It happens to me several times a week. I sit with a couple about to end their relationship. One partner is visible upset, typically believing the other is cheating, not in love with them, or no longer attracted to them like they once were. The other partner lowers his head in embarrassment, aware that something outside his control is causing the turmoil. I know from the moment I walk in the exam room that I am dealing with Erectile Dysfunction, a medical condition affecting nearly 30 million men in the United States and over 100 million around the world.
Erectile Dysfunction is defined as the inability to achieve or maintain an erection meaningful enough for sexual activity. A broad definition, but one men of all ages know all too well. For the couples I see, the knowledge that they are dealing with erectile dysfunction is only a small part of the problem. They want to know what causes such a life changing condition and what options I have to treat it. Declining testosterone that happens with age is the primary cause in a small percentage of men while nerve damage from prostate surgery, traumas or neurologic conditions affects another slightly larger group. However, it is a hardening of the small blood vessels to the penis that cause the majority of the cases of erectile dysfunction worldwide. Smoking, diabetes, high blood pressure, medications, and a sedentary lifestyle can all lead to a progressive inability of the arteries to the penis to bring enough blood into the penis for meaning sexual activity. To make things worse, once the damage is done there is no going back.
However, when it seems like all hope is lost, I am happy to tell patients that there are many options in treating Erectile Dysfunction. For men with nerve damage or blood flow issues, I typically start with pills to improve blood flow. Viagra, Cialis, and Levitra are all designed to stimulate the blood vessels to stretch open for a longer period of time, leading to better and longer lasting erections. Ultimately, some men will not get to where they need to be with the pills alone. For these men, the permanent solution is available in the form of a penile implant. The implant is a procedure done through a keyhole opening that allows men to achieve an erection on demand without the need for pill. Made famous when Telemundo star Andres Garcia publicly announced he had undergone penile implant surgery, the penile implant has been around for over thirty years. Garcia named his implant “La Bombita”, the little bomb, on public TV and proclaimed the benefits to thousands of men.
The take home is clear, despite erectile dysfunction being incredibly common and anxiety inducing, men can regain their confidence and intimacy through several treatment options. Seeing an expert allows for a customized and individualized plan to get men back in the game.