Articles on erectile dysfunction

Erectile Dysfunction (Ed) or Impotence

Dr. Adil Hingora, Homeopath
AllopathyAllopathy treatment gives a lot of emphasis to:Psychotherapy, counselling.Regular exercises, which increases blood flow to all parts of the body, increase level of male hormones, increase levels of certain neurohormones which are mood elevators.When psychotherapy fails to boost the person's self-image interventional modes are tried:Drugs (oral drugs, penile suppositories, ointments, injectibles hormone treatments and so on.)Vacuum devices - these work by drawing blood into the penis. It must be used just before intercourse.Surgery - as a last resort when all other methods fail to better erectile dysfunction (ED) or impotence. Prosthetic implants (artificial rods) are inserted into the penis and allowed to remain there. However, these are very expensive and also irreversible.All treatments aim at helping the individual achieve an erection and maintaining it long enough to perform intercourse. However, no treatment can provide a permanent cure for erectile dysfunction (ED) or impotence in allopathy.HomeopathyAn estimated 35 million men in United States of America experience erectile dysfunction (ED) or impotence at one time or another. That explains why there is such a huge market for products to strengthen or restore erections. There are many patients who tried herbal products that just did not work at all. And we have read alarming reports of men going blind or having heart attacks as a result of taking allopathic or conventional drugs prescribed.Fortunately, there is a permanent solution. Yes ED or impotence is treatable and at any age.Homeopathy offers remarkable results in erectile dysfuntion (ED) or impotence cases, which may have arisen from both physical and psychological causes. Both, the mental as well as physical components of the disorder can be addressed using homeopathic treatment.Homeopathy offers almost 203 remedies for men suffering from erectile dysfunction (ED) or impotence. Unlike allopathic medicines, homeopathic medicines are non toxic and non addictive. Doctors frequently treat patients suffering from anxiety, fear of failure to do sex, erectile dysfunction (ED) or impotence associated with stress and high blood pressure.Work stress, mid-life crisis and other issues affect men's health in various ways. Men facing the challenge of aging, retirement and finding new identities for themselves, find a particularly appropriate therapy in homeopathy, which addresses them on mental, emotional and physical levels.When combines with benefits of good nutrition, exercise and relaxation, homeopathy provides optimum support for such patients.Where the cause of erectile dysfunction (ED) or impotence is with other system diseases and due to drug effects, there also homeopathy provides better option.Homeopathy is strongly recommended.However, homeopathy is a 200 plus year old medical science that is fully regulated by the United States Food and Drug Administration (FDA). And all homeopathic medicines recognized by the well-respected Homeopathic Pharmacopoeia of United States (HPUS) have been tested and proven effective in carefully controlled clinical trials.Erectile dysfunction (ED) or impotence may be an indicator of other health imbalances which need to be addressed and should not be put off.There are 203 medicines which give great relief. However, the correct choice and the resulting relief is a matter of experience and right judgment on the part of the doctor. The treatment is decided after thorough case taking of the patient. Thus remedies are designer made unlike allopathy in which all patients receive the same surgery or drugs although trade name may be different.With homeopathy, it is an issue that can be treated and overcome, allowing you and your partner to enjoy a full and satisfying loving relationship.Wishing you the joy of love and intimacy.Frustrated and embarrassed by Erectile Dysfunction (ED) or impotenceFew experiences are as disheartening to the intimacy of a loving couple as erectile dysfunction, the inability of the male partner to achieve and maintain an erection.This means even though a man has a strong desire to perform sexual act with a cooperative partner, he can not perform sexual act because of looseness (absense of erection) of his penis. Even if he performs the sexual act with his determined efforts he does not get the erection and gets afflicted with tiredness, perspiration and frustration to perform sex or intercourse.The term erectile dysfunction can mean the inability to achieve erection, an inconsistent ability to do so, or the ability to achieve only brief erections. ED (erectile dysfunction) may sometimes be even termed as Impotence.The likelihood of developing it increases with age. It is estimated that 1 in 10 men over the age of 21 suffer from impotence of ED (erectile dysfunction); most men suffer in silence. In America today, it is estimated that 25 to 30 million men suffer from erectile dysfunction, also known as impotence or ED.Why and how does erectile dysfunction (ED) or impotence happen?Erection of penis is a sequential event and any disruption in this sequence can cause erectile dysfunction (ED) or impotence. The sequence includes nerve impulse in brain, spinal column, area around penis and response in muscles, fibrous tissues, veins and arteries in and around corpora cavernosa. Damage to nerves, arteries, smooth muscles, fibrous tissues often as a result of disease is the most common cause.Most cases (70 to 80%) have some underlying pathology. In older men, ED usually has a physical cause. Incidence increases with age.Erectile dysfunction (ED) or impotence does not have to be a part of getting older. It is true that as you get older, you may need more stimulation (such as stroking or touching) to get an erection. You might also need more time between erections. But older men should still be able to get an erection and enjoy sex.Physical causes:Alcohol and tabacco useFatigueBrain or spinal cord injuriesHypogonadism leading to lower testosterone levelsLiver or kidney failureMultiple sclerosisParkinson's diseaseRadiation therapy to the testiclesStrokeSome types of prostate or bladder surgerySide effects of medicines like antihypertensives, antihistamines, antidepressants, tranquilizers, appetite suppressants, cimetidine. Drug side effects account for about 30% of cases.Pschological causes (feelings) that can lead to erectile dsyfunction (ED) or impotence:Feeling nervous about sex, perhaps because of a bad experience or because of a previous episode of impotence or erectile dysfunction (ED).Feeling stressed, including stress from work or family situations.Being troubled by problems in your relationship with your sex partner.Depression.Feeling so self conscious that you can not enjoy sex.Thinking that your sexual partner is reacting negatively to you.Whether the cause is physical or psychological, the damaging effects on both partners can often lead to the break up of the relationship.Lifestyle changes that may be helpful:Massaging the body with a herbal oil which gives a relief from physical exertion and also acts as an aphrodisiac. Mutual massage slows down lovemaking and opens up communication.Practicing yoga and meditation to overcome mental exertion and to cope with daily stress.Sleep at least for 8 hours a day.Avoiding the consumption of alcohol, tobacco, heroin and so on.Exercise regularly. Moderate (not excessive) exercise helps relax the body, boost energy levels, increase physical awareness, and stimulate sexuality.Practice different kinds of intimacy and touching; try not to focus only on the erection. Partners who proceed with patience and learn to enjoy each other in a variety of ways often return to full potency.Avoid hot, spicy and bitter foods.Add little fat in your diet.Give a gap of 4 days between two consecutive intercourses.Frequent sex prevents erectile dysfunction (ED) or impotence.Dr. Adil HingoraRaipur, Chhattisgarh INDIAOnline Consultation -

