Understanding Erectile Dysfunction (ED): Now it is the 21st century with developed information, but there are still some patients with diseases who are reluctant to seek medical treatment, such as impotence. According to a survey data in the Klangel area, the prevalence of impotence can reach 50% to 55%, but many patients do not want to seek medical treatment, but secretly through friends’ introductions, or search for some home remedies on the Internet, or even buy drugs of unknown origin online, without realizing that this may cause great damage to health, especially the heart. Studies have also confirmed that patients with impotence without immediate treatment have a very high chance of coronary artery blockage within 18 months.
Modern medical research has confirmed that impotence is not only a matter of intercourse or face, it is directly related to cardiovascular health, because the penile artery is the smallest blood vessel in the human body (2 to 3 mm in diameter), followed by coronary arteries (6 mm to 1 cm in diameter) and cerebral blood vessels (1 to 1.5 cm). According to research, if a person has impotence, that is, the thinnest blood vessels appear hardened and not intervened, then he is very likely (57%) to have coronary artery sclerosis or blockage after 18 months, or cerebral blood vessels and peripheral arteriosclerosis or blockage, so impotence can be said to be the best warning light or aura of human blood vessels, when the patient is diagnosed with impotence, doctors must also pay attention to whether other blood vessels may be diseased.
The scientific name of impotence is Erectile Dysfunction (ED), which means that men have difficulty or inability to achieve enough hard and durable erections to complete satisfying sex before intercourse. However, there is another way of saying that if a man cannot get an erection in front of his partner, but he can do it to other women, in other words, he can get an erection but cannot have sex, which also belongs to the category of ED. After the epidemic, the “hemorrhoid” brother increased
According to the 2019 National Health and Morbidity Survey (NHMS), nearly half (47.1%) of men over the age of 18 are likely to have mild erectile dysfunction, while 31.6% have moderate to severe erectile dysfunction. Moreover, as mentioned in the report, ED cases are becoming younger. From my clinical experience, after the COVID-19 epidemic, there is an increasing trend of impotence patients, I believe that more than half, conservative estimate of 52% is not exaggerated. This data is also consistent with a 1992 survey conducted in the United States, which showed that 52% of men between the ages of 18 and 80 in the United States face some degree of erectile dysfunction.
As long as ED is mentioned, many people subconsciously think of ‘not lifting’, ‘premature ejaculation’ or even ‘kidney deficiency. Indeed, not citing is the manifestation of ED, but although premature ejaculation and ED are both sexual disorders, they are completely different and the treatment methods are different, so it must be clearly distinguished, as for kidney deficiency is Chinese medicine, and Western medicine urology has nothing to do with it.
In the past, doctors believed that ED would cause serious effects on patients’ sexual life and mental health, but as more studies appeared, they realized that it was originally related to cardiovascular disease. Similarly, in the past, ED was seen more as a psychological problem than a physiological problem. 80% caused by physiological factors
It was not until the 90s of last century, after the first generation of PDE-5 inhibitors for the treatment of ED (Phosphodiesterase Type 5 Inhibitors) were approved, that the medical community found that up to 80% of ED cases were caused by physiological factors in patients. The most common of these are the three highs (high blood sugar, high blood pressure, high blood lipids) and obesity.
Other things such as abuse of blood pressure-lowering drugs, menopause, poor testosterone levels, some surgeries (such as prostate cancer removal surgery), radiation therapy, and long-term smoking (which accelerates hardening of the arteries) and alcohol abuse (alcohol destroys male hormone production) can increase the risk of ED. It should be noted that if a person is chronically dehydrated, stays up late, lacks exercise, eats too greasy and stressed, it will also cause men’s testosterone levels to deteriorate, and testosterone levels are one of the causes of ED.
3 Major causes of impotence in adolescents
So is ED related to frequent intercourse or excessive masturbation? In fact, this is an unfounded statement, from a medical point of view, the number of intercourse and masturbation will not cause the appearance of ED, on the contrary, it can reduce the possibility of cancerous in the future.
