Erectile Dysfunction (ED)

Many men are encountering problems of Erectile Dysfunction (ED) and may not be aware that this disease is happening to themselves. They also do not know what kind of doctor to see for the dysfunction.

Introducing “Dr. Beer,” the founder of Eternity Clinic, directly treating erectile dysfunction. many of you should have searched for preliminary information about the disease erectile dysfunction from various sources, including Google, Pantip, and others, making it possible to know brief information.

Starting from male dysfunction, what drug can cause dysfunction at what age? Are there really drugs for men that can be used to treat erectile dysfunction? It is a significant matter for many families, and the wife would not be pleased with her husband’s deterioration. I will give you insights and methods of treatment.

Erectile dysfunction (Erectile Dysfunction) is commonly known as sexual ineffectiveness. It is a condition in which the penis cannot maintain a complete erection during sexual intercourse. This condition can occur in men of any age, but it is often found more with increasing age. Some patients may not have an erection or solidified for a short time, and some people have symptoms of premature ejaculation.The most common cause of these symptoms is insufficient blood supply to the genitals. People are found to be 3 times more likely to suffer from this condition than in the past due to changing lifestyles. Making more men at risk of developing erectile dysfunction.

Symptoms of sexual dysfunctionPhysical Characteristics of the Penis the Urethra is a cylindrical organ. Located in the middle of the penis, which divided into 3 parts: the head that is smooth and round- the end part has an opening of the urethra. The middle of the penis that is the protruding part, and the base which is attached to the trunk. The base and the protruding part of the penis are covered with skin. The head and the protruding joint are covered with a hat-like skin called the foreskin which can slide up and down.The internal components of the penis can expand and become hardened because it consists of 3 retractable cylindrical tissues that can be stretched-retracted and hidden urethra.The erection of the penis has 3 mechanisms:Erection during sleep (Nocturnal Erection), the penis will have an erection about 4-6 times a night, 15-30 minutes each time.Psychogenic Erection When various stimuli trigger sexual desire, commands are sent from the brain to the cerebral cortex called the cerebral cortex—paraventricular nucleus located in the hypothalamus. After that, the commands then pass through the spinal cord down to the erection center of the penis at the level of the coccyx and through the cavernous nerve, which stimulates the blood vessels in the penis to expand; the more blood that is coming in to circulate, making the penis harden.Erection from reflex (Reflexogenic Erection), when the penis is stimulated or touched, there will be a signal passing from the dorsal nerve to the erection center at the spinal cord at the coccyx level and returning the signal to the penis (Cavernous Nerve).When sexual stimulation occurs, most importantly, it has to be stimulated through inducements in the brain region known as the paraventricular nucleus (PVN), located in the hypothalamus of the brainstem, which is called the paraventricular nucleus (PVN). Erection from psychological stimulation (Psychogenic Erection), in which type 2 dopamine receptors most stimulate the nervous system.From there, commands pass through the spinal cord to the coccyx at levels 2 – 4, where they merge into a ganglion known as the Sacral Plexus and branch out into the Cavernous Nerve (Cavernous Nerve) to the penis, causing the blood vessels to swell. This net acts like a sponge and presses the veins that flow from the penis, causing very little blood to flow from the penis, and then it will become fully erect.The penis consists of 3 axes. Erection of the penis requires 2 principal axes, the Corpus Cavernosum, composed of spongy reticular muscles (Sinusoid). These are the capillaries of the penis.Symptoms of sexual dysfunction are divided into 3 types as follows:Firstly, is that the penis never becomes fully erected or not harden enough to complete sexual intercourse.Secondly, is where the penis was previously erect and sexually active but later experiencing abnormality in making it unable to harden as before.Thirdly, the temporary form is the periodic inability of the penis to become erect. In most patients in this case, if the problems are found and treated early, they can be healed. By middle age, most men will begin having inferior sexual problems. This disease occurs in 37 percent of men aged 40-70 years with one or all of the aforementioned symptoms because sex hormones decrease simultaneously with the deterioration of the body.The level of severity can be classified as follows.