Understanding Erectile Dysfunction - a Urologist's Perspective

Dr. Anish Kumar Gupta, Andrologist
What Is Erectile Dysfunction or ED?Men who have ED have a problem getting or keeping an erection that’s enough for sexual satisfaction. Most men have difficulty with erections from time to time. In some men, it is a regular, more severe problem. It can cause low self-esteem, performance anxiety, depression and stress. ED may affect the quality of a marriage or intimate relationship. Studies show that about one half of men over age 40 have some degree of ED. At one time, health care providers thought that psychological problems, such as stress and anxiety, were the main causes of ED. Recent studies show that most cases have a physical cause. While ED becomes more common as men age, growing old is not the cause of the problem. Though sexual function may decrease with age, many men enjoy sexual activity well into their senior years.Who Gets ED? ED can be an early warning sign of a more serious illness, such as heart disease, high blood pressure or diabetes mellitus. Diagnosing and treating the condition that causes ED can improve your overall well being, as well as help restore your sexual health.ED may be caused by a combination of factors that could also include medicine, alcohol or drugs. The physical and medical causes of ED include three basic problems:Not enough blood flows into the penis - Heart disease, diabetes and even smoking can contribute to the same.The penis cannot store blood during an erection. A man with this problem, called venous leak, cannot maintain an erection because blood does not remain trapped in the penis. This condition may occur at any age.Nerve signals from the brain or spinal cord do not reach the penis. Certain diseases, injury or surgery in the pelvic area can damage nerves in the penisSexual activity requires the mind and body to work together. Psychological, emotional or relationship problems can cause or worsen ED. These include: depression, relationship conflicts, stress at home or work, anxiety about sexual performanceMany prescription and over- the-counter medications cause erectile difficulties as a side-effect. Drug addiction and alcohol use can also lead to sexual problems.Who Will Treat me Erectile Dysfunction ?The treatment of ED requires one or many specialists. It’s normally prudent to start with a Urologist who can take a detailed history and examine you in detail.Urologists perform specialized evaluations, prescribe medications and perform surgery to correct erection problems. Endocrinologist - If your ED is due to a hormonal problem.Mental health professional - These specialists treat psychological or emotional causes of ED. Even if your ED is not caused by these factors, it may contribute to them. It may be helpful to get counseling, alone or with your partner, in addition to getting medical therapy for ED.Help is Available if you reach out. Do not suffer from Erectile Dysfunction, get treated.

