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Find a doctor or location close to you so you can get the health care you need, when you need it Subscribe to Our e-Newsletter Related ContentFebruary 4, 2022 .
There are two main causes of ED: physical and psychological. Most doctors agree that the majority of cases are physical but it's also clear that many men with ED also quickly start to feel anxious, stressed or depressed. These feelings can easily make the symptoms of ED worse. Relationship conflicts Stress and anxiety Depression (90% of men affected by depression also have complete or moderate ED) Unresolved sexual orientation Sexual boredom
Another second-line treatment is low intensity extracorporeal shockwave therapy. This can be very useful, especially in patients who failed oral therapy, but do not wish to start injections.73
This is especially important for erections. When a man is sexually stimulated, his penis fills with blood. This blood gives him the firmness he needs for sexual activity. Once he ejaculates, the blood flows out of the penis and back into the rest of his body.
The same concerns regarding the use of sildenafil with nitrates and alpha-blockers apply to vardenafil.
Picture of inflatable penile prosthesis. This inflatable penile prosthesis has fluid located at the base of the device. When the tip of the device is squeezed, the fluid is transferred into the cylinder. Erection problems usually produce a significant psychological and emotional reaction in most men. This is often described as a pattern of anxiety, low self-esteem, and stress that can further interfere with normal sexual performance. This "performance anxiety" needs to be recognized and addressed by your health care provider.
A man’s psychological state is clearly an essential consideration when addressing issues of sexual function. While ED that is purely psychological is not common, many men who experience difficulty with erections may develop anxiety or fear about being able to get an erection the next time they try. This anxiety may lead to a stress response involving activation of the sympathetic nervous system and release of adrenaline, which will tend to make it even more difficult to get an erection. Conflict with a partner (or the absence of a partner) will also tend to increase stress and potentially interfere with erectile function.
Check out the illustrations below for further insight into various ED treatments.
Anxiety and depression can be treated with counselling and cognitive behavioural therapy (CBT).
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Trouble getting an erectionTrouble keeping an erectionHaving an erection that is not firm enough for intercourseLess interest in sex
In patients who either fail to respond to first or second-line therapy, or are not interested in the conservative therapies, penile prosthesis implantation is available. Malleable and rigid implants were available for many years, but in 1973 the world of penile prosthetics took a giant leap forward with the advent of the inflatable penile implant. Most implants done nowadays are of the inflatable variety. Adverse events including malfunction and infection are rare, and patient satisfaction is very high.45
Be ready to answer certain questions that will help the urologist know the cause of your erectile dysfunction (ED), such as: If you suffer from any other health issues If you are taking medications for any illness If you are into using recreational drugs If you smoke Your alcohol intake per day If you have any history of surgery or other treatments targeted at the pelvic area If you have any problems with urination Your stress levels Your mental health status Your relationship with your partner
Penile self-injection therapy is a shot that is inserted into the penis and produces an erection for up to an hour or more. This injection is mostly used to treat erectile dysfunction, but can help with other penile conditions as well.
ED is usually easy to diagnose. If you are tempted to self-diagnose, talk to your doctor. He or she will want to make sure it isn’t related to another health condition.
The recommended starting dose of vardenafil is 10 mg taken orally approximately one hour before sexual activity. A doctor may adjust the dose higher or lower depending on efficacy and side effects. The maximum recommended dose is 20 mg, and the maximum recommended dosing frequency is no more than once per day. Patients can take vardenafil with or without food. As with sildenafil, for vardenafil to be effective, sexual stimulation must occur.