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Male Sexual Dysfunction
What is Male Sexual Dysfunction?
Problems with:
- Erections
- Ejaculatory difficulties
- Unsatisfactory levels of sexual activity
- Low sexual desire
Specifically, such dysfunctions are:
- Impotence
- Premature ejaculation
- Retarded ejaculation
- Marital problems
These may occur in single or married men of all age groups.
What causes Male Sexual Dysfunction?
Current medical research indicates that in approximately 80% of men
the problem is due to physical causes. These include: Physical Causes:
- Diabetes
- Side effects from medication, particularly blood pressure and
antidepressant medications
- Atherosclerosis
- Hypertension
- Hormonal disorders
- Alcohol
- Recreational drugs
- Neurological illness or injury
- Metabolic diseases
- Kidney diseases
- Structural genital problems
- Abdominal, pelvic or genital surgery
- Smoking
Psychological Causes:
- Performance anxiety
- Fear of intimacy
- Stress
- Marital problems
- Anxiety
- Depression
Diagnostic Testing
Diagnostic testing employed by the Association utilizing new and sophisticated
methods to determine the cause of the dysfunction are:
- Penile Arterial Blood Flow Studies
to measure if enough blood is delivered to the penis during an erection
- Duplex Doppler UltrasoundIntracavernous Vasoactive Agents (Pharmacologic stimulation)Penile Plethysmography
- Pudendal Arteriography
- Venous Studies
to identify an abnormal leak causing premature softening of the
penis
- Cavernosometry
- Cavernosography
- Neurological Studies
to determine if the nerves involved with the erections are functioning
normally
- BiothesiometryStimulus Evoked Response
- Electromyography
- Axial Rigidity Testing
Axial Penile Rigidity testing
- Axial Penile Rigidity testing
using the Androline Rigidometer
- Hormonal Studies
to determine if there are abnormal hormonal levels
- TestosteroneProlactinLHFSH
- Thyroid and adrenal studies
The selection of diagnostic studies is made with the patient's specific
problem and his desires considered. The patient's partner is encouraged
to participate in the evaluation and treatment selection. Most men
do not require all of the above tests. Appropriate treatment choices
are reviewed and selected based on the patient's wishes.
Treatment Approaches
Medical Treatments With the development of advanced
medical techniques, approximately 90% of patients of all ages are
helped without surgery.
- Oral Medication: Sildenafil (Viagra), Vardenafil (Levitra),
and Tadalafil (Cialis) are FDA approved medications for erectile
dysfunction. Erection occurs after arousal.
- Intraurethral Insert: Prostaglandin E-1/Alprostadil (Muse)
is a FDA approved intraurethral insert that provides an erection.
- Vacuum Erection Device: an external device that is used to get
an erection
- Intracavernosal Pharmacologic Agents: a painless self-injection
into the penis of one or a combination of Papavarine, Phentolamine,
Prostaglandin E-1 just before an erection is desired.
- Endocrine Therapy: topical patches or injectable treatment for
a hormonal condition.
Surgical Treatments
- Penile Implant: an internal device that is permanent and makes
the penis hard enough for penetration. There are several types
with different features. With the currently available state-of-the-art
implants, a success rate of almost 95% may be expected.
- Penile Arterialization: rerouting blood to the penis
- Venous Ligation: tying off leaky veins.
Treatment for
Psychogenic Dysfunction for Individuals and Couples
- Marital and Family Therapy
- Sex Therapy
- Psychotherapy
- Psychopharmacotherapy
- Intraurethral Insert (Muse)
- Prostaglandin E-1 (Caverject)
- Sildenafil (Viagra), Vardenafil (Levitra), and Tadalafil (Cialis)
For more information, please read our articles
page and the Book titled "Viagra - The Wonder
Drug for Peak Performance" by Dr. Whitehead and published by Dell
Publishing, 1999
For more information on AMSD contact:
E. Douglas Whitehead, M.D., F.A.C.S., Medical Director
Association for Male Sexual Dysfunction
24 East 12th Street, Suite 2 - 1
New York, NY 10003
Phone: 212-879-3131
Fax: 212-983-2476
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