French urologists avoid saying the word “impotence” at any cost, they prefer calling this condition “erectile dysfunction” or “erectile disorder”, which suggests the inability to obtain and maintain an erection sufficiently rigid for satisfactory sexual activity. Read this article to learn everything about the treatment of erectile dysfunction in France.
Erectile dysfunction: what does it mean?
Before you think that something happened to your (your partner’s) sexual capacity, wait to see if the inability repeats constantly for at least three months. Temporary problems in men are quite common and they are nothing to worry about.
The mechanism of erection does not depend on the man’s will. To get an erection, a man must be subjected to sexual stimulation (genital caresses, fantasies, etc.). The erection also depends on the proper functioning of the nervous system (which conveys the excitement signals), circulatory system (which carries blood to the penis) and the penis itself. Therefore, we can say that a man must be healthy to be able to have an erection.
A man with erectile dysfunction or incapacity can still well feel desire, have an orgasm and ejaculate, either through masturbation or by rubbing his genitals on those of his partner. Some men even succeed to conceive one or more children without having erections that would be sufficient for penetration (their partner becomes pregnant through ejaculating on the vulva or the vagina).
On the other hand, the erection is part of the normal sexual response, therefore any erection disorder is considered an anomaly and a possible symptom of an underlying disease. Even if men do not like to talk about erectile disorder, it is actually a very common disease: 10 % of men suffer from it at least once in their life. When a man reaches his fifties, the risk of experiencing problems in this area increases substantially. Erectile dysfunction may be of physiological (in 50% of cases), psychological or mixed origin.
Characteristics of erectile dysfunction:
– uncommon in men under 50 years old in good health and more common in older men;
– the disappearance of nocturnal or morning erections;
– appears consequently over months and even years;
– shows itself in disability (total or partial) to obtain or maintain an erection whatever the circumstances are;
– is treatable in most cases.
What are the causes of erectile dysfunction (impotence)?
– Abnormal blood vessels. Vascular, arterial, and venous disorders are responsible for the majority of cases. Most common diseases include arteries hardening (atherosclerosis), high blood pressure, high cholesterol (hypercholesterolemia), and diabetes.
– Certain drugs use. Antihypertensives, antidepressants, antipsychotics, anticonvulsants, cimetidine (used to decrease gastric acid secretion) and high doses of drugs against anxiety (Activan, Valium, etc.) can affect the vascular mechanism of erection.
– Radical prostatectomy (removal of the prostate). This is a surgical treatment of prostate cancer that can sometimes reach the nerves of the penis, causing erectile dysfunction in 50-60% of cases.
– Smoking. It is a major cause of erectile dysfunction because it aggravates hypertension and arteriosclerosis and enhances venous leakage (inability of the penis veins to hold the blood).
– Nerves and nerve center abnormalities (Inter alia, spinal cord trauma (e.g., paraplegia), multiple sclerosis, Parkinson’s disease, etc.) These diseases can affect the nerve impulses transmitted from the genitals to the brain or vice versa.
– Peyronie’s disease. This abnormal curvature of the penis is caused by an internal scar that can be palpated. However, it may cause erectile dysfunction only in case of significant deformation.
Consultation for treatment of erectile dysfunction in France
First of all, to make sure that this is a case of erectile dysfunction, it has to last for at least three months. However, don’t hesitate to see a doctor early if you suffer from the situation.
During the consultation, the doctor will track the sexual and medical history of the man and determine if erectile dysfunction is of physiological nature, or a psychological (mixed). The patient undergoes a specific physical examination (to check whether the genital organs, blood vessels, nerves, and penis tissues function normally). In this regard, the doctor can do several specialized tests including Penile Doppler to measure the arterial blood supply to the penis.
Treatment of erectile dysfunction in France: what are the options?
If the doctor determines that the erectile dysfunction is caused by physiological reasons, such as abnormal blood vessels, nerves, and nerve center abnormalities, he will suggest first treat those diseases. In case the treatment of these diseases does not improve the patient’s erectile function, the doctor may suggest specific treatments:
– An external prosthesis (or vacuum pump) installation. This is not a surgical but a mechanical treatment. The device consists of a plastic cylinder, connected to a pump. The penis is inserted into the cylinder of the pump which evacuates the air, creating a vacuum that causes the blood flow to the penile corpora cavernosa. Also, a ring is installed at the base of the penis to prevent the blood from flowing back, and then the cylinder is removed. The ring should absolutely be removed after 30 minutes of use to prevent blood clots. 80% of the couples who have mastered this technique consider it effective.
– A transurethral treatment. The Medicated Urethral System of Erection (MUSE) consists of inserting of an alprostadil mini suppository of a rice grain size into the urethra (the opening of the penis). When the urethra walls absorb the drug, it then travels through the bloodstream into the penis corpora cavernosa, where it makes the blood saturate the penis. The erection occurs in less than 20 minutes – regardless of whether there is sexual stimulation or not – and usually lasts less than an hour. This is an effective method in 40% of cases.
– Different types of prostheses or penile implants. The silicone prostheses are implanted under the skin and are completely invisible. Most of them are inflatable, which means that the prosthesis becomes stiff from manipulating a scrotum pump. It used to be the main treatment method for men with erectile dysfunction, however, now penile implants became the last resort. Since this surgery is irreversible, it is only recommended when all other methods failed. It is sometimes appropriate to combine medical treatment and psychosexual treatment to optimize results.
Don’t hesitate to improve the quality of your sex life with help from one of the best French urologists and sexologists.
Based on the materials of e-santé.fr