Then it is necessary to quote the 2019 National Health and Incidence Survey mentioned earlier, the reason why adolescents have ED can be viewed from 3 aspects, the first is self-blame for excessive masturbation, many adolescents were reprimanded by their elders for being addicted to masturbation when they were teenagers, so they will feel ashamed of masturbation behavior and excessive self-blame from an early age.
Normal sex for 4 to 8 minutes
The second is the three highs and obesity are younger, and the three highs and obesity are the causes of ED. Finally, it is misled by the plot of pornographic movies, and there is a wrong understanding of sexual behavior, such as normal sex is about 4 to 8 minutes, but pornographic movies are edited for up to 48 minutes, so after failing to meet the so-called ‘ideal standards’, they will feel confused and disappointed, wonder if there is something wrong with themselves, and eventually cause ED problems due to anxiety.
Due to the lack of awareness of ED, and many people label it as a sexual problem, unwilling to talk more and ashamed to talk about it, so that there has been a lot of information that is difficult to distinguish between true and false in the market or social media, which also causes patients to dare not and more reluctant to seek medical treatment, as a result, over time, the problem deteriorates to a serious level, and even causes unnecessary harm to life, so clarifying the misunderstanding of ED and seeking the right treatment is king.
After nearly 4 years of COVID-19 and vaccination, a new word has been added to ED, that is, vaccines will exacerbate the problem of ED, but this is without scientific basis. Studies so far have found no similar side effects from COVID-19 vaccines.
However, COVID-19 does make more ED patients have to face the facts, so after discussing with their partners, they are also willing to take the initiative to seek medical treatment, which may be regarded as the epidemic
Another ‘good thing’. In the past, if patients had ED problems, they could still use overtime or tiredness to escape their partners, but after the epidemic, everyone had to stay at home, and they couldn’t avoid it in such a situation, so patients were willing to take the initiative to mention this matter to their partner and choose to seek medical treatment. The epidemic made the “little brother” very hurt
The second scenario is the impact of COVID-19 sequelae (Long COVID). If a person recovers after being diagnosed, but does not regulate the body well, it is likely to have a certain impact on the body organs, including sequelae, such as poor physical fitness, poor memory, etc., and even affect male erectile function.
Finally, the medical community has confirmed that after COVID-19 infection, not only the respiratory system is damaged, but also the function of the male testicles, including testosterone secretion, which is why more and more ED patients come to the clinic during COVID-19 and even after the epidemic.
2 methods to diagnose impotence
How is a patient diagnosed if he or she has ED? In fact, when patients and partners take the initiative to seek medical treatment and propose it, they can treat it as ED. It must be clarified that the only thing that must prove whether the patient has an ED problem is only required in court, for example, if the suspected rape suspect claims that he cannot get an erection, then the doctor must prove whether what he said is true, there are two common practices:
Nocturnal Penile Tumescence (NPT)
- It takes advantage of a feature of male physiology, that is, during deep sleep, the penis is usually erected autonomously and uncontrollably without sexual stimulation; Through the sensors around the penis, the ability to get an erection is detected and recorded.
- Stamps It also uses the same physiological characteristics, and sticks stamps around the male penis, once erection during deep sleep, relevant information can be obtained.
Not only to improve the house, but also to find out the “dark” disease
The methods mentioned above are more for court purposes and not much for diagnosis and treatment. Is it possible to diagnose ED by examining the penile artery? The answer is that blocked penile arteries are not equated with ED, so patient and partner elaboration is key. From a clinical point of view, the vast majority (70%) of ED is caused by the three highs and obesity problems of patients, followed by long-term smoking and alcoholism, or unhealthy work and rest such as staying up late, drinking less water, eating greasy, less exercise and excessive stress. Therefore, for the treatment of ED, first of all, I would recommend that patients do a good job in life and rest and chronic disease control, otherwise the patient’s blood sugar management is not good, even if there is a strong aphrodisiac, it will not help, and the drug also has its limitations.
