Important information from a urologist about ED

It's awkward Conversation for Men to Discuss…Here's a Urologist's Top Information About ED (Erectile Dysfunction)

As a urologist, it was common for me to see patients for the diagnosis and treatment of impotence. Impotence is the ability to achieve and maintain an erection during sexual intercourse. Before treatment I had to make the correct diagnosis.

RELATED: E-cigarettes could have this effect on men

Through history, a physical exam, and testing, we first categorize impotence as either physical or psychological. Over decades of studying men, it has become clear that when a man has a physical cause of impotence, there is often a psychological overlay that exacerbates the physical cause. This often makes treatment more difficult.

These are subcategories of physical impotence. This can be caused by neurological disorders, vascular diseases, physical changes, hormonal problems or medications.

Some of the neurological disorders can be easily identified based on medical history or a physical examination. Typical causes include diabetes mellitus, alcoholism, multiple sclerosis, spinal cord and nerve injuries, and nerve injuries due to pelvic surgery such as prostate surgery.

As for vascular causes, this could be due to either the arteries (inflow) or the veins (outflow). To achieve an erection, more blood has to flow in than out. The most common blood flow abnormality is atherosclerosis (hardening of the arteries). This can be caused by smoking or high blood cholesterol levels, or it can have a family history. If the venous valves do not work, it can lead to incomplete erection or premature loss of erection.

Several physical changes may occur. The most common are Peyronie's disease, penile fractures, pelvic injuries or pelvic surgery.

RELATED: Which Is More Effective for Marijuana Patients: THC or CBD

Low testosterone levels or changes in thyroid hormone can lead to impotence.

There are several medications that can cause impotence. These are often antidepressants, antihypertensives, chemotherapy medications, Parkinson's medications, prostate cancer medications, and anti-anxiety medications. Drugs that affect or depress the central nervous system, such as alcohol, barbiturates, nicotine and opioids, may be suspected of causing impotence. My experience with patients using Cannibus is that it improves erections for some and worsens others.

Finally, psychological problems can also lead to impotence. The most common thing I saw in my practice was performance anxiety. This is when a man is so afraid of being in trouble that he frees himself from it. Other causes can include depression, lack of sleep, relationship problems, anxiety, stress and low self-esteem.

After the cause or causes of impotence are clarified, the doctor has a better guide for treatment.