Are there hidden health conditions that dysfunction can signal?
All men should know is that it is often a precursor to other medical problems. It can actually precede cardiovascular disease by three to four years. So even if they do consider themselves otherwise healthy, this may be a warning sign to take their health a little bit more seriously, to make sure they see their primary doctor on a regular basis.
Prostate and other pelvic cancer surgery has been associated with a risk of post-operative erectile dysfunction. Are there any new approaches to that circumstance?
At Stanford, we've found that there are things we can do before surgery or radiation to preserve function and expedite recovery. What we've learned also is that in the immediate post-operative period, an aggressive rehabilitation program is very important for maintaining penile health. If a normal oxygenated erection does not occur every day, natural erections either will not recover as fully as they were before, or the recovery can be delayed.
What kind of physical treatments are available?
The first thing we do is try and identify any modifiable causes. We also usually look at a hormone profile. For instance, low testosterone has been linked to problems with sexual function. That's something that could also be corrected. Then we move on to some of the different medications that we have, familiar ones like Viagra and Levitra, and Cialis, which work very well. If those don't work, we move on to some other options that are more invasive, like injection therapy or urethral suppositories. There's also something called a vacuum erection device. And, if none of these approaches work, there is surgery we can do to put an inflatable prosthesis in the penis, which also has very high patient and partner satisfaction rates.
Are there non-medical options, too?
Some men find that their erectile dysfunction very situational and want to learn different techniques or get psychological help.
Can treatment do more than just improve physical health?
Erectile dysfunction has a large impact on emotional life, on overall quality of life. I've seen relationships end. Once we initiate treatment, new relationships can begin.
What do you recommend to preserve and protect function?
I always tell men, in order to prevent erectile dysfunction, you should live a healthy life. Anything that's good for your heart is going to be good for your penis. So, a good diet and exercise will all benefit. If they have other risk factors that are modifiable, such as smoking, they should definitely cut that out. Weight control also is very, very important. If you do have a problem, I always do encourage a patient's partner to be involved in treatment as well, because it's a team sport, and I think having a very interested and active partner that's willing to help goes a long, long way.
By Sara Wykes