My advice to ED patients is that it is important to be honest with your partner about the problems they are facing in order to avoid unnecessary misunderstandings, and the purpose of seeking a doctor is not only to improve intercourse, but also to find out if there are any latent diseases, such as cardiovascular disease.
There must be sexual stimulation after taking the drug
In addition to improving lifestyle and managing chronic diseases, there are several ways to treat ED, including oral medications, injectable drugs, and non-invasive treatments.
PDE-5 inhibitors are oral drugs for the treatment of ED, and their principle is through a series of neuroendocrine factors that release a nitric oxide (Nitric Oxide, NO) that can cause penile erection. However, nitric oxide can not directly relax the smooth muscle of blood vessels, must activate a ‘G protein’, and then form a substance called ‘cGMP’, which is also known as ‘secondary messenger’, because of its action, vascular smooth muscle will expand, and the penis will gradually harden, but its first condition is that there must be sexual stimulation.
Inhibit PDE-5, improve cGMP, and help erection
From ‘NO’ to ‘cGMP’ is the way of penile erection, in this pathway there is an enzyme that PDE-5 can degrade cGMP, thereby inhibiting penile erection, and PDE-5 inhibitors are by inhibiting PDE-5 activity, increasing the content of cGMP, thereby improving the erectile function of the penis, and as mentioned above, in addition to sexual stimulation, but also sympathetic nerve function, in order to inhibit the degradation of cGMP and make the penis continue to erect.
There are currently 5 recognized PDE-5 inhibitors on the market, but all require a prescription, including sildenafil, tadalafil, vardenafil, avanafil, and udenafil. When using PDE-5 inhibitors, there are several points to note, including the duration, duration, and maintenance time, so it is important to consult a doctor and pharmacist before use.
In addition, the use of PDE-5 inhibitors may cause some mild side effects, such as muscle aches, acid reflux, headache, blurred vision and flushing, etc., while some PDE-5 inhibitors should not drink alcohol or eat greasy before taking, it is best to use them on an empty stomach, and it is necessary for patients to learn more about it before taking.
The penis injection increases the blood flow and hardens
As for the injection, the drug is Intracavernosal Injection (ICI), which uses a very thin syringe to inject the drug into one side of the penis. This procedure is usually performed by a doctor or medical professional to ensure the accuracy and safety of the injection. The drug causes local vasodilation in the corpus cavernosum, increasing blood flow, which makes the penis hard in less than 20 minutes, and is suitable for patients who cannot control their glycemic index.
The other is to use a vacuum-like instrument to ‘pull’ the penis blood flow forward, and then lock the penis with a ring buckle to partially engorge the penis, but this practice is very dangerous, if the ring is not removed within 6 hours, it may cause the penis to turn black. There are occasional news reports of people putting a ring on their penis, and then having to go to the door and sawing it open.
Another method is Extracorporeal Shock Wave Therapy (ESWT), which improves ED by applying high-intensity shock waves to penile tissue to promote new blood vessel growth and improve blood flow. This type of therapy is still very new, and the true effect needs more research data.
Avoiding Unverified Remedies
It’s crucial to steer clear of unverified remedies when it comes to addressing erectile dysfunction. While there are various methods available, it’s essential to rely on trusted solutions backed by medical expertise.
Understanding Alternative Approaches
Some individuals may consider using devices like inflatable or collectible dildos as an option. However, these methods are relatively uncommon because their primary purpose is functional, lacking the sensation aspect that many seek. Consequently, they aren’t widely favored.
A Holistic Perspective
From a urologist’s standpoint, it’s advisable not to view erectile dysfunction solely as a sexual issue. Instead, it should be seen as a signal from your body, prompting you to take care of your overall health. Addressing it properly not only ensures better sexual health but also helps preempt potential future problems.
Seeking Professional Guidance
Today, there exists a wide range of effective treatments for erectile dysfunction. It’s sincerely encouraged that those dealing with this issue seek medical guidance and choose the right path to recovery. Opting for unverified methods, including dubious aphrodisiacs of uncertain origin, can be detrimental to your health and should be avoided at all costs. It’s vital to prioritize your well-being and trust in proven medical solutions.
