Dr Nabil Mitry has been long recognised as a leading specialist in Impotence and Erectile dysfunction. If you have any problems in this area, Dr Mitry will have a solution for you.
What is Erectile Dysfunction / Impotence?
An erection problem is the inability to get or maintain an erection that is firm enough for a man to have intercourse. You may be unable to get an erection at all, or you may lose the erection during intercourse before you are ready. If the condition persists, the medical term is erectile dysfunction.
Erection problems are common in adult men. In fact, almost all men experience occasional difficulty getting or maintaining an erection. In many cases, it is a temporary condition that will go away with little or no treatment. In other cases, it can be an ongoing problem that can damage a man’s self esteem and harm his relationship with his partner, and thus requires treatment.
If you have difficulty having or maintaining an erection more than 25% of the time, it is considered a problem.
An erection requires the interaction of your brain, nerves, hormones, and blood vessels. Anything that interferes with the normal process can be a problem. Common causes include:
- Diseases and conditions — such as diabetes, high blood pressure, heart or thyroid conditions, poor circulation, low testosterone, depression, spinal cord injury, nerve damage (for example, from prostate surgery), or neurologic disorders (like multiple sclerosis or Parkinson’s disease)
- Certain medications — such as blood pressure medication (especially beta-blockers), heart medication (such as digoxin), some peptic ulcer medications, sleeping pills, and antidepressants
- Nicotine, alcohol, or cocaine use
- Stress, fear, anxiety, or anger
- Unrealistic sexual expectations, which make sex a task rather than a pleasure
- Poor communication with your partner
A “vicious circle” of doubt, failure, or negative communication that reinforces the erection problems. Erection problems tend to become more common as you age, but it can affect men at any age and at any time in their lives. Physical causes are more common in older men, while psychological causes are more common in younger men.
The doctor will perform a physical examination, which will likely include checking your circulation, a neurological exam, and an examination of your penis.
To help diagnose the cause of the problem, your doctor will ask medical history questions, such as:
- Have you been able to achieve and maintain erections in the past?
- Is the difficulty in achieving erections or maintaining the erection?
- Do you have erections during sleep?
- How long have you had difficulty with erections?
- What medications are you taking (including prescription medications, over-the-counter medications, recreational drugs)?
- Do you smoke? How much each day?
- Do you use alcohol? How much?
- Have you recently had surgery?
- Have you ever had vascular surgery or other treatments for your blood vessels?
- Are you depressed?
- Are you afraid or worried about something?
- Are you experiencing a lot of stress?
- Has your energy level decreased?
- Are you sleeping well each night?
- Are you afraid of sexual activity because of physical problems?
- Have there been any recent changes in your life?
- What other symptoms do you have?
- Have you noticed changes in sensations in your penis?
- Do you have any problems with urination?
Tests that may be performed include:
- Urine analysis
- Blood tests
- Blood pressure check
The Doctor will discuss the most effective treatment, following assessment and diagnosis made, by means of a detailed sexual and medical history. Treatment of erectile dysfunction takes a hierarchical approach, with the least invasive and most acceptable treatment tried initially.
Oral medication (such as Viagra or Cialis) is the first-line therapy for most men. Depending on the diagnosis, the Doctor will differentiate between erectile dysfunction caused by psychogenic or medical conditions. Oral medication if successful, may provide confidence and spontaneous resolution of the problem.
There are many treatment options today. These include medication, vacuum devices, and surgery including penis implants ( Dr Mitry has extensive experience in performing this operation) . In order to treat erectile dysfunction effectively, you must be aware of, and be comfortable with, the possible side-effects and complications that may occur with each therapy.