Erectile Dysfunction: Don’t Believe These Myths!

Dr. Yuvraj Arora Monga, General Physician
What is Erectile Dysfunction (ED)?A person having Erectile dysfunction (ED) is not able to achieve and/or maintain an erection of the penis sufficient for sexual activity. So, penis do not get hard at all or not enough for doing sex. ED is responsible for great deal of stress and anxiety as well as low self-confidence in men. Mostly its occasional, when you cannot get an erection and it is only temporary. But sometimes it occur repeatedly. There are lot of misconceptions about it in the mind of common man.Normally after emotional or physical stimulation there is an increased filling of blood in sponge like tissue of penis and decreased blood flow out of penis, so blood remain trapped in penis and it becomes hard and erect. Thus our ability to have erection is dependent of multiple factors like our emotions, hormones, nerves, blood vessels and cells of penis itself. A problem with anyof these elements can cause ED.It can occur at any age, but becomes more commonwith increasing age. In the older adult male, it is a major problem affecting more than 75% of men. Common Causes of ED:There are several factor's which causes bodily or mood changes & lead to ED. Physical causes means you have problems with penile structure itself or any bodily disease affecting it. Diseases include less blood flow to the penis or injury of  the nerves going to the penis (For example, multiple sclerosis, a stroke, Parkinson's disease, Spinal Injury etc.). Lifestyle disorders like high blood pressure(BP), Obesity (high body weight than normal for our height and Age), Diabetes (high blood sugar), etc. Also lack of male sexual hormone called testosterone, alcohol and drug abuse, clogged blood vessels (Atherosclerosis) and side effects of some medications causes ED. Sometimes psychological issues like anxiety, stress due to work or home environment, depression, relationship difficulties leads to ED.Myths associated with EDMyth 1: ED is part and parcel of your body’s aging processContrary to popular belief, ED is not a normal part of the aging process. If you’re having difficulty in getting an erection, the underlying cause can be medical in nature such as undiagnosed or diagnosed  cardiovascular disease, high blood pressure or diabetes.Myth 2: ED can’t be reversedThrough the right treatment and certain lifestyle changes, most of the cases of ED can be reversed to almost normal. It is said that sexual health and erectile performance can be enhanced when you improve the health of your heart. Exercising to bring about weight loss and quitting smoking are ways that experts advocate for improving the health of your heart.Myth 3: You are the only person to suffer from this problemThe common belief that ED affects only a few men is not true. Scientific studies  show that ED strikes about 5% of men aged 40 years and between 15-25% of men aged 65 years.Myth 4: It’s completely in your headThis isn’t true at all. The source of the problem could be certain parts of your body. In most cases, the cause is usually certain physiological problems such as heart disease, clogged arteries, high cholesterol, and Parkinson’s diseasesetcMyth 5: Only drugs and surgery can help you remove the problemED can be treated using a number of treatment options. Apart from pills and surgery, simple lifestyle changes can help to provide respite from the problem. Decreasing the consumption of alcohol, losing weight and even quitting smoking can improve your sexual health. Moreover, since the problem can also be due to an underlying medical condition such as high blood pressure; treating the underlying cause can help in easing your erection problems.You can continue reading more about this in Part 2 of this series here.

