 Feb;120(2):151-7.

Vardi M, Nini A. Phosphodiesterase inhibitors for erectile dysfunction in patients with diabetes mellitus. Cochrane Database Syst Rev. 2007 Jan 24(1):CD002187.

Reviewed last on: 7/8/2009
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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