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The choice of the treatment for erectile dysfunction directly depends on the cause of the problem. The treatment is usually started with the therapy of the underlying condition which contributes to the impotence in a person, in addition, lifestyle alterations are advised to enhance the general health and sexual life of a person. If there is a special need for medical treatment of erectile dysfunction doctors usually recommend using one of the PDE5 inhibitors, known as sexual agents improving man’s sexual abilities. This drug class includes most popular Viagra, Cialis, Levitra and other generic alternatives. In case a person cannot use these medications because of other conditions he may have, he may be recommended to try other methods to fight erectile problems:
• Medications inserting (placing) directly into the urethra;
• Medications injected into the penile tissue;
• Penile surgery;
• Special mechanic devices to provide extra blood flow into the penis.
Remember that it is always necessary to consult your doctor before trying any of the mentioned methods to treat ED.

Many common drugs for treating certain disorders such as depression, hair loss in men, hypertension, and high blood lipids can contribute to the development of impotence in men.

The antihypertensive medications often cause sexual dysfunctions in males. There are different classes of antihypertensives such as beta-blockers, diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors (ACE inhibitors), and angiotensin receptor blockers (ARBs). The lowering blood pressure medications are often used in combination with other drugs to manage blood pressure. Each class of blood lowering medications has different effects on male sexual function. Some of them such as calcium channel blockers and ACE inhibitors do not affect male abilities, while others beta blockers and diuretics cause erectile dysfunction. It is necessary to discuss with your doctor possible side effects of antihypertensive medications and their combinations.

You should also tell your doctor about other medications which you take on a regular basis. These drugs may include antidepressants and other psychiatric medications, Parkinson’s disease medications, hormonal medications, opiate analgesics, recreational drugs such as alcohol, amphetamines, nicotine, heroin, cocaine, marijuana, barbiturates.

Sometimes doctors need more information to put the correct diagnosis or to determine the actual cause of the problem. In this case doctors usually recommend making other tests which specifically help to understand the underlying cause and severity of ED condition. One of these tests may be prostaglandin E1 injection test. It is performed to assess the penile blood flow. Prostaglandin is directly injected into the corpora cavernosa of the penis, this is made to cause the blood vessels wide and provide blood flow into the penile tissues. If erection occurs as a result of this procedure it assures normal blood flow to the organ. In addition the procedure provides information for possible therapeutic possibilities.
The other method or procedure which monitors erections that happen during sleep is called nocturnal penile tumescence. This helps distinguish if erectile dysfunction is a result of psychological or physical disorders. During two or three night a man has to sleep with a band around his penis to determine intensity and duration of erections if they occur. If nocturnal erections do not happen, erectile dysfunction affliction is of physical rather than psychological character. Still this procedure is not absolutely reliable and should be accompanied by other tests and methods.
One of the methods to estimate the penile nerve function is direct vibrational stimulation which is known as biothesiometry. Vibration amplitude is adjusted with the help of electromagnetic electrodes which are put on the shaft of the penis. The patient is tested to notice the sensation of the penis to this vibration. The procedure is used as a screening method to discover any sensory nerve loss caused by impotence.

A medical professional will adjust for you common laboratory tests to evaluate erectile dysfunction. They may include: complete blood tests, lipid profile to estimate the level of LDL cholesterol which can have harmful effects on the health. If a doctor suspects that a patient may have diabetes he will adjust to make urinalysis and blood glucose level testing, blood hemoglobin A 1 c and serum creatinine. Other special tests may be recommended to undergo if a patient has other diseases. These may contain: liver enzymes and liver function tests to find out if there are any hormonal imbalances leading to low testosterone levels.

If a patient is over 40 years of old a doctor may advise to make a total testosterone level testing. Other hormone levels tests may include luteinizing hormone (LH), prolactin level, and cortisol level which may reveal other causes of erectile problems.

Doctors usually order to undergo prostate specific antigen (PSA) test and prostate examination to determine if a person may suffer from prostate disorders.

Mineral deficiency such as zinc can also lead to ED in men. Tests to evaluate potential risks of having colon cancer, sickle cell anemia and leukemia may also be adjusted.

The tests necessary to perform are followed by  each individual’s history and symptoms.

When you first visit a doctor to consult about your problems with erections you may expect that your doctor will do special manipulations to evaluate your general health and your condition.

First of all your doctor will make a physical examination which is necessary to find out if there are any physical causes of erectile dysfunction. The penis may not respond to touching may reveal damaged nerves and problems in the nervous system. Absence of facial hair, enlarged breasts and lack of sexual desire can be the signs of hormonal imbalance such as low testosterone levels. A medical professional may also listen with a stethoscope to the pulse in the arteries of legs. If the blood flow is reduced in the arteries, there may be a problem with arteries and atherosclerosis.

Peyronie’s disease of deformed penis may also be the affliction of the erectile dysfunction.

A careful medical examination is a very important part of putting the right diagnosis and adjusting the right treatment. After physical examination your doctor may recommend you to undergo special laboratory tests and procedures to evaluate your erectile dysfunction.