Erectile Dysfunction: Causes and Treatment

Dr. Sujoy Dasgupta, Gynecologist/Obstetrician
Erectile dysfunction (ed) occurs when the man is unable to achieve or maintain his erection of penis to meet his or his partner's sexual satisfaction. The problem is often faced by newly married men. Fortunately with experience, most of them are able to overcome this problem. Again it is increasingly common with increased age. So, what are the causes. In some male, it is psychological, caused by anxiety, depression, stress, marital disharmony etc. Use of alcohol and smoking will aggravate the problem. Psychological causes can happen at any age but more common at younger age. But in some cases, it is associated with serious diseases, especially at old age. It has been seen that in apparently healthy male ed is the first sign of heart disease. So, if you have ed, make sure that i's not caused by your heart problem. Again diabetes is another important cause. Excessive weight gain will also cause hormonal imbalance and thus problems in erection. Some hormone may also cause ed like thyroid, prolactin and even testosterone (male sex hormone). If you have chronic diseases like liver or kidney disease, it may also lead to ed. Diseases of nerves and spines should also be kept in mind. Sometimes, infections or tumour in private parts (prostate, testis etc) will also add to ed. Other diseases of penis like abnormalities in blood vessels can also be responsible, especially in young guys. Apart from these, some surgeries in abdomen and some drugs (like drugs to lower blood pressure, antidepressants, hormonal drugs etc) will also cause ed.Now, what you can do? if you want to suffer silently, you will land up in other problems like problem in sexual life, problem in family relationships, depression and even inability to make your partner pregnant. But do all men with ed have to go to doctor? initially, the men should try life style modifications like avoiding smoking and alcohol; avoiding stress and anxiety; making good understanding with partner and also reducing weight. The partner should also have sympathetic attitude to the husband who is having ed.But if still the issue is not resolved you have to consult doctor. It's not a mater of hesitation or embarrassment, as you may think. Rather it is needed to ensure that you are healthy. So, your doctor will talk to you, will check you and try to find out if any cause is there or not (like heart disease, diabetes, hormones etc). He may order some basic tests to ensure that everything is alright. After that he will advise you the treatment. If the cause is found, treatment of the cause (like diabetes) may cure ed. Even if no cause is found, ed can be treated by various ways.But should you try the drugs shown in television or newspaper? remember, drugs used in ed have important side effects and we advise drugs only when it is absolutely necessary. In most cases simple measures like stress reduction, exercise help. Sex counselling of both the partners helps a lot. And if still ed persists, we advise drugs. There are variety of drugs, all are having own advantages and disadvantages. Particularly sildenafil group of drugs can affect heart and retina. So, we always practice caution before prescribing such drugs. And when patients are advised such drugs we advise to inform us when he feels eye problems, chest pain, fainting or even painful persistent erection of penis (" priapism").There are other drugs that can be applied directly over penis. Testosterone group of drugs are prescribed only in selective cases as they have serious side effects and even they can reduce the size of your testes. In some cases where drugs cannot be given or drugs fail, we advise penile implants or artificial pump to maintain erection. Finally in very few cases, where blood vessels of penis is blocked, we can cure it by some operations. So, if you feel ed, don't get depressed. At the same time don't feel embarrassed to take medical help. Today's embarrassment may harm you in future. So, get cured and enjoy your personal life.

Erectile Dysfunction: All That You Need to Know!

