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Anxiety, depression and other emotional issues can lead to premature ejaculation. For these issues, seeking the help of a psychologist, psychiatrist or sex therapist may be helpful. Couples therapy may also help if relationship problems are the cause of premature ejaculation.
The survey did not ask volunteers if a doctor had diagnosed either of the disorders, only about related symptoms, which is a weakness, said Dr. Thomas Pollm?cher, the director of mental health at Ingolstadt Hospital, Germany.
The reported frequency of sexual intercourse in this population was between 0.25 – 10 per week (mean 2.4). Evaluation of sexual function log revealed that there was good concordance between the pre-study reported frequency and logged frequency during the study period. Of the 113 men in the study, only 33 (29%) reported having some amount of spontaneous erection, but not suitable for enjoyable intercourse at Visit 1. Following sildenafil therapy, 82/99 (82.8%) men had improved erections (based on GEQ) suitable for intercourse. Seventeen (17.2%) failed treatment. There were no differences in the response rates between the various aetiological groups. A total of 33/99 (33.3%) men reported return of spontaneous erections suitable for penetrative intercourse, at least once, following treatment, of whom 14 (42.4%) did not have any spontaneous erections suitable for intercourse prior to therapy. Of the 74 men reviewed at Visit 4, 59 reported that they would continue using Viagra on a long-term basis (79.7%). Three men had reported complete return of spontaneous erections and had stopped using Viagra (1 at Visit 2 and 2 at Visit 4).
In a few cases there is a vascular problem which can be treated surgically.
A useful and simple way to distinguish between physiological and psychological impotence is to determine whether the patient ever has an erection. If never, the problem is likely to be physiological; if sometimes (however rarely), it is more likely to be psychological.
Treatment for depression may include medication, psychotherapy (talk therapy), or a combination of both.
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If the man's life expectancy is low due to old age or other factors, surgery or radiation for prostate cancer might actually do more harm than good, some doctors feel.
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Nutritional Supplements: nutritional supplements including the amino acid arginine, bioflavonoids, zinc, Vitamin C, Vitamin E, and flaxseed meal have been used to improve erectile function. In addition, certain ED patients with low levels of the hormone dehydroepiandrosterone (DHEA) showed improvement in erectile function after receiving supplemental doses of DHEA. However, because the long-term safety of DHEA is not known, most experts do not recommend its use.
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"The mechanisms underlying the association between RLS and erectile dysfunction could be caused by hypofunctioning of dopamine in the central nervous system, which is associated with both conditions," said Gao.
Diagnosis Non-ischemic priapism due to a ruptured left helicine artery, intermittent penile turgidity and erectile dysfunction.
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Numerous alternative therapies are used to improve sexual function. Some include: niacin, zinc, copper, Korean red ginseng root, ginkgo, pine bark, Tribulus terrestris, arginine, Avena sativa, horny goat weed, maca root, muira puama, saw palmetto, and Swedish flower pollen. None of these however have been recognized as effective by the FDA.[30] While zinc deficiency may be a cause of lower testosterone levels in hemodialysis patients, which may benefit from zinc supplementation,[31] such supplements have no effect on the testosterone levels of healthy males who consume a zinc-sufficient diet.[32]
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Several laboratory tests can help diagnose ED. Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measuring the amount of free testosterone in the blood can yield information about problems with the endocrine system and is indicated especially in patients with decreased sexual desire.
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