Erectile Dysfunction Education

Erectile dysfunction is a serious organic and psychological issue that significantly lowers the quality of life for any man. But what is erectile dysfunction? It encompasses a whole range of different sexual sphere pathologies when a patient cannot achieve an adequate erection, maintain it throughout the entire sexual act, or complete it with ejaculation. A combination of several of these definitions may also be observed. Due to the change in terminology, men question the difference between erectile dysfunction and impotence. Impotence has the same definition (reduction in erectile function), however, the term itself is the previous name for erectile dysfunction.

There are two types of erectile dysfunction based on the causative factor:

• Primary – the man originally could not achieve an adequate erection, maintain it, or complete the sexual act with ejaculation.
• Secondary – an acquired pathology that occurs during a man's life who previously could perform sexual function fully.

The first scenario is more rare, often caused by obvious congenital anatomical features, psychological trauma received in childhood, or early-diagnosed severe illness (for example, cancer).

The second is more common, with over 90% of cases being secondary disorders. But why do men experience erectile dysfunction if they could maintain an erection and complete sexual intercourse all their life? There are two main reasons:

• Psychogenic – include various depressive, anxious, and sexual disorders, lack of experience, sexual education, or family values.
• Organic – most often represented by vascular and neurological disorders, but also include anatomical features and metabolic disorders.

Additionally, a mixed form that includes both psychological and somatic factors is noted. This format is possible with a long-standing chronic disease when a patient overly worries about their condition, focusing on the manifestations of the disease. They start to worry that they will not be able to complete sexual intercourse and try not even to start it.

Thus, answering the question of whether erectile dysfunction is a disease, it is not possible to confidently say yes or no. In the International Classification of Diseases 10th edition (ICD-10), there is no such diagnosis, however, it has appeared in the 11th edition (ICD-11). It is important to understand that erectile dysfunction is not an independent pathology; it is always a symptom of another disease – diabetes, atherosclerosis, thrombosis, psychological disorders, and other disturbances.

The manifestations of the pathology are quite noticeable for almost any man:

• Lack of adequate erection during sexual activity;
• The erection that does occur is insufficient for penetration and the beginning of sexual intercourse;
• Inability to maintain an erection until the end of sexual intercourse;
• Absence of ejaculation (inability to achieve it) even after sexual intercourse or premature ejaculation;
• Low confidence of the patient in achieving or maintaining an erection, satisfying a partner;
• Lack of personal satisfaction from sexual intercourse;
• Absence or weakening of morning and nocturnal erections;
• Increased time between sexual acts.

Depending on the severity of the listed symptoms of erectile dysfunction, there is the IIEF-5 test. Specialists use it to determine the severity of the disorder, which can also be divided into three stages in a more simplified classification:

• Mild – slight decrease in erection, the possibility of performing sexual intercourse is still preserved;
• Moderate – significant erectile disorder, sexual intercourse is unlikely but still possible;
• Severe – absence of erection, performing sexual intercourse is impossible.

Classification with the erectile dysfunction test is the most accurate option. The questionnaire can also be found online for self-completion – detailed scoring and its meaning are indicated on our website in a special section answering the question of how to know if you have erectile dysfunction.

Patients often wonder how long erectile dysfunction can persist, but this all depends on the quality and timeliness of therapy. With timely treatment and correctly prescribed medications at early stages, this disorder can be completely cured using shock wave therapy or medicinal drugs:

• Hormonal agents (androgens);
• Vasodilators (including those that can be administered via injections);
• Phosphodiesterase type 5 inhibitors – they act as erection stimulants.

In some cases, patients may be prescribed antidepressants, normotimics, blood thinners, sugar-lowering, and lipid-lowering drugs depending on the cause of the disorder. Therefore, self-medication should be avoided, and only a qualified specialist can choose the specific medication. In severe cases, the doctor may opt for surgical therapy over conservative treatment:

• Embolization (introduction of air bubbles) of additional vessels in case of venous leakage;
• Electromagnetic stimulation of muscles to strengthen the pelvic floor;
• Penile prosthesis (replacement of the penis with an artificial one).

Erectile dysfunction in men is a curable disorder that requires timely therapy. Therefore, one should not feel embarrassed about seeking medical help, worrying about what others may think, and should book an appointment at the early symptoms of erectile dysfunction.