– Low severity level at this level can be observed when you want to have sexual activity; it can reach orgasm almost every time.- Moderate severity level if sexual activity reaches orgasm about half the number of times in intercourse.- High severity level fails every time having sexual activity.Causes of erectile dysfunction can be divided into 5 causes.1. Abnormalities in the blood vessels in the genitals are found in about 70 percent of patients and are the leading cause of erectile dysfunction. Which can be divided into 3 types: arteries that feed the genitals clogged, causing insufficient blood supply to the genitals. Mechanism of venous stenosis abnormalities causing the blood to be unable to collect in the genitals. There is a joint disorder between arterial occlusion and abnormal venous pressure mechanism.2. Disorders in the nervous system. Patients may have abnormalities from the level of the brain, spinal cord, pelvic nerves, genital nerves, etc.3. There may also be other symptoms of Testosterone hypothyroidism in patients with testosterone deficiency, such as decreased sex drive, decreased erection, especially in the morning, feeling weak, and exhausted, decreased willingness to work, or maybe found in patients with hyperthyroidism or hypothyroidism.4. Mental state disorders, in the past, it was believed that psychological conditions caused 90% of patients with erectile dysfunction. Nowadays, it is found that it is caused by physical rather than mental diseases that affect sexual performance. It can be found in patients with stress, depression, and schizophrenia or may be caused by psychiatric drugs as well.5. The cause of lifestyle behavior, alcohol: many men may prefer alcoholic beverages to set the mood or to induce sexual arousal, but it can make it harder for them to perform sexual activities. Excessive amounts of alcohol may temporarily interfere with the erection.Outdoor activities: outdoor activities or playing outdoor sports can cause fatigue, tiredness, and fatigue at night.Smoking Habits: Smoking inhibits blood flow, damaging the blood vessels or restricting blood flow to the penis. This will result in chronic health problems that lead to erectile dysfunction.Addicted to games: Sitting in front of the screen for long-time results in poor physical health. Lacking freshness, rejuvenation, fatigue, and sleepiness, it’s clear why this leads to erectile dysfunction.Insomnia: This can be caused by sleep problems: including living a life that does not require much sleep or traveling, causing insufficient rest—an exhausted body.Eating unhealthy food: For those young men who like to eat junk food because of the laziness of finding food, the easiest way is to order junk food delivered directly to your doorstep. Nevertheless, did you know that these foods contain excess amounts of fat? Resulting in obesity: fat clogging in the blood vessels leading to atherosclerosis, making it unable to transport red blood to supply your manhood.On examination and diagnosis, the doctor will ask about the nature of sexual intercourse, past illnesses, surgeries, congenital diseases, and medications used regularly. Then conduct a physical examination to assess abnormalities in the genital testicle size and check the prostate gland. In some cases, the doctor will then send you for the appropriate laboratory tests to look at congenital diseases that may result in diseases, such as blood sugar, blood lipids, and liver and kidney function—screening for prostate cancer and checking testosterone levels in patients with decreased sexual desire.Additionally, the doctor may perform additional tests by ordering an ultrasound to find abnormalities in the blood vessels of the genitals (Penile Doppler Ultrasound), which will be examined in some patients with severe problems. It measures the function of the arteries and veins in the genitals to determine the cause and other treatment options.Treatment begins with treating congenital diseases, such as controlling blood sugar, blood lipids, and blood pressure, refraining from smoking, refraining from drinking alcohol, getting enough amount of sleep, exercising regularly, and weight loss, including some medications that affect erectile dysfunction.If the patient has a mental disorder, the patient needs to see a therapist. In patients with testosterone deficiency, the patient needs to be treated by giving testosterone replacement.1. Drug treatment by using drugs in the PDE-5 Inhibitor