What is it?
Erectile Dysfunction, also called impotence, is a medical condition found in
                    male patients where they either cannot get or keep an erection firm enough for sex. 
If the patient has
                    erectile dysfunction from time to time, it is not a cause for concern. However, if this condition lasts for a
                    long time then it can cause stress, affect their self-confidence and also might cause problems in their
                    relationship. 
It advisable for patients suffering from erection problems to consult a doctor as in some
                    cases, it can be cured if an underlying problem is treated.
                
                When to see a doctor?
                It is recommended that the patient consult the doctor if any of the following symptoms are present:
                
                    - Cannot get an erection
- Cannot keep an erection
- Diminished sexual desire
- Concerns about other sexual problems
- Premature or delayed ejaculation
                    The doctor would need to know if the patient has any health conditions like diabetes, heart disease or any
                    other health conditions that can be linked to erectile dysfunction.
                
                
                    Diagnosis
The doctor usually performs the following tests to confirm the diagnosis of
                    erectile dysfunction:
                
                
                    - 
                        Physical Examination: involves the examination of the penis and testicles carefully and
                        check the nerves for sensation.
                    
- 
                        Blood Tests: involves testing the patient’s blood for heart disease, diabetes, low
                        testosterone level, and other medical conditions.
                    
- 
                        Urine Tests: will be done to look for signs of diabetes and other underlying medical
                        conditions.
                    
- 
                        Ultrasound: is usually done in combination with an injection of medications into the
                        penis to stimulate the blood flow and cause an erection.
                    
- 
                        Psychological Examination: might be done to rule out depression or any other
                        psychological problems that can cause erectile dysfunction.
                    
                    Treatment
The doctor might opt for the right treatment options depending on the cause
                    and severity of the erectile dysfunction. Some of the treatment options are:
                
                
                    - 
                        Medications: include the following types:
 
                            - 
                                Oral Medications: like viagra etc., will help enhance the effects of nitric oxide
                                produced by the body to relax the muscles of the penis, allowing for an increase in blood flow helping
                                for an erection when stimulated sexually.
                            
- 
                                Alprostadil Self-Injection: is done directly into either the base or side of the
                                penis to create an erection that can last nearly an hour.
                            
- 
                                Alprostadil Urethral Suppository: involves in placing this suppository inside the
                                penis in the penile urethra allowing for an erection that will start in 10 minutes and lasting from
                                30-60 minutes.
                            
- 
                                Testosterone Replacement: might be recommended in combination with other therapies
                                for patients with low levels of testosterone.
                            
 
- 
                        Penis Pumps, Surgery, and Implants: are usually recommended when medications are not
                        effective. 
 
                            - 
                                Penis Pump: consists of a hollow tube with a pump, either hand-powered or
                                battery-operated, which are placed over a penis and the pump is used to suck out the air inside the
                                pump. This leads to a vacuum that will help pull blood into the penis.
                            
- 
                                Penile Implants: involves in surgically placing implants, consisting of either
                                inflatable or bendable rods, on both sides of the penis. These devices will help in controlling the time
                                and length of the erection.
                            
 
                    
                        Authored by Dr. Anitha Mani - Infertility Specialist &
                        Laparoscopy Surgeon