Erectile dysfunction (ED) is the inability to achieve and maintain an erection firm enough for sexual intercourse. This condition is also commonly known as impotence.
Occasional difficulty in getting or keeping an erection isn’t necessarily a cause for concern. However, if the problem is persistent, erectile dysfunction can lead to stress, low self-confidence, and problems in relationships. It may also be a warning sign of an underlying medical condition that needs treatment, or a risk factor for heart disease.
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Symptoms of Erectile Dysfunction
It’s common for men to occasionally experience erection difficulties. However, ED symptoms are usually persistent and may worsen over time. Symptoms may include:
- Difficulty getting an erection
- Difficulty maintaining an erection
- Decreased sexual desire
When to See a Doctor
Consult a doctor if you experience any of the following:
- Concerns about your erections or other sexual problems, such as premature or delayed ejaculation
- You have diabetes, heart disease, or other health conditions that may be linked to erectile dysfunction
- You experience other symptoms along with erectile dysfunction
Causes of Erectile Dysfunction
Sexual arousal in men involves a complex interaction of the brain, hormones, emotions, nerves, muscles, and blood vessels. Erectile dysfunction can result from problems in any of these areas. Additionally, stress and mental health issues can either cause or worsen ED.
Sometimes, erectile dysfunction results from both physical and psychological causes. For example, a mild physical condition that slows sexual response may trigger anxiety about maintaining an erection, which then aggravates the ED.
Common Physical Causes:
- Heart disease
- Clogged blood vessels (atherosclerosis)
- High cholesterol
- High blood pressure
- Diabetes
- Obesity
- Metabolic syndrome (a combination of high blood pressure, high insulin levels, excess body fat around the waist, and high cholesterol)
- Parkinson’s disease
- Multiple sclerosis
- Side effects of certain medications
- Smoking
- Peyronie’s disease (curved or painful erection, shortened penis during erection, or noticeable lumps)
- Excessive alcohol consumption and substance abuse
- Sleep disorders
- Prostate cancer treatment or prostate enlargement procedures
- Pelvic or spinal cord injuries or surgeries
- Low testosterone levels
Psychological Causes:
The brain plays a vital role in initiating the physical events that lead to an erection. Psychological conditions that can affect sexual arousal include:
- Depression, anxiety, or other mental health disorders
- Stress
- Relationship problems
Risk Factors for Erectile Dysfunction
As men age, erections may take longer to develop and may not be as firm. Direct stimulation of the penis might also be necessary. However, erectile dysfunction is not an inevitable part of aging.
Risk factors that can increase the likelihood of ED include:
- Certain health conditions, such as diabetes or heart disease
- Smoking, which affects blood flow and can cause long-term health issues linked to ED
- Being overweight or obese
- Medical treatments such as prostate surgery or radiation therapy for cancer
- Injuries, especially those affecting the nerves or blood vessels involved in erections
- Use of certain medications, including antidepressants, antihistamines, and drugs for high blood pressure, pain, or prostate conditions
- Mental health issues such as stress, anxiety, and depression
- Long-term or excessive use of alcohol or recreational drugs
Complications of Erectile Dysfunction
Erectile dysfunction can lead to:
- Unsatisfactory sex life
- Depression, anxiety, or stress
- Embarrassment or low self-esteem
- Relationship difficulties
- Inability to conceive
Preventing Erectile Dysfunction
The best way to prevent erectile dysfunction is by maintaining a healthy lifestyle and managing any chronic medical conditions. Prevention tips include:
- Work with a doctor to manage diabetes, heart disease, or other chronic health conditions
- Schedule regular checkups and health screenings
- Quit smoking, limit or avoid alcohol, and avoid illegal drugs
- Exercise regularly
- Effectively manage stress
- Seek medical help for anxiety, depression, or other mental health issues
How to Treat Erectile Dysfunction
The first step in treating erectile dysfunction is identifying the underlying cause. A doctor will help determine the most appropriate treatment method.
Possible treatment options include:
- Cardio exercise: Engaging in moderate to intense cardio activity for at least 45 minutes, three times a week, can help improve mild ED. This can include brisk walking, jogging, swimming, cycling, or jumping rope.
- Quitting smoking: Men with mild ED often see improvement within a few months of quitting smoking.
- Sex therapy or counseling: Useful for addressing psychological causes of ED.
- Oral medications: Such as sildenafil, vardenafil, tadalafil, or avanafil, which help improve blood flow to the penis. These typically begin to work within an hour.
- Low-intensity shockwave therapy (LiSWT): A non-invasive treatment using sound waves to improve blood flow. Results are usually seen within two months.
- Penile injections: Medications like alprostadil, papaverine, phentolamine, or a combination of drugs can be injected directly into the penis, producing an erection within 10 minutes.
- Vacuum erection devices (penis pumps): These work almost immediately to help achieve an erection.
- Testosterone replacement therapy: Available in gel, injection, patch, or pellet forms. Results typically appear within four weeks.
Andrology Specialist at Mandaya Royal Hospital Puri: Expert in Treating Erectile Dysfunction
Premature ejaculation and other male sexual health issues can be effectively treated by an andrology specialist. Andrology is a subspecialty of urology focused on male reproductive health. Conditions treated include:
- Premature ejaculation
- Erectile dysfunction
- Male hormone disorders (e.g., low testosterone)
- Male infertility
- Disorders of the testicles, penis, and prostate
If you are experiencing premature ejaculation or other sexual dysfunctions, consulting an andrology specialist is an important step toward effective treatment.
At Mandaya Royal Hospital Puri, you can consult with dr. Heru Harsojo Oentoeng, M.Repro, Sp.And (K), FECSM, a highly experienced andrologist and graduate of Udayana University. He also holds the title of Fellow of the European Committee of Sexual Medicine and is a certified Andrology Consultant with expertise in sexology and anti-aging medicine.
In addition to treating premature ejaculation, dr. Heru provides various diagnostic and therapeutic services, including:
- PSA (Prostate-Specific Antigen) testing
- Semen analysis
- Hormone therapy
- Micro-TESE (Microdissection Testicular Sperm Extraction)
- Fertility consultation and rehabilitation programs
- Personalized pharmacological therapies
Clinic Schedule for dr. Heru Harsojo Oentoeng, M.Repro, Sp.And (K), FECSM at Mandaya Royal Hospital Puri:
- Monday: 18:00 – 20:00 WIB
- Friday: 18:00 – 20:00 WIB
To make your visit easier, you can use the Chat on WhatsApp, Book Appointment feature, or download the Care Dokter app from Google Play or the App Store to check queue numbers, schedule visits, and access more information.
