Medications that affect sexual function and self-testing methods for erectile dysfunction

[Drugs that affect sexual function] (1) Hormones: ① Estrogen: Clinically used to treat benign prostatic hyperplasia. These patients may experience obvious adverse reactions such as male breast hyperplasia, reduced and slowed beard growth, decreased libido, erectile dysfunction, ejaculation disorders, and reduced semen volume.

②Adrenocortical hormones; sexual dysfunction can occur when the daily dosage reaches 20 mg.

③ Testosterone: Abuse of testosterone can worsen the condition of patients with erectile dysfunction.

Because exogenous testosterone suppresses the endocrine function of the pituitary gland and testes.

④ Cyproterone acetate: It is a synthetic steroidal compound with anti-androgenic activity, which can lead to decreased libido, erectile dysfunction, and long-term use can lead to oligospermia and infertility.

(2) Diuretics: such as spironolactone, which is an aldosterone antagonist that can inhibit the activity of testosterone synthase, thereby reducing testosterone synthesis and lowering blood levels.

It can cause decreased libido in 20% of men. Additionally, diuretics can cause potassium loss, lowering blood potassium levels, reducing neuromuscular sensitivity, and relaxing vascular smooth muscle, which can lead to weakened penile erection.

(3) Antihypertensive drugs: These are common drugs that affect male sexual function.

25% of patients taking antihypertensive drugs experience erectile dysfunction, compared to only 7% of healthy individuals who do not take medication.

In addition, 25% of people taking antihypertensive drugs experience ejaculatory dysfunction.

(4) Sedatives: High doses of diazepam have a specific effect on the limbic system of the brain, directly reducing or enhancing libido.

Drugs like diazepam have a muscle-relaxing effect and can cause decreased libido and erectile dysfunction via the spinal cord efferent nerves.

(5) Antipsychotic drugs: Long-term use of large doses can cause vasoconstriction, leading to erectile dysfunction.

[Prevention and treatment of erectile dysfunction] (1) Stamp test: Use four perforated stamps to encircle the penis, stick the overlapping parts together to form a ring, and then go to sleep.

In the early morning, check the perforation of the stamps for tears; tears indicate nocturnal erections.

(2) Penile circumference measurement: There is a commercially available soft tape measure (usually made of paper) with a square buckle attached to one end. Before going to sleep, wrap it around the penis and pass the other end through the buckle. First, read the base circumference of the penis in a flaccid state, and then check the data the next morning to see if there is any change.

The difference between the data before sleep and after waking up is the increase in penile circumference after nocturnal erection.

The normal range for erectile dysfunction is 1.5 to 4.1 cm. If it is greater than 1.5 cm, the erectile dysfunction may be caused by psychological factors; if it is less than 1.5 cm, then medical conditions should be considered.

(3) Penis strength measurement: Use a commercially available paper penis strength measuring tape, wrap it around the penis before going to sleep, and observe the breakage of the three small colored strips on the tape the next morning.

If none of the small colored bands are broken, it indicates the absence of nocturnal erections, and erectile dysfunction is caused by a disease.

A broken red band alone indicates an ineffective erection, while a broken red and yellow band indicates an insufficient erection. The cause of erectile dysfunction still needs to be considered as a medical condition.

If all three small colored bands (red, yellow, and blue) break, it indicates that nocturnal erection is good, and erectile dysfunction is caused by mental and psychological factors.

Clearly, self-measuring nocturnal penile tumescence in men with erectile dysfunction is very helpful in identifying the cause of erectile dysfunction.

Some patients with psychogenic erectile dysfunction experience a surge in confidence upon seeing their penis erect normally at night, leading to a spontaneous cure of their erectile dysfunction.

[Psychological treatment for erectile dysfunction] (1) Patients should understand the psychological factors that cause erectile dysfunction and relieve their mental concerns.

There are many psychological factors that cause erectile dysfunction. Because everyone's environment, experience, psychological state and personality are different, they react differently to the same psychological and social factors.

Generally, negative mental and psychological factors do not cause erectile dysfunction, but there are great individual differences. Some people, during their growth and development, are influenced by their family and society and regard sexual behavior as improper. Some are afraid to talk about sex, or they masturbate for a long time during their adolescence and blindly exaggerate the harm of masturbation, which leads to psychological problems.

Patients should understand that normal sexual activity can regulate a person's mental state and is a normal physiological phenomenon. They should have confidence and reduce panic, which is beneficial to the treatment of erectile dysfunction.

(2) Gradually establish harmony in sexual relationships.

Erectile dysfunction can result from psychological barriers caused by family conflicts, marital discord, excessive mental burden, or dissatisfaction, distrust, or lack of sexual attraction towards the female partner.

For these patients, it is important to remove barriers and for the couple to work together intimately with mutual understanding, cooperation, and patience to maintain a good sex life.

(3) Patients should acquire sexual knowledge and treat sexual life correctly.

After a person is born, there is a physiological process from the occurrence, formation to the peak of sexual desire.

Sexual organs begin to develop between the ages of 10 and 12, and between the ages of 13 and 16, a stage of developing ambiguous desires for the opposite sex emerges. Between the ages of 17 and 25, sexual desire is expressed and continues throughout life.

Sex hormones play a regulatory role in the maturation of sexual organs.

Some patients lack sexual knowledge and become overly nervous and helpless during intercourse, especially after their first failed sexual encounter, which causes long-term anxiety and eventually leads to erectile dysfunction.

Psychotherapy can be used to gain the patient's understanding and cooperation. The patient should strengthen their confidence, pay attention to mental well-being in daily life, and strengthen physical exercise.