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Erectile Dysfunction (ED)

Erectile Dysfunction

What types of sex problems can men have? — Sex problems in men can include:
Being unable to get or keep an erection most times you have sex. Doctors call this "impotence" or "erectile dysfunction."
Having little or no interest in sex. Doctors call this "low libido."
Ejaculating too soon after sex begins, before they are ready to ejaculate. Doctors call this "premature ejaculation."
Being unable to ejaculate (even though they can get and keep an erection).
What causes sex problems? — Men can have trouble getting or keeping an erection if they have a condition that keeps the penis from getting enough blood. Things that reduce blood flow to the penis can include:
Getting older
High blood pressure
Drinking alcohol or taking drugs
Sex problems can also occur when men feel depressed or worried, or have problems with their partner or relationship. Plus, sex problems can be a side effect of certain medicines. For example, medicines to treat depression or heart disease sometimes cause sex problems.
Should I see a doctor or nurse? — Yes. Your doctor or nurse can help figure out the cause of your problem. He or she will talk with you, do an exam, and order blood tests. He or she might also order another test, such as a test that measures your night-time erections.
Is there anything I can do on my own to improve things? — Maybe. If you are having relationship problems, you can try to improve your relationship with your partner. For example, you can:
Talk to your partner about how to make sex better
Make an effort to have more fun together by having a regular "date night"
Read books or websites about sex
Go to counseling, either on your own or with your partner
If you are overweight, losing weight might help improve your sex problems. Getting regular exercise can help, too, even if you are not overweight.
How are sex problems treated? — Treatment depends on the cause of the problem and can include:
Medicines to help you get and keep an erection – Examples of these medicines include sildenafil (sample brand name: Viagra), vardenafil (sample brand name: Levitra), tadalafil (sample brand name: Cialis), and avanafil (sample brand name: Stendra). These medicines can cause side effects, such as low blood pressure. It's important to follow your doctor's instructions closely when taking these medicines. Also, let your doctor know if you are taking any other medicines, as certain combinations can be unsafe. Men who take certain medicines should not take medicines to get an erection. Examples include "nitrates" that are used to treat heart problems, and certain "alpha blockers" that are used to treat an enlarged prostate gland.
Some medicines for treating sex problems are sold over the internet. However, these are not always safe, and they can even contain harmful ingredients.
Devices to help you get and keep an erection – Erection devices work in different ways. Some are implanted into the penis to form an erection. Others work a bit like a vacuum and help pull blood into the penis.
Hormone treatment – Sex problems can happen when a man's body does not make enough male hormones (testosterone). If your hormone levels are very low, your doctor might treat you with testosterone, which can come in a shot, skin patch, skin gel, capsule, or tablet that sticks to your gums.
Treatment to improve mood – Doctors might prescribe medicines or counseling for men who feel depressed or worried.
Treatments to delay ejaculation – Doctors can prescribe medicines to keep men from ejaculating too quickly. Some of the medicines used to treat depression work very well for this. Some men also use a method called "pause and squeeze." In this method, a man stops having sex and presses behind the tip of the penis when he feels like he is going to ejaculate. After the feeling goes away, he continues having sex.
Treatment to help ejaculation problems caused by depression medicines – Sometimes, medicines used to treat depression can make it hard or impossible for a man to ejaculate. Let your doctor know if this happens. He or she can change your dose or your medicine so the problem gets better.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15497 Version 11.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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