Erectile Dysfunction (Impotence)
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Erectile dysfunction is the inability to get or keep an erection that is good enough for satisfying sexual performance in Thailand
Written by Dr.Deyn Natthakhet Yaemim (Founding Director) on 6 June 2015, last update 17 July 2022
ABOUT ERECTILE DYSFUNCTION IN THAILAND
Erectile Dysfunction (Impotence) is a common condition affecting men worldwide, including in Thailand. Erectile dysfunction is the inability to get or keep an erection that is good enough for satisfying sexual performance.
Erectile dysfunction (ED), or impotence, is more likely to happen in Thailand if you are older, overweight, have high blood pressure or diabetes, smoke, or drink alcohol. In addition, psychological factors such as stress, anxiety, and depression can also contribute to ED.
In Thailand, several treatment options are available for erectile dysfunction, including oral medications, injections, acupuncture, and shockwave therapy for erectile dysfunction (Shockwave therapy is only available in our Silom, Bangkok, and Tanjong Pagar, Singapore branches). But many men in Thailand may not get help for ED because of cultural barriers, stigma, or because they don't know enough about the condition and the available treatments.
There have been efforts to raise awareness about ED and encourage early detection and erectile dysfunction treatment to solve this medical problem. This includes education campaigns, making it easier to get medical care, and making medicines cheaper and work better. (Learn more about where getting erectile dysfunction pills)
Even though ED is a significant health problem in Thailand, steps are being taken to make it easier to diagnose, treat, and help men who have it.
What is erectile dysfunction (ED)?
Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It’s sometimes referred to as impotence, although this term is now used less often.
Occasional ED isn’t uncommon. Many men experience it during times of stress. Frequent ED, however, can be a sign of health problems that need treatment. It may also be a sign of emotional or interpersonal issues that require professional attention.
Erectile dysfunction symptoms
You may have ED if you regularly have:
- trouble getting an erection
- difficulty maintaining an erection during sexual activities
- reduced interest in sex
Other sexual disorders related to ED include:
- premature ejaculation
- delayed ejaculation
- anorgasmia, or the inability to achieve orgasm after ample stimulation
Speak with your doctor if you have any of these symptoms, especially if they’ve lasted for 3 or more months. They can help determine whether your symptoms are caused by an underlying condition that requires treatment.
When to see a doctor
A family doctor is a good place to start when you have erectile problems. See your doctor if:
- You have concerns about your erections or you're experiencing other sexual problems such as premature or delayed ejaculation
- You have diabetes, heart disease or another known health condition that might be linked to erectile dysfunction
- You have other symptoms along with erectile dysfunction
What causes erectile dysfunction?
ED can occur because of problems at any stage of the erection process. An erection is the result of increased blood flow into your penis. Either sexual thoughts or direct contact with your penis usually stimulates blood flow.
When a man is sexually excited, muscles in the penis relax. This allows for increased blood flow through the penile arteries, filling two chambers inside the penis. As the chambers fill with blood, the penis grows rigid.
An erection ends when the muscles contract and the accumulated blood can flow out through the penile veins.
Erectile dysfunction causes
Physical causes of erectile dysfunction
In many cases, erectile dysfunction is caused by something physical. Common causes include:
- Heart disease
- Clogged blood vessels (atherosclerosis)
- High cholesterol
- High blood pressure
- Diabetes
- Obesity
- Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
- Parkinson's disease
- Multiple sclerosis
- Certain prescription medications
- Tobacco use
- Peyronie's disease — development of scar tissue inside the penis
- Alcoholism and other forms of substance abuse
- Sleep disorders
- Treatments for prostate cancer or enlarged prostate
- Surgeries or injuries that affect the pelvic area or spinal cord
- Low testosterone (Male Hypogonadism)
Psychological causes of erectile dysfunction
The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:
- Depression, anxiety or other mental health conditions
- Stress
- Relationship problems due to stress, poor communication or other concerns
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Risk factors
As you get older, erections might take longer to develop and might not be as firm. You might need more direct touch to your penis to get and keep an erection.
Various risk factors can contribute to erectile dysfunction, including:
- Medical conditions, particularly diabetes or heart conditions
- Tobacco use, which restricts blood flow to veins and arteries, can — over time — cause chronic health conditions that lead to erectile dysfunction
- Being overweight, especially if you're obese (Read more on Saxenda for weight loss & obesity treatment)
- Certain medical treatments, such as prostate surgery or radiation treatment for cancer
- Injuries, particularly if they damage the nerves or arteries that control erections
- Medications, including antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate conditions
- Psychological conditions, such as stress, anxiety or depression
- Drug and alcohol use, especially if you're a long-term drug user or heavy drinker
Complications
Complications resulting from erectile dysfunction can include:
- An unsatisfactory sex life
- Stress or anxiety
- Embarrassment or low self-esteem
- Relationship problems
- The inability to get your partner pregnant
ED can be caused by only one of these factors or by several of them. That’s why it’s important to work with your doctor so that they can rule out or treat any underlying medical conditions.
