Understanding Erectile Dysfunction (ED): Causes, Symptoms, and Treatment
An erection is a complex physiological process. When Sexual Stimulation occurs:
- Nerve endings release Nitric Oxide.
- This causes the relaxation of smooth muscles in the penis.
- Blood flow to the penis increases significantly, resulting in an erection.
What Causes Erectile Dysfunction?
ED can be categorized into two main types based on the root cause:
1. Organic Erectile Dysfunction (Physical Causes)
Vascular Issues: Obesity, smoking, hypertension (high blood pressure), diabetes, or history of pelvic surgery/radiation.
Neurological Issues: Spinal cord disorders, stroke, or brain tumors.
Structural Issues: Phimosis (tight foreskin), Penile Cancer, or Peyronie’s disease.
Endocrine (Hormonal) Issues: Low Testosterone (Low T), high thyroid hormones, or diabetes.
Trauma: Injury or radiation therapy to the pelvic area.
Medications & Substances: Side effects from certain drugs or substance abuse.
2. Psychogenic Erectile Dysfunction (Psychological Causes)
This is often related to mental health factors such as anxiety, depression, and Obsessive-Compulsive Disorder (OCD).
The Link Between Erectile Dysfunction and Cardiovascular Disease
There is a strong connection between sexual health and heart health.
A Warning Sign: ED acts as an early indicator of future cardiovascular issues. Studies show an 80% chance of developing cardiovascular disease within 10 years for men with ED.
Risk Assessment: If the cause of ED cannot be identified (e.g., no psychological issues or low testosterone), it is highly recommended to undergo a CT for Coronary Artery Calcium. This assesses the current risk of coronary artery disease.
What Should You Do if You Have Erectile Dysfunction?
If you are experiencing symptoms, follow these steps:Consult a Doctor: To assess the type and severity of ED and perform a physical exam to find co-morbidities.
Lab Tests: Check Testosterone levels and screen for other conditions like diabetes, high blood pressure, high cholesterol, and Benign Prostatic Hyperplasia (BPH).
Lifestyle Changes:
- Weight Reduction: Lose excess weight.
- Stop Smoking: Quit smoking immediately.
- Exercise: Engage in regular physical activity
Treatment Options for Erectile Dysfunction
Effective treatment often involves a combination of lifestyle changes and medical intervention:
Behavioral Modification: Weight loss, smoking cessation, exercise, and adequate sleep.
Medication (PDE5 Inhibitors): Two main types are available in Thailand:
Sildenafil: Short-acting medication.
Tadalafil: Long-acting medication.
Alternative Therapies:
PRP Injection: Platelet Rich Plasma Injection for rejuvenation.
Shockwave Therapy: Low-intensity shockwave therapy to stimulate blood vessel growth.
Vacuum Erection Devices: Mechanical aid to induce an erection.
Surgical Options:
Penile Prosthetic Implant: Considered when other treatments are ineffective.
Expert Insight: Dr. Dong’s Opinion
"Erectile dysfunction is a very common issue among Thai men, and it is not something to be ashamed of. Most causes stem from co-existing health conditions that are treatable. Treating the root cause yields the best long-term results."
The final message I want to leave with anyone facing this problem is: "Erectile Dysfunction does not equal Viagra." "And if the bird doesn't sing, we can treat it."
Article by: Dr. Phurin Thoprasert (Medical License No. 56017) Obstetrician-Gynecologist and Clinical Sexologist
