Nearly every prominent care physician, internist, and geriatrician now knows that many more experienced men hold an interest in sexual exercise as they age. Some essential care physicians think that sexual energy in older men is the norm and that it is ‘all in the head if it is lacking.’ The current literature has not approved this position.
The Massachusetts Male Aging Study found that 53% of men between 50 and 80 described having some form of erectile dysfunction (ED). The truth is that ED is a normal part of aging and that the frequency increases with age. In the MMAS, they found that roughly 60% of men at 60 years old, 70% of men at 70 years old, and 80% of men at 80 years old had ED. Thus, almost all men who live long enough should gain ED. The myths encompassing impotence or ED problems confound patients’ efforts to receive therapy and physicians’ attempts to help them.
A brief history of the treatment of ED
Infertility treatments were presented in the oldest Chinese text, The Yellow Emperor’s Classic of Internal Medicine, representing traditional Chinese physicians during the Yellow Emperor’s rule, which closed around 2600 BC. One of the ways for treating impotence discussed is a potion with 22 parts.
Nearly a thousand years later, the Egyptian Papyrus Ebers, an Egyptian pharmaceutical report dated 1600 BC, describes a cure for infertility in which baby crocodile hearts were mixed with wood oil and applied topically to men.
Review of physiological changes and other risk factors
As with most, another organ system in the human body moves, and loss of function is the aging process’s typical result. This is true of the endocrine system, especially the levels of testosterone result from the Leydig cells of the testicle.
Following the decrease in testosterone reduces erections, decreasing the blood supply, making erection not as standard and not as rigidly as a young man’s erectile function. Although these differences are not life-threatening, they can change a man’s relationship with his partner. ED may sign other undiagnosed conditions such as coronary artery disease, hypercholesterolemia, or diabetes mellitus. Ageing and comorbidities and polypharmacy factor considerably influence the growth of ED.
Role of the endothelium in ED
The endothelium’s role in ED has been seen for several years, and the overlapping of ED and other diseases, particularly coronary heart disease, cardiovascular disease (CVD), impairing endothelial function/dysfunction, started. The endothelial group is now known to influence vascular tone, impact atherosclerosis, ED and CVD, and peripheral vascular disorder.
The endothelium’s role in erectile function grew more likely with the view that the phosphodiesterase type 5 inhibitor, sildenafil, improved erectile function. Erection occurs with the discharge of nitric oxide from the vascular endothelial cells.
The decrease in endothelial cell production of NO results in a negative influence on the smooth muscles in the corporal bodies and works in less relaxation of the smooth muscle cells, reducing blood supply and resulting in ED. A similar phenomenon is well known to affect the coronary arterial system resulting in CVD.
The association of ED, CVD, and endothelial dysfunction
The pathogenesis of organic ED is linked to dysfunction of the endothelium. Endothelial cells can become damaged through various mechanisms, most of which create oxidative stress on the tissues. Many of these oxidative stress conditions are related to lifestyle problems that lead to hypertension, diabetes, and dyslipidemia.
Endothelial cell dysfunction occurs in the reduction of endothelium-dependent vasorelaxation and improved adhesion of leukocytes to the endothelium. Endothelial cell injury leads to various sequelae, including ED, other kinds of vasoconstriction, atherosclerosis, and thrombus formation.
Current treatment options
As is true in so many medical situations, lifestyle modifications recognized first-line therapy could indeed affect ED management. Men should be inspired to make the required changes to benefit their sexual capacity and overall health. Notwithstanding the advantages of behavior modification, men doing with ED want the physician to help with projects that can immediately impact.
Management options beyond behavior modification include TRT, PDE5 inhibitors, intracavernosal medicine therapy, vacuum compression devices, intraurethral prostaglandin suppositories, and surgical induction of a penile prosthesis.
Clinicians need to order these drugs to make the patient informed of the drugs’ action, mainly because they do not result in an instant erection and do not cause an erection without sexual stimulation. There is often a great expectation when men begin using these drugs. It is smart to temper their enthusiasm and demonstrate they do not work quickly and may not work every time, but also let the patient know that if these medications do not work, there are other benefits.
Besides PDE5 inhibitors and second-line treatments are VCDs, clear plastic chambers compressed against the lower abdomen with a tool to create a vacuum inside the room. If enough erection occurs inside the chamber, the patient slips a small reduction band off the VCD end. An erection beyond 30 min is not advised. These things can be a bit cumbersome but are very reliable.
Another second-line treatment is the use of alprostadil, either intracavernosal or intraurethral. Two results are available for direct injection, Caverject or Edex. A tiny needle is used to introduce the medicine into the lateral appearance through a small-gauge hand.
The answer is dose-related and usually happens within 10–15 min and does not need stimulation. The intraurethral development, medicated urethral suppository for erection, consists of a tiny pellet of drug injected into the urethral meatus. The answer is also dose-related and onset-related to the cavernosal products.
How to Treat ED?
For everyone struggling with ED or related issues, we have good news. A non-invasive treatment for ED has been already introduced and put in use. It’s called Gainswave and it helps you GAIN back your erection and satisfaction from sexual performance. It is an all-time device that does not recognize barriers as age and works effectively for everyone.
Many men even report improvements after the first couple of sessions. If you are living in Redmond, WA, there is an exclusive opportunity for you to visit Dr. Kate Kass, the pioneer in practicing Gainswave and learning how to treat your ED. Make sure to schedule an appointment at her clinic and do one more step towards restoring your erection and bettering your relationships.
