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Erectile Dysfunction (Impotence)

Erectile Dysfunction (Impotence) is the inability to get and keep an erection of penis firm adequate for sex. Difficulty in erection from time to time does not cause of concern usually. If erectile dysfunction is a continuous ongoing issue then it should be considered as a cause of concern. However, it can be a sign of an underlying health condition (heart disease, diabetes) that needs to be treated.


  • Stressful situations
  • Relationship problems
  • Reduced sexual desire
  • Breech in self-confidence
  • Trouble getting an erection
  • Trouble keeping an erection
  • Embarrassing situations all the time

When to see a doctor

Contact us or your family doctor if you are experiencing few of following symptoms regarding erection

  • Breech in self-confidence
  • Trouble getting an erection
  • Trouble keeping an erection
  • Premature or delayed ejaculation
  • You have diabetes or heart disease
  • Embarrassing situations all the time

For Consultation Contact at 03009434930

Causes of erectile dysfunction

Male sexual arousal is a complex process that involves

  • Brain
  • Stress
  • Nerves
  • Anxiety
  • Muscles
  • Hormones
  • Emotions
  • Blood vessels
  • Physical causes
  • Psychological causes

Physical causes of erectile dysfunction

Psychological causes of erectile dysfunction

  • Stress
  • anxiety
  • Depression
  • Starting with feelings of sexual excitement.
  • Relationship problems due to poor communication or other concerns
  • The brain plays a key role in triggering the series of physical events that cause an erection

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Risk factors for erectile dysfunction

  • Obesity
  • Erections might take longer to develop with age
  • Might not be as firm as compared to young age
  • Long-term drug usage or heavy alcohol drinking
  • Medical conditions such as diabetes or heart disease
  • Psychological conditions, such as stress, anxiety or depression
  • You might need more direct touch to your penis to get and keep an erection.
  • Various risk factors can contribute to erectile dysfunction, including:
  • Tobacco use restricts blood flow to veins and arteries and can lead to erectile dysfunction
  • Injuries causing damage to nerves or arteries that control erections
  • Medications, including antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate conditions

Complications of erectile dysfunction

  • Stress or anxiety
  • Relationship problems
  • An unsatisfactory sex life
  • Embarrassment or low self-esteem
  • The inability to get your partner pregnant

Prevention of erectile dysfunction

  •  Exercise regularly.
  • Take steps to reduce stress
  • make healthy lifestyle choices
  • manage any existing health conditions
  • Stop smoking, limit or avoid alcohol, and don’t use illegal drugs.
  • Get help for anxiety, depression or other mental health concerns
  • Work with your doctor to manage diabetes, heart disease or other chronic health conditions.
  • See your doctor for regular checkups and medical screening tests.

Treatment of erectile dysfunction

Do vigorous aerobic activity/execercise, Quit smoking, loose excess weight, work through relationship issues

Oral medications

  • Sildenafil (Viagra)
  • Tadalafil (Adcirca, Cialis)
  • Vardenafil (Levitra, Staxyn)
  • Avanafil (Stendra)

Mechanism of action of oral medications

All above four medications increases the effects of nitric oxide (NO) a natural chemical produced by our body that relaxes muscles in the penis, increases blood flow and allows you to get an erection in response to sexual stimulation

Nitric Oxide and Erection Mechanism

Side effects of oral medications

  • Flushing
  • Backache
  • Headache
  • Stomach upset
  • Visual changes
  • Nasal congestion

Other Medications For Erectile Dysfunction

  • Alprostadil self-injection.
  • Alprostadil urethral suppository
  • Testosterone replacement 
  • Penis pumps
  • Penile implants

Alprostadil self-injection

  1. Injection alprostadil (Caverject) is injected through a fine needle to into the base or side of your penis.
  2. Sometimes injection alprostadil and phentolamine are used as bimix (if two medications are included) or trimix (if three are included)
  3. Each injection is dosed to create an erection lasting no longer than an hour.  Pain from the injection site is usually minor because the needle used is very fine
  4. Side effects can include mild bleeding from the injection, prolonged erection (Priapism) and, rarely, formation of fibrous tissue at the injection site.
Appropriate Injection Site is at 2 o Clock Position As shown in above

Alprostadil urethral suppository

  1. Alprostadil (Muse) intraurethral therapy involves placing a tiny alprostadil suppository inside your penis in the penile urethra
  2. You use a special applicator to insert the suppository into your penile urethra.
  3. The erection usually starts within 10 minutes and lasts between 30 to 60 minutes
  4. Side effects can include a burning feeling in the penis, minor bleeding in the urethra and formation of fibrous tissue inside your penis.

Testosterone replacement

Some people have erectile dysfunction that might be complicated by low levels of the hormone testosterone.

Penis pumps

  1. A penis pump (vacuum erection device) is a hollow tube with a hand-powered or battery-powered pump
  2. The tube is placed over your penis, and then the pump is used to suck out the air inside the tube
  3. This creates a vacuum that pulls blood into your penis.
  4. Once you get an erection, you slip a tension ring around the base of your penis to hold in the blood and keep it firm. You then remove the vacuum device
  5. The erection typically lasts long enough for a couple to have sex
  6. You remove the tension ring after intercourse
  7. Bruising of the penis is a possible side effect, and ejaculation will be restricted by the band. Your penis might feel cold to the touch.

Penile implants

  1. This treatment involves surgically placing devices into both sides of the penis. These implants consist of either inflatable or malleable (bendable) rods. Inflatable devices allow you to control when and how long you have an erection.
  2. The malleable rods keep your penis firm but bendable.
  3. Penile implants are usually not recommended until other methods have been tried first.
  4. Implants have a high degree of satisfaction among those who have tried and failed more-conservative therapies.
  5. As with any surgery, there’s a risk of complications, such as infection.
  6. Penile implant surgery is not recommended if you currently have a urinary tract infection.

For Consultation Contact at 03009434930