Erectile dysfunction (ED) is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory erotic sexual performance. It affects millions of men globally and becomes increasingly prevalent with age.
The causes of ED may be vascular, neurological, hormonal, psychological, or medication-related. Cardiovascular disease, diabetes mellitus, hypertension, and obesity are significant risk factors. Psychological stress, anxiety, and depression may also contribute.
Diagnosis involves detailed medical history, physical examination, and laboratory testing. Penile Doppler ultrasound may be used to evaluate blood flow. Hormonal testing identifies testosterone deficiency when suspected.
Treatment options include phosphodiesterase type 5 (PDE5) inhibitors such as sildenafil, tadalafil, and vardenafil. These medications enhance nitric oxide-mediated vasodilation, improving blood flow to penile tissues. Other treatments include vacuum erection devices, intracavernosal injections, hormonal therapy, and penile implants in severe cases.
Lifestyle modification significantly improves outcomes. Weight management, regular exercise, smoking cessation, and control of chronic diseases are essential.
ED is often an early indicator of systemic vascular disease. Therefore, addressing ED may provide an opportunity for early cardiovascular risk assessment.
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