Erectile dysfunction tests
Testing for ED can involve a variety of steps, including a physical examination and taking your health and sexual history. Additional tests may be performed to determine if your symptoms are caused by an underlying condition.
Physical exam for Erectile Dysfunction
You should expect a physical exam where your doctor will listen to your heart and lungs, check your blood pressure, and examine your testicles and penis. They may also recommend a rectal exam to check your prostate.
Psychosocial history
Your doctor will ask you questions or request that you fill out a questionnaire about your symptoms, health history, and sexual history. The responses can help them evaluate the severity of your ED.
Some questions that you may be asked include:
- How long have you been experiencing ED? Did it come on suddenly or gradually?
- Are you having any problems with feeling sexual desire, ejaculating, or reaching orgasm?
- How often do you have sex? Has this frequency changed recently?
- How firm are your erections? Is this affected by particular situations or types of stimulation?
- Do you wake up in the morning or in the middle of the night with erections?
- How’s your current relationship? What expectations do you and your partner have for each other? Have there been any changes?
- Have you recently been experiencing a lot of stress?
- What medications are you currently taking? Do you use tobacco, alcohol, or nonprescription drugs?
- Do you have any underlying conditions or have you had any surgery on or injury to your pelvic area?
Additional tests
Your doctor may perform additional testing to help diagnose your ED. Tests can include:
- Ultrasound. An ultrasound can be used to examine the blood vessels of the penis to determine if there’s a problem with penile blood flow.
- Nocturnal penile tumescence (NPT) test. A portable, battery-powered device, worn on the thigh, is used to evaluate the quality of your nocturnal erections. Data is stored in the device, which your doctor can access later.
- Injection test. During this test, a medication is injected into your penis to stimulate an erection. This allows your doctor to evaluate the firmness of the erection and how long it lasts.
- Urine tests. Urine tests can be used to check for diabetes or other underlying health conditions.
- Blood tests. Blood tests can be used to check for conditions such as diabetes, heart disease, thyroid issues, and low levels of testosterone.
These tests can help your doctor guide your treatment as well as determine if an underlying condition may be causing your ED. Find out more about how blood tests can be used to diagnose ED.
Erectile dysfunction treatment
Treatment for ED will depend on the underlying cause. You may need to use a combination of treatments, including medication or talk therapy.
Erectile Dysfunction Shockwave Therapy (EDSWT)
Low-intensity shock waves that have a strong impact on the penis, which have been categorized as alternative technology, have been made to improve the penis hardness. The discovery helps improve blood circulation within the blood vessels in the penis to improve erection.
By using low-intensity shock waves with external shocks on the penis, when these waves reach the blood vessels in the penis, that would work to stimulate the performance of the erection, help the vitality of the erection, maintain the size of the penis, and actually make it more effective.
In some cases, in patients with erectile dysfunction and non-response to medication, shock waves can help.
It helps improve and enhance sexual performance.
Patients do not experience any pain or side effects during or after treatment.
The treatment of shock waves has been very effective as a non-surgical innovation to find a solution and reduce ED. (Low-intensity shock waves for ED is available in PULSE CLINIC Bangkok and Singapore branch too)
Medications
Your doctor may prescribe medication to help you manage the symptoms of ED. You may need to try several medications before you find one that works.
Medications used for other conditions may cause ED. Talk to your doctor about your medications and whether they could be causing your symptoms. There may be others that you can take instead. Never stop taking medications without first talking to your doctor.
Medications for ED can cause side effects. If you’re experiencing unpleasant side effects, talk to your doctor. They may be able to recommend a different medication.
You can start ED treatment at any PULSE CLINIC for men near you.
For ED medication price list, please click here (ED Medication refill home delivery is possible)
Talk therapy
A number of psychological factors can cause ED, including:
- stress
- anxiety
- post-traumatic stress disorder (PTSD)
- depression
If you’re experiencing psychological ED, you may benefit from talk therapy. Over several sessions, you and your therapist will discuss:
- major stress or anxiety factors
- your feelings around sex
- subconscious conflicts that could be affecting your sexual well-being
If ED is affecting your relationship, consider speaking with a relationship counselor as well. Relationship counseling can help you and you partner reconnect emotionally, which may also help your ED.
Vacuum pumps
This treatment uses the creation of a vacuum to stimulate an erection. Blood is drawn into the penis as the device is used, leading to an erection.
A vacuum pump device consists of a few different components:
- a plastic tube, which you place over your penis
- a pump, which works to create the vacuum by drawing air out of the plastic tube
- an elastic ring, which you’ll move to the base of your penis as you remove the plastic tube
The elastic ring functions to maintain the erection, holding the blood in the penis and preventing it from returning to circulation. It can be left in place for 30 minutes.
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