A diagnosis of erectile dysfunction is put only by a medical professional. ED is a repeated inability in men to achieve and/or maintain an erection for satisfactory sexual performance for at least three months.

A frank and open communication between the patient and the doctor is essential in making the correct diagnosis of erectile dysfunction. Only a doctor can assess the severity of ED and determine the underlying factor causing it. Doctors usually ask their patients the following questions:

1.     Are you suffering from erectile dysfunction or from lack of desire as well? Or from rapid ejaculation?

2.     Is erectile dysfunction caused by psychological or physical afflictions? Healthy males usually have reflex erections in the early morning and at night. Men with erectile dysfunction caused by psychological factors such as stress and anxiety usually have these reflex erections. Men with physical underlying afflictions of impotence such as atherosclerosis, diabetes, nerve diseases usually do not have these uncontrolled erections.

3.     Does ED result from physical disorder? What disorder causes ED? Such habits as cigarette smoking, drinking alcohol as well as history of heart attacks, strokes, and atherosclerosis can provoke erectile dysfunction. If penile sensation is diminished or there is a bladder dysfunction a doctor may suggest diabetic nerve damage. Lack of sexual libido and gynecomastia may be the signs of low testosterone levels.

4.     Are you taking any medications that can contribute to development of erectile dysfunction? Such medications belong to the drug classes of pain relievers, antidepressants or for hair regrowth.

Then your doctor will make a thorough physical examination and adjust special tests to evaluate the severity of ED in each individual case.

The causes of erectile dysfunction are divided into 2 main groups: physical and psychological. Read this information about ED afflictions carefully, if necessary ask your doctor for more information.

The following are the physical causes of erectile dysfunction:

Aging – is without doubt a reason why men experience problems with getting and maintaining erections. This happens due to medical health conditions that develop in men with age. Older men suffer from heart attacks, angina, cardiovascular disease, strokes, diabetes, and high blood pressure. Besides, the aging process can cause erectile dysfunction in some men, primarily by less production of nitric oxide in the nerves that involves in the mechanism of natural erection.

Diabetes is the second main reasons why males over 45-50 years are more vulnerable to erectile dysfunction. ED is more likely to develop 10-15 years earlier in diabetic men than among those who do not suffer from this disorder.

Hypertension (high blood pressure) increases the risk of developing ED because of its close connection with such medical condition as arteriosclerosis which accompanies hypertension.

Cardiovascular disease is also associated with atherosclerosis in the coronary arteries and thus with developing of erectile dysfunction.

Cigarette smoking and alcohol in large amounts aggravate atherosclerosis and thereby increases the risk for erectile dysfunction.

Very often the damage caused to the spinal cord and nerves in the pelvis can cause erectile dysfunction. Nerve damage can be afflicted by disease, trauma, or surgical procedures.

The usage of certain medications and constant abuse of illegal drugs can contribute to development of potency problems.

The risk factors for developing ED can include the following:

• Age over 60;
• Cardiovascular disease (heart disease);
• Diabetes;
• High cholesterol;
• Smoking;
• Drinking large amounts of alcohol;
• Using of recreational drugs;
• Stress, depression, other psychiatric diseases.

A man to get and sustain erections needs:

1.     A healthy nervous system that conducts nerve impulses in the brain and penis.

2.     Healthy arteries.

3.     Healthy smooth muscles and fibrous tissues.

4.     The necessary amount of nitric oxide in the penis.

If any of these necessary things goes wrong or does not work properly, an erection will not occur.

To have a normal erection you should be sexually aroused. Erection happens with sexual stimulation. Sexual stimulation can be tactile or mental. Sexual stimulation is necessary that is why sexual foreplay may be helpful for those men who have problems with erections.

When you are sexually aroused, electrical impulses are produced by brain and along the nerves go to the penis and this makes the nerves to release nitric oxide. Nitric oxide enlarges the production of cyclic GMP in the smooth muscle cells of the corpora cavernosa. The cGMP makes the smooth muscles of the corpora cavernosa to relax and allow rapid blood flow into the penis. The incoming blood fills the penis and it expands.

Diabetes is one of the most common diseases worldwide. Diabetes causes ED very often: men with diabetes are three times more likely to have problems with potency than men who do not suffer from this disorder.

The risk of developing ED increases if you suffer from diabetes for a long time and if your blood sugar levels are high.

Though practically all men with diabetes have problems with erections, these problems can be successfully solved by proper treatment.
Diabetes has a negative impact on a peripheral nerve function which is associated with bad peripheral blood flow. Bad blood inflow into penis results in inability to have or maintain normal erections in men.
Diabetes often causes damage to the nerves of the penis. This damage negates male’s ability to have erections.

In case blood sugar level is constantly high or over the normal level the nitric oxide (NO) necessary for normal erection process is not produced in enough amounts.  That is why high blood sugar level prevents natural erection process to occur.

To make the impact of the disease less negative, you can stop smoking, make more physical exercises and control your blood sugar level regularly. Special diet and medical therapy can also help to avoid developing of ED.