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Impotence (Erectile dysfunction)

Description

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

Treatment

The cause of impotence dictates the mode of treatment. The first step is to define the cause, if possible, and then try the simplest and least-risky solution.

Before a certain treatment is prescribed, the following factors should be considered:

• Any pre-existing illnesses and medications
• The degree of comfort with the treatment method
• Partner satisfaction and safety profiles need to be considered. Experts strongly recommend that the patient's partner be involved to help with any necessary sexual adjustment.

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

Treatment Choices

Medical and Surgical Treatments. Sildenafil (Viagra), the first effective oral drug for erectile dysfunction, has been on the market since 1998 and rapidly became the treatment of choice for most men with erectile dysfunction. In 2003, the FDA approved two other oral medications, vardenafil (Levitra) and tadalafil (Cialis), for the treatment of erectile dysfunction.

Those who cannot or choose not to take the drugs still have many other options, including:

• Medications inserted or injected into the penis
• Vacuum devices
• Intracavernosal injection therapy
• Invasive procedures, such as penile implants or surgery (limited to those for whom other treatments haven't worked and who have been carefully screened).

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, sexual, or combination therapy is often recommended for individuals suffering from severe impotence, regardless of cause.

• Review Date: 6/27/2006
• Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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