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Reality: Although the majority of diagnosed ED cases are a result of physical diseases that cause damage to nerves, fibrous tissues, and arteries (such as diabetes, MS, vascular disease, and neurological disease), experts theorize that up to 20 percent of ED cases are due to anxiety, stress, depression, and other psychological factors, according to the National Kidney and Urologic Disease Information Clearinghouse (NIDDK). One of the most common psychological causes of erectile dysfunction is performance anxiety that may result after several failed attempts at intercourse. The anxiety may increase, leading to more failed attempts, ultimately resulting in a cycle of anxiety and sexual failure.
for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians*
Seek care immediately if your erection lasts longer than 3 hours.
rgery to repair arteries can reduce impotence caused by obstructions that block the flow of blood to the penis. The best candidates for such surgery are young men with discrete blockage of an artery because of a physical injury to the pubic area or a fracture of the pelvis. The procedure is less successful in older men with widespread blockage of arteries.
Psychological therapy may be effective in conjunction with medical or surgical treatment. Sex therapists emphasize the need for men and their partners to be motivated and willing to adapt to psychological and behavioral modifications, including those that result from medical or surgical treatment.
Nocturnal penile tumescence (NPT) This is a simple test of normal erections during sleep. Their absence may indicate a problem with nerve function or blood supply in the penis. There are two methods used to test for nocturnal erection changes: snap gauge and strain gauge. The presence of NPT tends to signify physically functional systems, but the absence of NPT may not be conclusive.
Gao agreed that the diagnosis of restless legs syndrome is not as straightforward as other diagnoses, and that some of the men who reported restless legs syndrome probably did not really have it.
One simple device now making a comeback is the penile pump. It's a vacuum pump that lets a man draw blood into the penis. A constriction ring placed at the base of the penis keeps the penis erect during intercourse.
Your partner is affected by the problem, and is an important part of the solution. Nothing is going to help you more than talking with your partner about what works, and doesn't work, for both of you.
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According to the National Institute of Diabetes & Digestive & Kidney Diseases, it's estimated that about one-half of all people with diabetes have some kind of neuropathy. It becomes more common in those who are older, overweight, and those with high blood pressure.
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Following completion of this phase, the physician should be able to determine the medical status of the patient, to identify and characterize the type of dysfunction, and to determine the need for additional testing such as penile or pelvic blood flow studies, nocturnal penile tumescence testing, or other blood tests. The patient's needs, expectations, and priorities should be discussed in order to decide about further management or referral.
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