It is a medical condition characterized by the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Also known as impotence, ED can affect men of all ages and have a significant impact on quality of life, self-esteem, and intimate relationships. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), erectile dysfunction is a common disorder, but fortunately treatable with success thanks to the many therapeutic approaches available today. In this article, Prof. Fabio Castiglione, expert in urology and andrology, clearly explains what erectile dysfunction or ED is, what causes it, and how to treat it effectively.
What is Erectile Dysfunction or ED? Complete guide with Prof. Fabio Castiglione
Causes of Erectile Dysfunction
ED can result from a combination of physical and psychological factors. Identifying the underlying cause is essential to determine the most appropriate treatment.
Physical Causes
Physical causes are often linked to pre-existing medical conditions that affect blood flow, nerve function, or hormone levels. These include:
- Cardiovascular diseases: Conditions such as hypertension and atherosclerosis may reduce blood flow to the penis.
- Diabetes: Can damage nerves and blood vessels, compromising the ability to achieve an erection.
- Obesity: Being overweight is associated with lower testosterone levels and vascular problems.
- Hormonal disorders: Low testosterone levels can affect erectile function.
- Surgery or injuries: Damage to the nerves or arteries controlling erection, often following pelvic surgery or trauma.
Psychological causes
Emotional and psychological factors may contribute to or cause ED, including:
- Stress and anxiety: Work or personal issues can interfere with sexual arousal.
- Depression: Often associated with reduced libido and ED.
- Relationship problems: Conflicts or poor communication with a partner can affect sexual function.
Symptoms of Erectile Dysfunction
The primary symptom of ED is the inability to achieve or maintain an erection sufficient for sexual activity. However, other symptoms may include:
- Reduced sexual desire: A decrease in interest in sexual activity.
- Less rigid erections: Difficulty achieving full erection hardness.
- Less frequent erections: Fewer spontaneous erections, such as morning erections.
Diagnosis of Erectile Dysfunction
An accurate diagnosis is essential to identify the cause of ED and plan effective treatment. Prof. Fabio Castiglione, expert urologist and andrologist in London, uses a comprehensive approach that includes:
- Medical and sexual history: In-depth discussion of the patient’s overall health and sexual history.
- Physical examination: Evaluation of the genitals and secondary sexual characteristics.
- Blood and urine tests: To detect conditions like diabetes, thyroid problems, or low testosterone levels.
- Psychological tests: To identify any emotional or psychological contributing factors.
- Penile ultrasound (Doppler): Assesses penile blood flow and can help detect vascular problems.
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Treatments for Erectile Dysfunction
ED treatment depends on the underlying cause and may include lifestyle changes, medications, mechanical devices, and psychological support. Prof. Castiglione provides personalized solutions for every patient.
Lifestyle changes
Healthy changes can significantly improve erectile function:
- Regular physical activity: Aerobic exercise improves circulation and cardiovascular health.
- Balanced diet: Nutrient-rich foods support overall and sexual health.
- Avoid smoking and alcohol: Both can contribute to ED; quitting smoking and reducing alcohol are excellent strategies.
ED medications
Medications are often the first-line treatment for many ED patients. Prof. Fabio Castiglione prescribes them only after a personalized evaluation.
Main medications include:
- Phosphodiesterase type 5 (PDE5) inhibitors: such as Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra), and Avanafil (Spedra). These drugs enhance blood flow to the penis and work only with sexual stimulation.
- Hormone replacement therapy: if testosterone levels are low, replacement therapy may be prescribed. However, it is not a direct solution for all ED patients and must be assessed on a case-by-case basis.
- Intraurethral or injectable medications: such as alprostadil, used when PDE5 inhibitors are ineffective.
Warning: ED medications must always be prescribed by a specialist, as they can have side effects and interact with other medications.
Mechanical Devices and Advanced Solutions
When medications are not enough, there are safe and effective alternatives:
- Vacuum devices: external devices that promote erection by creating suction around the penis.
- Constriction rings: often used in combination with pumps to maintain the erection.
- Penile implants: In severe and refractory cases, the implantation of an inflatable or semi-rigid penile prosthesis may be considered. Castiglione performs these procedures in highly specialized centers in London.
These solutions are ideal for patients who do not respond to other treatments and are seeking a definitive solution.
Prof. Fabio Castiglione’s Innovative Approach: Shock waves and regenerative medicine
In recent years, medicine has made great strides in managing ED. Prof. Fabio Castiglione, a pioneer in male regenerative medicine, offers innovative treatments aimed at regenerating tissues and improving penile blood flow:
Low-Intensity Shock Waves (LI-ESWT)
- Stimulate new blood vessel formation (neovascularization)
- Improve erections naturally, without medications
- Non-invasive, painless, and well-tolerated
Prof. Castiglione is one of Europe’s leading experts in shock wave treatment for ED.
PRP (Platelet-Rich Plasma)
- Derived from the patient’s blood
- Injected directly into the corpora cavernosa
- Stimulates tissue regeneration and enhances erection
An advanced technique requiring specific expertise in regenerative andrology.
Erectile Dysfunction and Mental Health
ED is not just a physical issue. It is often deeply connected to emotional and psychological health.
- Performance anxiety
- Low self-esteem
- Depression
- Relationship conflicts
Prof. Castiglione uses a holistic approach, working alongside psychologists and sex therapists to offer comprehensive patient care.
Pelvic Exercises and Natural Remedies: Do They Really Work?
One of the most common searches is: pelvic exercises for erectile dysfunction. Here’s what to know:
- Kegel exercises for men can strengthen pelvic floor muscles and improve erection control.
- Aerobic activity and weight loss improve testosterone and vascular health.
- Natural remedies and supplements (ginseng, maca, L-arginine) have limited effectiveness and are not regulated.
It’s always best to consult a specialist before using any ED supplements.
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FAQ – Frequently asked questions
Does ED mean erectile dysfunction?
- Yes. ED stands for Erectile Dysfunction.
What is the main cause of erectile dysfunction?
- The primary cause is usually vascular (blood flow problems), but it can also stem from hormonal, neurological, or psychological factors.
How do I know if my partner has ED?
Common signs include:
- Frequent or persistent difficulty maintaining an erection
- Weaker or absent erections
- Decreased sexual desire
Open communication is important. Encourage a visit to a specialist.
How is erectile dysfunction treated?
Treatment depends on the cause. Options include:
- Oral medications
- Hormone therapy
- Shock wave therapy
- PRP
- Psychotherapy
- Penile implants
Prof. Castiglione offers personalized evaluations and a combined approach for lasting results.
When to Consult Prof. Castiglione
Don’t wait for erectile dysfunction to become chronic. It’s advisable to see a specialist if:
- You’ve had erectile issues for more than 3 months
- ED causes stress or relationship issues
- You want to avoid long-term medication
- You’re seeking a natural or surgical solution
Conclusion
Erectile dysfunction, or ED, though common, should not be seen as a life sentence. Today, science offers advanced, safe, and personalized treatments to help every man regain confidence, desire, and sexual function. Prof. Fabio Castiglione, with years of international experience and an integrated approach, is one of Europe’s leading specialists in treating erectile dysfunction. Whether you’re seeking a medical, regenerative, or surgical solution, you’ll find the right support here.