Investigation of erectile dysfunction/impotence is done by a doctor. An investigation always begins with seeking medical care for one's symptoms, after which the doctor's task is to identify possible underlying causes in order to understand how to best treat it. It is important to early exclude physical conditions such as atherosclerosis and various hormonal disorders, as they may be associated with an increased risk of serious illnesses such as heart problems if not detected in time.
The investigation is conducted with the following focus:
Assessing the erection and erectile difficulties
When do the difficulties arise?
How long do they last?
How often do they occur?
How does it affect the sex life?
How long have you been experiencing these symptoms?
Did it start suddenly or gradually?
Mapping underlying risk factors such as diseases and lifestyle
Alcohol and drug habits
Smoking
Medications
Sexual habits and relationship status
Blood tests
Questionnaires
Possible investigation of different diseases that can cause erectile difficulties
Treatment of erectile dysfunction/impotence can be divided into three different categories:
Medication
Therapy
Assistive devices
Medication is the first-line option for erectile difficulties. The common denominator among them is that they make it easier to achieve an erection, but none of them treat the underlying cause of the erectile difficulty from the beginning.
The medications are further divided into two groups:
Tablets
Locally acting medications
Tablets such as sildenafil, avanafil, tadalafil, and vardenafil all have in common that they dilate the blood vessels in the penis. The effect is not that they cause an erection in themselves, but that it becomes easier to achieve an erection when sexually aroused. Their main differences lie in how quickly they take effect, how long the effect lasts, and what side effects may occur. It is individual to each person which one is perceived to work best, and the easiest way to know is to try them until one is satisfied.
The tablets belong to the group of PDE5 inhibitors and are sold under names such as Viagra, Cialis, and Spedra.
Locally acting medications such as Alprostadil are used to relax the muscles around the penis. This dilates the arteries in the penis, resulting in the filling of blood vessels and the occurrence of an erection. Unlike tablets, locally acting medications cause an erection regardless of sexual stimulation.
Locally acting medications come in three forms:
Cream
Wax suppositories inserted into the urethra
Injection
NOTE! You should not attempt treatment with medications without consulting your doctor!
For many, therapy can be helpful if the difficulties stem from psychological/mental issues. Depending on the needs and questions, therapy can be provided by:
Sexologist
Psychologist
Psychotherapist
Psychiatrist
There are assistive devices that can work well for erectile difficulties. Two of these are:
Penis ring
A ring placed over the penis to prevent blood reflux -> longer erection.
Vacuum pump
Works by inserting the penis into a cylinder connected to a pump. When pumped, the penis fills with blood -> erection.
Remember that the above treatments help to address the erectile difficulty but do not treat the underlying cause!