Urologist
4.Can erectile dysfunction be treated with oral medications?
What tests are used to diagnose erectile dysfunction?
To detect conditions that may lead to atherosclerosis (hardening of the arteries), fasting blood tests are often conducted, including glucose, cholesterol, triglycerides, and creatinine levels. Additionally, it is important to check male hormone (testosterone) levels. Even if the penile arteries are healthy, erectile dysfunction may occur with low testosterone levels. In men with low testosterone levels, sexual desire (libido) may also decrease.
If an abnormality in the penile arteries is suspected, a diagnostic test called penile Doppler ultrasound can be performed to measure blood flow velocity in the penile arteries. To assess the severity of erectile dysfunction, various questionnaires are used, the most common being the IIEF (International Index of Erectile Function).
These evaluations provide crucial insights for diagnosing and managing erectile dysfunction effectively.
How is the severity of erectile dysfunction (ED) assessed?
The severity of erectile dysfunction can be calculated by scoring the patient's answers to 5 questions in the international erectile dysfunction index .
If erectile dysfunction is not severe—meaning the blood flow to the penis and the dilation capacity of the vascular structures within the penis are not irreversibly impaired—improvement can be achieved in the medium term through lifestyle changes.
For individuals with diabetes and high blood sugar, regulating blood sugar levels is crucial. If high cholesterol is present, it should be treated, and uncontrolled hypertension should be brought under control. Alongside these measures, engaging in brisk walking for at least 30 minutes daily can lead to improvement in erectile function within six months.
During this six-month period, nightly medication treatments can be used to maintain sexual activity.
Can erectile dysfunction be treated with oral medications?
Unfortunately, a permanent cure with just medication is not currently possible. The effect of the medications used is limited to the time it takes for the drug to be eliminated from the body, which typically ranges from 8 to 72 hours, depending on the specific medication. These drugs are known as phosphodiesterase inhibitors. They primarily work by dilating the blood vessels in the penis, supporting an erection, but they can also cause dilation in other blood vessels in the body.
Patients who are taking medications that dilate coronary arteries, such as nitrates, should not use these drugs. Combining them can lead to severe complications, including death. Therefore, these medications should not be used without the approval of a urologist. In some cases, even urologists do not prescribe these drugs without the consent of a cardiologist.
Additionally, there are unethical traders who mix these drugs into herbal supplements claiming to enhance sexual performance. For this reason, we strongly advise against using any products not recommended by a doctor.
Are there other treatments for erectile dysfunction besides oral medications?
There are connections between the tissue called corpus spongiosum surrounding the urinary tract and the spongy cylinders (corpus spongiosum) consisting of vascular pools that provide erection. Some chemicals administered into the urinary tract can be absorbed from the urinary tract and reach the corpus spongiosum. Erection can be achieved by administering vasodilator drugs into the urinary tract using this method; however, this method can cause problems such as irritation and urinary tract infection in the urinary tract. In addition, some patients may have difficulty applying this method.
Are there any non-surgical treatments besides oral and urethral medications?
Vasodilator medications (alprostadil, papaverine, phentolamine) can be injected into the spongy cylindrical structure (corpus spongiosum) made up of vascular spaces using a fine needle, similar to an insulin syringe used by diabetic patients. A doctor can teach the patient or their partner how to perform this procedure. It is typically done 10-15 minutes before intercourse.
This is one of the most effective treatment methods; while it may seem challenging at first, many patients successfully adopt this technique. The most significant issue with this method is the possibility of an erection not subsiding after sexual activity. This condition is called priapism and is a urological emergency that requires immediate medical attention.