Dr. Ashwini Billampelly, Sexologist
Understanding Erectile dysfunction • What is ED • Erectile dysfunction is when a man is unable to get and/or keep an erection for sexual intercourse • ED is very common and becomes more common as men age. It can be decisive factor causing an end to couple’s sexual life    irrespective of the woman’s participation and interest in sex.Is ED just a part of getting old?• It has been found that men even in their 30s or 40s can develop significant problems with erection and sex life • Healthy couples can continue their sex lives well into their 60s and 70s, menopause being no bar ending the couple’s sex life• Elderly couples in fact enjoy their time together sharing their intimacy once the kids are grown and have left home• Longer the erectile dysfunction is left untreated greater is the effect on the relationship What causes it?• Many factors lead to ED• Physical and/or psychological • Combination of both• Inter-personal relationship problems• Physical causes• Heart disease- high B P • Diabetes mellitus• Smoking• Obesity• Alcoholism• Inadvertent use of Viagra• Hormone imbalance • Retrograde ejaculation• Prostate enlargement – on medications • Psychiatric/neuroleptic drugs • Peyronie’s disease Inter-personal • Relationship conflicts• Premature ejaculation• Loss of libido – desireEven if not wanting to restore sexual activity, men with erectile dysfunction need to have an assessment of their general health to  look for causes of the erectile problems How do you get treated • Meet your doctor who will assess you to find out more about the problem.• It is a good idea for you to see the doctor with your partner, if possible• The treatment can be more successful if you both understand the problem and help each other to treat the ED  • History of sexual function and general medical factors, medications if any• Physical examination that may include checking the penis, testes and prostate • Investigations:Blood check up for cholesterol, kidney functions, and hormones • Your doctor may suggest a sonography to assess the blood flow of the penisHow to treat• Underlying reversible factors • Medication • Lifestyle modification•Temporary devices • Injections/urethral • Surgery– including penile prosthesis• Couple counseling • Psychological support Workable solutions • The aim is satisfaction of the couple • Re-establishment of the self esteem and confidence • Harmony in relationship

How to Manage Your Erectile Dysfunction Effectively

Dr. Yuvraj Arora Monga, General Physician
There are enough options available which can keep every man sexually active regardless of the cause of erectile dysfunction (ED). However, it is important to get treated by a physician who is willing to give time to understand your problem and identify a suitable and most appropriate therapeutic option.Counselling Sessions:As with an electrical circuit, if there are any breaks in the system it will not function as a unit. Part of the process of psychosexual therapy would be to think about the actual emotional and/or psychological issues behind ED, and to attend to these with weekly counselling sessions. This realisation is an important first step for you to begin and resolve your erection problem. The patient normally implements the therapy advice at home, either alone or with a partner, between therapy sessions. This may help you maintain an erection for once, gradually building confidence.Relieving sexual anxiety:Telling your partner before you make love that you have this anxiety, and the feelings it causes. As a result, your partner will understand, and the two of you can work on it together.You can reduce some worries by being more giving with foreplay, even if your sexual performance isn't what you or your partner wanted, your partner will still be satisfied.Consider regular exercise which brings confidence in your body as your energy is also an important part of overcoming sexual anxiety.Non-Medical TherapiesWatermelon juice (Nature’s Viagra) & Ginseng (Herbal Viagra): L-Citrulline, an amino acid, present in watermelon can bring about significant improvement in blood flow to the penis, showing an improvement in erectile function. Another herb called Ginseng, specifically “red ginseng,” is known as the “herbal Viagra” that can improve sexual performance. Several research studies provide evidence for the effectiveness of these herbs in ED treatment.Kegel exercises: Pelvic exercises, involving the portion of the body between your waist and thighs, are commonly known as kegel exercises. Three months of kegel exercises twice daily can help to significantly improve your erection ability which strengthens the penile muscle. They also promote urinary control.Acupuncture therapy: The acupuncture needles are placed in the wall of the abdomen. By stimulating specific acupoints, the practitioner aims to restore the proper flow of energy in the body resolving ED.Eat  Right: Scientific study at Massachusetts on Male Aging has found that eating a diet rich in fruit, vegetables, fish, lesser red and processed meat, whole and refined grains decreased the likelihood of having ED. Intake of daily multivitamin and fortified foods is the best remedies for treating ED.Walking: Just 30 minutes of walking a day is linked with 41% drop in risk for ED. Moderate exercise can help restore sexual performance in obese middle-aged men with ED.Attention towards vascular health and making body slim: High blood pressure, high blood sugar, high cholesterol, and high triglycerides can all damage arteries in the penis along with heart and brain thereby leading to ED. Maintaining a trim waistline is a good defence for ED, as men with a 42-inch waist are 50% more likely to develop ED in comparison to 32-inch waist people.Avoid excessive alcohol: Chronic heavy drinking of alcohol can cause liver damage, nerve damage, and other conditions, interfering with the normal balance of male sex hormone (androgens) levels ultimately leading to ED.Intake of L-arginine: L-arginine, an amino acid, which is naturally present in the body and helps make nitric oxide, supports a successful erection. Nitric oxide is responsible for making the blood vessels relax, which helps sustain an erection for men.Medical therapy:ED can also be treated with oral medications, drugs insertions or injections into the penis. Oral medications that are normally prescribed to treat the dysfunction work for about 80% of men. They work by boosting the natural signals, which are generated during sexual activity so as to help you sustain an erection. Alprostadil is a type of medicine that causes blood vessels to expand, increasing  blood flow to the penis, thus facilitate an erection. Cialis, Levitra, Staxyn and Viagra work by a similar mechanism to cause erections. There are subtle differences in how long the drug works and how quickly it works.But kindly note drugs like Viagra are not recommended for normal person for recreational use. They should not be used as performance enhancing drugs for they also have their set of side effects and hence, should be taken under medical supervision.A vacuum erection device is a plastic tube that slips over the penis, making a seal with the skin of the body.  A pump at the other end of the tube creates a low-pressure vacuum around the erectile tissue, which results in an erection.Ayurvedic Medications:Klaibya in Ayurveda is defined as an inability to attain and keep sufficient rigid (firm) erection which is essential during sexual intercourse for the sexual needs or the needs of his female partner. Also, Vajikarana in Ayurveda means producing a horse's vigor. Some of the herbs used in Vajikarana include:Bulb of Allium sativum (Garlic) Root of Asparagus recemosus (Shatavari)Root of Boerhavia diffusa (Punarnava)Whole part of Cocculus cardifoli (Guduchi)Root of Panax ginseng (Ginseng)Seeds of Myristica fragraus (Nutmeg)Leaf & Root of Withania somnifera (Ashwagandha)Leaf & Seeds of Ginkgo bioloba (Ginkgo)Pitch of Asphaltum bitumen (Shilajit)Dried root of Lepidium Meyenii (Maca)Again please remember, all the above drugs/ remedies  should be taken under medical supervision after consultation from registered medical practitioner after proper diagnosis has been made.

