Erectile Dysfunction (ED)
Who does ED affect?
ED can be an embarrassing and challenging problem for men. Athough this disorder is highly age dependent, it affects men of all ages. Up to 10% of men below the age of 40, 20% at the age of 40, and increases every decade until 50% are affected by the age of 70. It affects approximately 50% of men during their lifetime.
What is ED?
Erectile Dysfunction, or impotence, is the inability to develop or sustain an erection for sexual activity. If the blood flow into the penis is not sufficient, or if the valves that are supposed to keep the blood inside are defective, then a complete, firm erection will not occur. Unfortunately, once an episode of ED occurs, performance stress complicates future sexual encounters and can aggravate the condition further.
Why does it happen?
There are many factors that could contribute to ED, including:
- Hormonal disorder such as diabetes
- Blood flow reduction to the penis
- Peyronie’s disease – the scarring of the penile tissues
- Nerve damage
- Injury or surgical procedures to the spinal cord or pelvic area
- Vascular disorders
- Neurologic related conditions such as multiple sclerosis or Parkinson's disease
- Psychological conditions
- High cholesterol
- Heart disease
- Occurrence or treatment for an enlarged prostate or prostate cancer
- Sleep-related disorders
- Tobacco use
- Alcohol and other recreational drug use
- Alcoholism and other substance abuse disorders
- Vein leakage
How is ED diagnosed?
A provider typically asks a series of questions to determine family and sexual history, the male's ability to produce, sustain, and frequency of erections and sexual relations, levels of satisfaction, etc. In some cases, blood tests, a urinalysis or ultrasound are needed to help determine if there are any medical conditions known to cause ED.
How can someone be treated for ED?
The most common treatment for erectile dysfunction is with prescribed medication known as phosphodiesterase-5 (PDE-5) inhibitors. Some commonly used examples of this class of medication are sildenafil and tadalafil. These tablets are usually taken around an hour before sex, and their benefits last between 4 and 36 hours. Daily dosing of tadalafil is another popular treatment option. This treatment option eliminates the concern for medication timing. Overall, this class of medication is effective for about 75% of men with erectile dysfunction.
If PDE-5 inhibitors are not appropriate or do not provide the desired effect, other therapies might be offered, which include: injections into the base of the penis, which cause flow of blood into the penis and an immediate erection that lasts around an hour, or surgical and mechanical treatments.
Lifestyle changes that improve erectile dysfunction include weight loss, exercise, reducing stress levels, decreasing or eliminating the use of alcohol, recreational drugs and cigarettes.
What is the cost of ED medication?
ED medications are available in both branded and generic formulations. The generic formulations are a much more cost effective option, especially considering that many health plans do not cover the cost of ED medication. Although the price of ED medication varies, visiting discount pharmacies provides the least expensive alternative. Additional savings may be realized by presenting a prescription coupon (RxSaver®, WellRx®, SingleCare®, HelpRx®, etc.) at those pharmacies. For example, a typical prescription for Sildenafil 50 mg might be for 15 tablets. The fee for this medication using a discount pharmacy and an availble coupon is less than $1 per tablet, which works out to about $10/month for most treatments.
Where can someone be treated for ED?
Any NEW occurrence of ED should be evaluated in-person by a licensed medical provider. Men already diagnosed with ED that is treatable with oral medication may visit a telehealth provider to have treatment done online.
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Disclaimer: The information provided above is for educational purposes only and should not be construed as medical advice. Please consult with your healthcare provider or visit MDAnywhere for treatment.