Q&A: Erectile Dysfunction

”Can you give us an article about what wives can do to help their husbands who have ED?  Techniques?  Positions?  Toys?  Where can we get real honest info about pumps? The sex toy sites offer 100s of penis pump choices. Do these really work? How can one choose one? Which ones are “novelties” and which ones are real tools (as opposed to toys)?  But it seems that the best approach would be a couple-based approach. Any advice or ideas?”

Erectile Dysfunction is the inability to get or maintain an erection.  It isn’t something that just affects men.  It can wreak havoc in a marriage and leave both spouses at a loss as to how to handle the physical and emotional stresses it brings.  It often leaves men feeling frustrated, inadequate, and confused, and leaves their wives feeling helpless.  Causes of ED vary and can include but aren’t limited to:

  • Head/spinal cord trauma
  • Alcoholism
  • Stroke & heart conditions
  • Diseases (kidney disease, Parkinson’s disease, vascular disease, & others)
  • Depression
  • Anxiety & stress
  • Obesity
  • Smoking
  • Certain surgeries
  • Medications (antidepressants, blood pressure medications, and others)
  • Low testosterone

Once you have sought medical help and have been diagnosed with ED, there are several treatments out there.  Usually doctors like to start off with the easier suggestions and then move on to more invasive ones as needed.  Not all treatments work for all couples, so you will need to be patient as you try the suggestions given to you, to see if they help.  Here is a list of several treatment options out there for today’s couples:

Lifestyle Changes: This involves losing weight, becoming more active, eating healthier, cutting out alcohol, and quitting smoking.  Also, making sure that you have your diabetes under control.  (Diabetes that is out of control can do permanent damage to the nerves in the penis.)  It helps if the couple makes these lifestyle changes together, so that the husband feels totally supported by his wife.  And just think of how much healthier you both will be.

Sex Counseling: This involves seeing a licensed sex therapist or counselor.  He will work with you and your spouse together, to try and find the specific cause for your ED and then discuss with you both which options/treatments he thinks will be the most effective in your case.  You can get your PCP or Urologist to refer you to a sex counselor in your area.  This is usually helpful along with other treatments, and helps you both keep your communication open.

Pelvic Floor Exercises: Remember those Kegels?  Well they are good for men too!  They strengthen the muscles and help the blood supply for the penis.  Check out this article for more in-depth information about how Pelvic Floor Exercises can help couples that suffer from ED.

Oral Prescription Drugs: This includes drugs such as Levitra, Cialis, and Viagra.  These drugs do not automatically cause an erection.  They simply improve the blood flow to the penis, so that when sexual stimulation occurs, an erection is easier to get and to maintain.  (So yes, wives, your loving hands and/or mouth is still needed!)  Uprima is a newer prescription out there that works differently, although it is still taken orally.  It stimulates the part of the brain that is believed to be partially responsible for erections.  You will need to ask your doctor for more information on this drug.

Suppositories: You may hear this called “MUSE” in the medical field.  This is simply where you (or your wife) use a small plastic applicator to inject a caplet full of medication into the urethra of the penis.  It is absorbed into the penis and helps increase blood flow to allow for an erection.  This is reported to be less effective than other treatments in most men, but is a good alternative for men who are unable to take the oral medications.

Injections: There are some medications that can be injected directly into the penis via a very small needle.  Your doctor will decide on the right combination of drugs for you, and then show you how to inject yourself (or show the wife how to do it).  I have actually heard men speak positively about this procedure, saying that it really isn’t painful like one may think.  There is more in-depth information about penile injections  found here.

Vacuum Devices: This is where you can use a small vacuum pump to aid in getting an erection.  You place your penis into the chamber and then pump out the air, which causes the penis to become engorged with blood and expand.  Then you put on a restriction ring (penis ring) to help maintain the erection and slip the penis out of the chamber to have sex.  It is best to get your urologist to recommend a vacuum that has been proven to produce results, rather than searching through toy sites online looking for something you hope will work.

Penile Implants: This is surgery to implant two expandable cylinders into the penis that attach to a small fluid reservoir and pump located at the scrotum.  You mash on the skin under the scrotum to fill the chambers with fluid, thus causing them to expand, giving you an erection.  The implants are all inside and nothing can be seen externally.  (Yes, there is a ‘deflation valve’ that lets you return the penis to its regular state.)

There are different side effects to all of the above-mentioned treatments, and so it is extremely important for you to discuss these things thoroughly with your primary doctor or urologist.  He will be able to look at your medical history and help you decide which option is best for you.  Urologists also are able to give you specific information as to which vacuum pumps are the most reliable so that you aren’t wasting money on “novelties” and toys that say they produce results.

I agree that a ‘couple based approach’ is best.  ED causes both physical and emotional ramifications for couples, and it is important to seek help together.  You are right about the many toys out there that are marketed ‘to enhance’ your sex life, but it’s important to get solid recommendations from your doctor about vacuum pumps and penis rings that are actually made to help ED and not just sold as toys.

Related Articles:  ED Part 2 (by Lauren Jordan, Licensed Sex Therapist)

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