Erectile Dysfunction - a Warning Signal for Cardiac Problem

Dr. Saatiish Jhuntrraa, Psychiatrist
It is a well known fact that ED is caused in 70% of cases by vascular insufficiency  orreduced blood supplyThe arterial System in body supplies oxygenated  blood  to all organs for their normal functioning. There are arteries of different internal diameters in body :Cavernosal and Halacine arteries to penis with diameter     2.5-3 mmCardiac arteries to the heart with internal diameter              4-5 mmCarotid arteries to brain having internal diameter                 6 mm  Femoral Artery to the lower limb having internal diameter  8-9 mm               Reduction in blood supply causes gangrene in lower limbs, brain stroke in brain,  ischemic disorder in heart and ED in Penis. Disorders like increased lipids, atherosclerosis causing reduction of internal lumen or tobacco , pollution causing spasm  will affect all the arteries but produce symptoms in the organ supplied by the smallest artery first As the smallest artery is in penis, any reduction in blood supply will produce symptoms in the penis first of all ( ED)HENCE, IF ED PERSISTS FOR A FEW WEEKS IN A YOUNG PERSON (30-40 YEARS), it should never be ignored as it may be a warning sign for a future cardiac event.What to do?Immediately consult your physician , or better asexologist Assessment for associated risk factors likediabetes, hypertension, obesity, raised lipids, stress,inadequate sleep  or sedentary life styleManagement of above factors can not only improveyour sex life and save your marriage, but may also save you from a catastrophicfuture event and prolonging your life

