Men will be particularly anxious when they find that their erection hardness has decreased, which will make the sex life between couples extremely disharmonious, thus affecting the relationship between the couple. Therefore, it is very important to improve the hardness of the erection. At the beginning, psychological counseling and adjustment should be done well, without any psychological pressure and burden, so that sexual function can be enhanced. Some drugs can also be taken for intervention and treatment. 1. Psychosexual therapy Since most patients with erectile dysfunction have psychological factors, psychological treatment is very necessary. It is best for both husband and wife to participate in sexual psychological treatment. Sexual concentration training is currently the most important treatment method for psychological erectile dysfunction. It is applicable to the treatment of almost all sexual dysfunctions. Its purpose is to relieve anxiety, enhance communication and interaction between husband and wife, improve skills from verbal communication to non-verbal communication, and gradually improve the relationship between husband and wife and sexual function. The improvement rate of erectile dysfunction treated by this method is 20% to 81%. 2. Drug treatment Oral medications are the simplest and most acceptable first-line treatment for erectile dysfunction. (1) Non-hormonal drugs can be roughly divided into the following categories according to the site of drug action. ① Oral drugs that act on the central system: such as adrenal receptor antagonists; dopamine drugs; 5-hydroxytryptamine receptor antagonists. ② Oral drugs that act peripherally: PDE5 inhibitors (such as sildenafil, tadalafil, vardenafil, etc.) are specific phosphodiesterase inhibitors that can inhibit cGMP degradation and increase cGMP concentration, thereby relaxing smooth muscles and causing penile erection. This type of drug is currently the first choice for the treatment of ED, with an overall effective rate of over 70%. ③ Topical drugs: Creams and ointments are the oldest methods for the treatment of erectile dysfunction, but the effect is uncertain. (2) Hormone drugs androgen replacement therapy is mainly used to treat endocrine erectile dysfunction, including ED caused by primary and secondary hypogonadism. ① Primary hypogonadism: Testicular tumors, Klinefelter syndrome, trauma, surgery and other lesions can lead to a decrease in testosterone levels and an increase in FSH and LH levels in the body. For such patients, exogenous testosterone replacement therapy is the most effective. Secondary hypogonadism: secondary to hypothalamic and pituitary lesions, due to the lack of gonadotropin, gonadal development is arrested, and the levels of testosterone, FSH and LH in the body are reduced. After supplementing gonadotropin or gonadotropin-releasing hormone, sexual desire can be increased and erectile function can be improved. The androgens used for ED treatment mainly include testosterone undecanoate capsules, injections and patches. For patients with prostate cancer or suspected prostate cancer, androgen supplementation therapy is contraindicated. |
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