“หย่อนสมรรถภาพทางเพศ” รู้สาเหตุไว ฟื้นฟูได้เร็ว

<p>Erectile dysfunction has been a nightmare for men of all ages for a long time, dating back to the ancient Egyptians around 2,000 BC. This has led to the search for ways to combat this problem almost everywhere in the world, whether it be exotic food menus, various herbal formulas, or even some unimaginable devices. In reality, erectile dysfunction is the inability to maintain an erection throughout sexual intercourse, resulting in dissatisfaction. This condition usually persists for about 3 months or more.</p>
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<h4 style="color: #008080;"><span style="color: #00826a;">How common is erectile dysfunction?</span></h4>
<p>Erectile dysfunction (ED) can occur in all age groups but is more common as men get older. It is found in about 5-10% of men under 40 years old, increases to about 40% in men under 70 years old, and reaches approximately 75% in men aged 80 years.</p>
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<h4><span style="color: #00826a;">Studies have found that this condition arises from two main factors:</span></h4>
<ul>
<li>Internal factors, which can be divided into two groups: psychological conditions and abnormalities in various body systems. Psychological factors were originally considered the main cause of erectile dysfunction. Causes can include the patient&#8217;s own diseases such as depression, anxiety, work-related stress, poor relationships with partners, or even lack of confidence due to previous sexual failures. However, nowadays, the main factors often come from abnormalities in various body systems such as the penis itself, vascular system, nervous system, and hormones.</li>
<li>External factors are also common causes, such as medications that affect penile erection and the patient&#8217;s lifestyle.</li>
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<h4 style="color: #008080;"><span style="color: #00826a;">How do you know if you have erectile dysfunction?</span></h4>
<p>Most patients or their partners usually recognize erectile dysfunction themselves. However, seeing a doctor for history taking and physical examination helps identify the exact cause. The doctor will ask about severity, underlying diseases, medications used, daily lifestyle, perform relevant physical examinations, and laboratory tests such as measuring male hormone (Testosterone) levels in cases suspected of low testosterone.</p>
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<h4 style="color: #008080;"><span style="color: #00826a;">Treatment options… various methods</span></h4>
<p>Treatment must consider patient safety and the spouse&#8217;s opinion. Therefore, before treatment, the doctor will assess overall health, especially the risk of heart disease, to determine the appropriate treatment approach. According to the World Health Organization (WHO) guidelines, treatment is recommended in a stepwise manner, starting with non-drug treatments, then medications (oral, injection, suppository), and finally surgery. Currently, there is also an alternative non-drug rehabilitation treatment.</p>
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<p>Generally, doctors recommend patients stop medications that affect erection, lose weight, exercise, quit smoking, get enough rest, and reduce stress, combined with oral medications, which are currently the main treatment for erectile dysfunction. These drugs work by dilating blood vessels to increase blood flow to the penis, similar to opening a shoulder lane on an existing road, allowing more traffic to reach the destination. Thus, erection improves. However, medication has limitations because it is a symptomatic treatment. Erections are still unnatural, dependent on medication, require time to take effect, and the drug&#8217;s effectiveness depends on the condition of the patient&#8217;s blood vessels. It is like opening a shoulder lane, but if the road is still full of potholes, traffic cannot flow as fast as expected.</p>
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<h4 style="color: #008080;"><span style="color: #00826a;">What if medication doesn’t work or you don’t want to take medication?</span></h4>
<p>If the penis does not respond to medication or the patient does not want to take medication, local treatments can be used, such as vacuum devices, direct penile injections, and urethral suppositories. These two groups of drugs have been used before oral medications. Both injections and suppositories work by dilating blood vessels similarly, but their use is more complicated and has a higher chance of side effects, making oral medications more popular today. However, if local treatments still do not meet the patient&#8217;s needs, the next step is penile implant surgery, which can guarantee erection success but has limitations regarding cost and unnatural sensation.</p>
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<h4 style="color: #008080;"><span style="color: #00826a;">Can the root cause be treated?</span></h4>
<p>Most of the treatments mentioned above are symptomatic. Currently, there are two treatments that address the root cause: testosterone replacement therapy in cases of erectile dysfunction caused by low testosterone, and low-intensity shock wave therapy.</p>
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<h4 style="color: #008080;"><span style="color: #00826a;">What is low-intensity shock wave therapy?</span></h4>
<p>Shock wave therapy has been used in medicine for a long time, such as breaking stones in the urinary tract and bile ducts, as well as for physical therapy. Low-intensity shock wave therapy for erectile dysfunction works by causing microinjuries to the tissue in the penis, stimulating the body to respond by creating new blood vessels to repair the damage, resulting in increased blood flow to the penis.</p>
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<p>Each treatment session takes about 30 minutes, is not very painful, and does not require hospitalization. However, this treatment has limitations; it is only suitable for mild erectile dysfunction, takes some time to see results, is more expensive than oral medications, and requires repeated sessions. The difference is that the new blood vessels created are like building a new parallel road alongside the old one, so the tissue receives more blood continuously. This is a long-term tissue rehabilitation method for the penis, resulting in erections that are more natural compared to other treatments.</p>
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<p>Whatever the treatment method, the goal is the same: to restore confidence in men and create satisfaction in their relationships. Therefore, erectile dysfunction is not as worrying as it seems. The earlier it is recognized, the better the chance of restoring natural-like function.</p>
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<div align="right"><span style="color: #00826a;"><strong>Assoc. Prof. Dr. Wiroj Rakkanakul</strong></span><br />
Urological Surgeon<br />
Urology Center<br />
Phyathai 3 Hospital</div>


Erectile dysfunction in men refers to the condition where the penis cannot maintain an erection throughout the sexual intercourse, resulting in dissatisfaction. This condition persists continuously for about 3 months or more.

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