Male Erectile Disorder or the Dreaded Impotence in Men

Dr. Ramesh Maheshwari, Sexologist
Persistent or recurrent inability to attain, or to maintain until completion of sexual activity, an adequate erection. This is also know as erectile dysfunction.The disorder may cause marked distress or interpersonal difficulty. There are different patterns. Some individuals report inability to obtain erection from the beginning of sexual experience; while others report being able to experience erection only during masturbation or on awakening, but not during the coitus. Some experience adequate erection, lose it when attempting penetration. Still other report that they have an erection that is sufficiently firm for penetration, but they lose erection before or during thrusting.Male erectile disorder is frequently associated with anxiety, fear of failure, pressure of sexual performance, and decreased sexual excitement and pleasure. This can disrupt marital relationship and may be the cause of unconsummated marriage and infertility.Causes: Ageing: With advancing age,The orgasm is less intensive,The ejaculate is reducedThe interval between the two successive acts is increased.Psychological factors: Fatigue,Depression,Stress,Mental disorders,Guilt,Fear of failure,Low self esteemReligious restrictionsHomosexualityLong/serious illnessTraumatic initial experienceNegative feelings towards the partnerVascular causesUse of tobacco/AlcoholAtherosclerosisPeyronie’s diseaseDiabetesHypertensionVenous leak or occlusionTraumaSurgeryRadiationHormonal causes: HypogonadismHyperprolactinemiaDiabetesThyroid diseaseAndrogen deficiencyEstrogen excess Adrenal pituitary of Hypothalamic diseaseNeurogenic causes:Peripheral NeuritisAutonomic neuropathy (in Diabetes)Multiple sclerosisSpinal cord diseaseDrug related causes:AntiandrogensH2receptor antagonistsDiureticsAntihypertensiveAnticholinergicsAntidepressantsAntipsychoticsCNS DepressantsSubstance abuseMiscellaneous:Renal failureProstatectomyDiagnostic testsStamp Test: A long strip of postal stamps is wound around the base of the penis at night before going to bed. Next morning if the perforations of the strip are found to be torn off, impotence is supposed to be of psychological in origin.Peno-brachial index: The ratio of penile systolic blood pressure to that of brachial systolic blood pressure is normally 0.6. If found to be low, impotence is vascular in origin. Papaverine Injection Test:  Papaverine is a vasoactive drug. Using a 26 gauge needle, 30 mg papaverine is injected at the mid-shift of Corpus cavernosum of penis. He is isolated, asked to stoke the penis and expose to erotic literature. Erection will occur in 10 to 15 minutes. If the erection is short-lived or partial, then impotence is considered as vasculogenic.  If the erection is full, then impotence is considered to be neurogenic or psychogenic in origin.Caution : This test should be performed in a hospital setting or where the facilities for detumescence  are available. The patient should be observed for next few hours till the erection subsides.Rigiscan Test: This is a gold standard for evaluation of Nocturnal Penile Tumescence and Rigidity (NPTR). This test is based on the physiological principle that a male gets erection 3 to 5 times during REM sleep. At night, before going to sleep one ring of Rigiscan is slid over the base of the penis and the over the tip. Next morning, the tracing obtained are studied. This test can quantify erectile tumescence and rigidity. Rigiscan tracing indicates whether the impotence is organic or psychological in origin.Arterial insufficiency  and venous leaks can also be suspected on the basis of Rigiscan graphs. Patients with purely artery disease have low levels of rigidity but of adequate duration. Patients with venous leak will have varying rigidity levels with shortened duration.Penile Ultrasound : This test is for evaluation of functioning of the penile areteries. A simple acoustic Doppler emits auditory signals or a colour Doppler can help visualization of arteries. Cavernosometry  & cavernosography: This haemodynamic  test is useful for diagnosing veno-occlusive dysfunction of the corpora. Biothesiometry, electromyography , nerve conduction studies: These are for evaluation of neurogenic impotence.TreatmentCounselingSexual dysfunction is a marital unit problem and therefore both, husband and wife, should attend. Counselling is towards strengthening marital relationship. Wife is requested to co-operate. Client is requested to quit smoking and alcohol. He is advised relaxation exercise, yoga. The couple is educated about anatomy, physiology of sexual organs sexuality are countered. Their myths and misconceptions about  sexuality are countered. They are also explained that he does not have to do anything to have an erection. Erection is a physiological response to effective stimuli.

