What is erectile dysfunction? 什麼是勃起功能障礙？男仕們，你有沒有陽萎、性無能、不舉、腎虧呢？

Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It’s sometimes referred to as impotence, although this term is now used less often.

Occasional ED isn’t uncommon. Many men experience it during times of stress. Frequent ED, however, can be a sign of health problems that need treatment. It can also be a sign of emotional or relationship difficulties that may need to be addressed by a professional.

ED can occur because of problems at any stage of the erection process. An erection is the result of increased blood flow into your penis. Blood flow is usually stimulated by either sexual thoughts or direct contact with your penis.

When a man is sexually excited, muscles in the penis relax. This allows for increased blood flow through the penile arteries, filling two chambers inside the penis. As the chambers fill with blood, the penis grows rigid.

An erection ends when the muscles contract, and the accumulated blood can flow out through the penile veins.

Erectile dysfunction causes

There are many possible causes of ED, and they can include both emotional and physical conditions. Common causes include:

• cardiovascular disease
• diabetes
• hypertension, or high blood pressure
• high cholesterol
• obesity
• low testosterone levels or other hormone imbalances
• kidney disease
• increased age
• stress
• anxiety
• depression
• relationship problems
• certain prescription medications, such as those used to treat high blood pressure or depression
• sleep disorders
• drug use
• consuming too much alcohol
• using tobacco products
• certain health conditions, such as Parkinson’s disease or multiple sclerosis (MS)
• damage to the pelvic area through injury or surgery
• Peyronie’s disease, which causes scar tissue to develop in the penis

ED can be caused by only one of these factors or by several of them. That’s why it’s important to work with your doctor so that they can rule out or treat any underlying medical conditions.

Medications

Your doctor may prescribe medication to help you manage the symptoms of ED. You may need to try several medications before you find one that works. The following oral medications stimulate blood flow to your penis to help treat ED:

• avanafil (Stendra)
• sildenafil (Viagra)
• tadalafil (Cialis)
• vardenafil (Levitra, Staxyn)
• Alprostadil (Caverject, Edex, MUSE) is another medication that can be used to treat ED. It can be administered in two ways: as a penile suppository or as a self-injection at the base or side of the penis.
• Testosterone therapy (TRT) may also be recommended if you have low levels of testosterone.

Medications used for other conditions may cause ED. Talk to your doctor about your medications and whether they could be causing your symptoms. There may be others that you can take instead. Never stop taking medications without first talking to your doctor.

Medications for ED can cause side effects. If you’re experiencing unpleasant side effects, talk to your doctor. They may be able to recommend a different medication. Also, get more information on the medications used to treat ED.

Talk therapy

Several psychological factors can cause ED, including:

• stress
• anxiety
• post-traumatic stress disorder (PTSD)
• depression

If you’re experiencing psychological ED, you may benefit from talk therapy. Over several sessions, you and your therapist will discuss:

• major stress or anxiety factors
• your feelings around sex
• subconscious conflicts that could be affecting your sexual well-being

If ED is affecting your relationship, consider speaking with a relationship counsellor as well. Relationship counselling can help you and your partner reconnect emotionally, which may also help your ED. In addition, explore the effects of stress and anxiety on ED.

Vacuum pumps

This treatment uses the creation of a vacuum to stimulate an erection. Blood is drawn into the penis as the device is used, leading to an erection. A vacuum pump device consists of a few different components:

• a plastic tube, which you place over your penis
• a pump, which works to create the vacuum by drawing air out of the plastic tube
• an elastic ring, which you’ll move to the base of your penis as you remove the plastic tube

The elastic ring functions to maintain the erection, holding the blood in the penis and preventing it from returning to circulation. It can be left in place for 30 minutes. Read more about vacuum pumps and how to use them.

Erectile dysfunction symptoms

You may have ED if you regularly have:

• trouble getting an erection
• difficulty maintaining an erection during sexual activities
• reduced interest in sex

Other sexual disorders related to ED include:

• premature ejaculation
• delayed ejaculation
• anorgasmia, or the inability to achieve orgasm after ample stimulation

Speak with your doctor if you have any of these symptoms, especially if they’ve lasted for 3 or more months. They can help determine whether your symptoms are caused by an underlying condition that requires treatment.