group, such as Viagra, Levitra, and Cialis, must be taken about 30 minutes to 1 hour before sexual intercourse. The drugs in this group cannot be combined with those in the nitrate group. The side effects include palpitations, headache, vision flashes, nasal congestion, etc.2. The use of a vacuum cylinder (Vacuum device) by using a vacuum cylinder to cover the genitals. After that, the air is pumped out of the pipe, causing the blood to flow into the penis until the penis fully erects well. After that, a rubber band keeps the blood from flowing out.3. The use of low-frequency sound waves (Shockwave therapy) is the use of low-frequency sound waves to strike the tissues of the penis. It is a new technology and alternative that helps create new blood vessels in the penis this will cause the rehabilitation and treatment of erectile dysfunction. The treatment should be received 1time/week continuously for 5 weeks. It is found to help create new blood vessels in the penis, creating a better erection of the penis. It is used in patients with insufficient blood supply to the genitals area, such as in diabetic patients with erectile dysfunction or in patients who respond to erectile dysfunction drugs and do not want to take them regularly. Patients treated with this method have been found with no pain and experience no side effects during and after the treatment.4. Injectable drug treatment is a drug that is injected directly into the genitals 5-10 minutes before sexual intercourse.  It is about 70% effective and is considered in a group of drugs in Prostaglandin E1, which can make the penis erect for about 1 hour.  This method must be under the supervision of a medical professional.5. Surgical treatment is a last resort in treating patients with erectile dysfunction. It is a surgical procedure where the prosthetic core is inserted directly into the penis. Which is more than 90% effective, used in cases where other treatment methods are ineffective.What is Minimally Invasive Surgery? Endoscopic surgery Minimally Invasive Surgery is a modern medical technology that helps reduce the size of the surgical wound. Reduces the pain of the wound, and it takes less recovery time than an open surgery. As a result, the patient can return to everyday life faster.Procedures and brief surgical process, the surgeon will make a small puncture, approximately 5-10 ml, through the abdomen or skin near the organ that needs to be operated on, amounting to 1-4 holes, depending on the disease to be treated. And then, insert a tube with a flashlight and a small camera that can clearly record images of the patient’s internal organs and send them to the monitor so that the surgeon can clearly see the operated area leading to the accurate and precise result after the surgery.Advantages and Limitations of Laparoscopic SurgeryAdvantages of Laparoscopic Surgery-Minimum Incision – the scar is smaller than that of the open incision method.-Minimal Pain– patients will feel less pain after surgery than after comprehensive open surgery.-Fast recovery- the tissue is less injured minor incisions, less fibrosis, and significantly reducing the chance of wound infection, allowing the body to recover faster.- The cost of recovery at the hospital is not very high due to a short recovery time.Limitations or Disadvantages of Laparoscopic Surgery– The cost of laparoscopic surgery is relatively high due to the need for special equipment.- Patients with certain conditions cannot use laparoscopic surgery, such as patients with severe lung and heart disease—people who have had surgery and have a lot of fasciae in the stomach.- Doctors and staff must have expertise in laparoscopic surgery techniques.How to make reduced in sexual deteriorate performance.Avoid risk factors, especially alcohol, smoking, and high-fat foods.Early control of existing diseases such as diabetes, high blood pressure, etc.Nourish your body and mind to be healthy, reduce stress, and find ways to get rid of stress that are effective for yourself, such as singing, dancing, reading, traveling, going to a spa, meditating, exercising, etc.Exercise, eat a well-balanced diet, focus on vegetables, fruits, and whole grains, and get enough rest. Have time to take care of yourself, doing your favorite hobby to make a meaningful life.Change the setting of sexual activity, such as changing the environment, and change the usual sexual positions.Maintains a good relationship with your lover, pays attention to each other, and knows how to listen, talk, discuss regularly, and do activities together.Consult a doctor if you cannot solve the problem of erectile dysfunction by yourself to detect the cause and fu rther corrections.