Author: edquestions

Although the incidence of erectile dysfunction among younger men is much smaller than it is among those over 40, it does occur, according to EverydayHealth.com. In fact, the National Institutes of Health estimates that about 5 percent of men between the ages of 20 and 39 suffer from some form of ED.

The younger the man, the greater the likelihood that his ED can be traced to psychological causes, the most common of which are depression and performance anxiety. Depression-related erectile dysfunction can be difficult to treat because some of the medications prescribed to ease the symptoms of depression may make it difficult to get and keep an erection.

While most ED among young men is psychological in origin, other factors that may be causing erectile problems include heavy drinking, drug abuse, and obesity. Some young men may lose their erections while putting on a condom, because that procedure represents a break from stimulation that can wilt some erections.

Unless you’ve recently experienced irritation or trauma to the penis, erections should not be painful. If they are, you should see a doctor as soon as possible. According to NetWellness.org, the leading causes of erectile pain are the following:

Peyronie’s Disease: Characterized by a lump or plaque that forms on the penis, Peyronie’s can cause painful erections but can be treated.

Penile Mass: Any abnormal growth or lump on the penis should be thoroughly investigated and evaluated by ultrasound or biopsy if indicated.

Priapism: A prolonged erection — lasting more than four hours — is not only painful but also can cause scarring of erectile tissues if left untreated.

Phimosis: This condition involves a tightness of the foreskin that prevents it from retracting over the head of the penis upon erection. This can be a congenital condition or a symptom of infection.

Penile injury: This covers a wide range of possible damage to the penis itself and the blood vessels and nerves that serve it. Seek medical attention immediately if you suffer from such a trauma.

Penile prostheses — surgically implanted — come in two basic types: malleable and inflatable. The cost of the implants varies sharply depending on the type of implant you choose, the surgeon performing the procedure, and the part of the country in which surgery is done. That said, the total cost of penile implant surgery ranges from a low of $10,000 to a high of $20,000. Health insurance plans often cover implant procedures, particularly if the patient is suffering from ED caused by a disease or as a side effect of surgery, such as prostate surgery.

Of the two types of implants, the malleable prosthesis represents older technology and involves somewhat less surgery, making it the cheaper of the two. Because inflatable penile implants consist of additional components that must also be hidden beneath the patient’s skin, they cost more than the malleable type.

Penile prostheses come in two basic types, malleable or inflatable, and both involve surgery to implant the devices in the penis. In the case of the inflatable prosthesis, your surgeon must also implant a pump and a reservoir to hold the fluid that is used to inflate the penis for sexual activity.

For both malleable and inflatable prostheses, the surgeon will implant two cylinders — usually made of medical grade silicone. One goes into each of the penis’s two corpora cavernosa, which are cylinders of erectile tissue that ordinarily fill with blood to create an erection.

According to the Urology Care Foundation, the malleable implants create “a degree of permanent penile rigidity or firmness that enables the man to have sexual intercourse.” A malleable implant can be bent downward to allow urination or upward to facilitate sexual intercourse.

Other components for the inflatable prosthesis include the aforementioned pump and reservoir, the former implanted in the scrotum and a fluid-filled reservoir implanted under the skin of the lower abdomen. To prepare for sexual activity, the man triggers the pump that draws fluid from the reservoir to fill the cylinders in the penis making it rigid enough for intercourse.

Key factors in how you and your doctor decide to treat your ED include the cause of the dysfunction, your overall health, other medications you may be taking, and the ease with which you can tolerate various treatments.

If the cause appears to be psychologically based, you may have to spend some time with a psychiatrist or psychotherapist to work through the hangups and anxieties that are interfering with your ability to achieve an erection.

For the vast majority of men, the first line of attack against ED is drug therapy, which involves taking one of the FDA-approved PDE5 inhibitors, which temporarily increase blood flow to the penis and allow erection to occur.

If drugs don’t work or are inappropriate, your doctor may suggest that you use a vacuum constriction device (penis pump) or penile injection therapy. Finally, there is surgery, which sometimes can restore normal nerve and vascular function in the penis or implant a device that makes it possible for you to have an erection when appropriate.