Sexual Problems in Infertility- Make Sure That It's Not Diabetes

Dr. Sujoy Dasgupta, Gynecologist/Obstetrician
Scenario one: Mr PS, 35 years old, married for 5 years, now planning to have a child, suddenly felt that his erection of penis is not as good as it was earlier. initially he tried medicines shown in TV and newspaper and then many treatments through internet. but his problems persisted. Finally when he came to doctor, he was diagnosed to have ERECTILE DYSFUNCTION. Finally after checking, when doctor advised him blood test, it revealed high blood sugar and then he was advised anti-diabetic drugs. After starting this, his sexual performance improved much better.So, what went wrong? Erectile dysfunction may be an early indication of diabetes. So, if you feel such problems, never ignore it and never feel ashamed to talk to doctor. If you try medicines shown in TV/ newspaper, your problem will persist and the diabetes may go to such point that your life will be threatened. So, never ignore such problem, however embarrassing it might be.Scenario two: Mrs AM, a 42 years old lady having two children, gradually feeling of low sexual urge. Her husband tried many things but nothing worked. She also had repeated attacks of vaginal infections. After trying many things by themselves, they consulted doctor. And the cause of her LOW SEX DRIVE and VAGINAL INFECTION was found to be uncontrolled diabetes. And the story was same. She was put on insulin therapy and her conditions improved. But if she came earlier, she could have avoided insulin therapy.So, if any male or female is experiencing low sex desire, he or she should not try various types of treatments by themselves. Proper diagnosis is necessary, so that life threatening diseases are not missed. And as you all know, diabetes can sometimes be life-threatening. So, just imagine, a situation for which you feel embarrassed to talk to doctor, can endanger your life.Scenario three: Mr MQ, a 30 years old male, is feeling pain and discomfort during intercourse and also sometimes during urination. He thought it may solve automatically after marriage. But it did not. And then he also had bleeding sometimes during intercourse and the pain increased. When he presented to doctor, doctor diagnosed it as a case of tight foreskin or PHIMOSIS. And the next day blood sugar was found to be very high. He was cured by circumcision after controlling blood sugar level with insulin. But after that he was found to have problems in retina and kidney. These are all because of diabetes. had he not ignored Phimosis, he could have avoided these complications of diabetes (retinopathy and nephropathy).So, if you feel any problems, particularly infections in private parts, do not ignore them Consult doctor and try to find out the cause.Scenario four:. Mrs AR, 32 years female, having REPEATED MISCARRIAGE in previous three pregnancies. No apparent cause was found. Then blood sugar test was done properly and she was found to have very high blood sugar. Then she was advised to avoid pregnancy until sugar was controlled. She followed the advice and then conceived fourth time when blood sugar was normal. Then she delivered a baby who was totally normal.So, if any couple is experiencing repeated miscarriage, they should test for diabetes first.So, never feel that diabetes is merely a disease of sugar. It can affect every organ and system. So, if you feel any problems in personal or conjugal life, however embarrassing to you it might be, never feel ashamed, rather consult doctor and have proper diagnosis done. A stitch in time saves nine.

Erectile Dysfunction

Dr. Amar Deep, Homeopath
Guys with erectile dysfunction have a 70 percent increased risk of premature death, a new study from the university of mississippi finds.Poor cardiovascular health is the most common cause of ed. So if you're unable to get hard, it's often an early sign that your heart is in trouble. In fact, many guys whose ed is caused by poor cardiovascular health wind up having life-threatening heart problems like a heart attack in the next five years. The vessels that carry blood to your penis are tiny, only one to two millimeters across, so they get clogged easily.If plaque starts to build up in your vessels thanks to a poor diet, a lack of exercise, smoking, age or genetics-the blood flow to your penis is the first thing that will get blocked off. That can make it impossible to get an erection.If the plaque continues to build, it will start affecting larger arteries, like the ones that carry blood to and from your heart. That can cause a heart attack or sudden death. That's why it's crucial to get your ed checked out by a doctor. If you heed the early warning sign, you may be able to fix your cardiovascular problems before they become fatal. If you've been consistently unable to get it up, or keep it up, for three months, make an appointment with your primary physician. Tell your doc about your erection problems and make it the first thing you bring up, so your doctor has time to thoroughly check you out.If blocked arteries turn out to be the culprit, an improved diet and exercise regimen may reverse the damage and get your penis back in working order.