Overview
Erectile dysfunction is defined as the inability to maintain an erection sufficient for sexual intercourse.
Achieving an erection is a complex process involving the brain, hormones, nerves, muscles, and blood circulation. If something interferes with this process, the result may be erectile dysfunction.
The mechanisms for erection are fairly complex: A sensory stimulus triggers the brain to send nerve impulses down through the spinal cord. These signals trigger the release of a chemical messenger that causes the vessels to supply blood to the penis to dilate. The rod-shaped spongy tissues (corpora cavernosa) in the penis then fill with blood and expand, pressing against the veins that normally allow blood to drain from the penis, thus producing an erection. Interference with any part of this process – whether psychological or physiological – may cause erectile dysfunction.
Although an occasional inability to achieve or maintain an erection is common and not a sign of a chronic problem, a doctor should be consulted if erectile dysfunction persists. Treatment depends upon the underlying cause of erectile dysfunction.
Commonly Associated With
Erectile dysfunction; Impotence; Sexual dysfunction – male
Cause
To get an erection, your brain, nerves, hormones, and blood vessels all need to work together. If something gets in the way of these normal functions, it can lead to erection problems.
An erection problem is usually not “all in your head.” In fact, most erection problems have a physical cause. Below are some common physical causes.
Disease:
- Diabetes
- High blood pressure
- Heart or thyroid conditions
- Clogged arteries (atherosclerosis)
- Depression
- Nervous system disorders, such as multiple sclerosis or Parkinson disease
Medicines:
- Antidepressants
- Blood pressure medicines (especially beta-blockers)
- Heart medicines, such as digoxin
- Sleeping pills
- Some peptic ulcer medicines
Other physical causes:
- Low testosterone levels. This can make it difficult to get an erection. It can also reduce a man’s sex drive.
- Nerve damage from prostate surgery.
- Nicotine, alcohol, or cocaine use.
- Spinal cord injury.
In some cases, your emotions or relationship problems can lead to ED, such as:
- Poor communication with your partner.
- Feelings of doubt and failure.
- Stress, fear, anxiety, or anger.
- Expecting too much from sex. This can make sex a task instead of a pleasure.
- Erection problems can affect men at any age but are more common as you get older. Physical causes are more common in older men. Emotional causes are more common in younger men.
If you have erections in the morning or at night while you sleep, it is likely not a physical cause. Most men have 3 to 5 erections at night that last about 30 minutes. Talk with your provider about how to find out if you have normal nighttime erections.
ED can result from health problems, emotional issues, or both. Some known risk factors are:
● Being over age 50
● Having high blood sugar (Diabetes)
● Having high blood pressure
● Having cardiovascular disease
● Having high cholesterol
● Smoking
● Using drugs or drinking too much alcohol
● Being obese
● Lacking exercise
Even though ED becomes more common as men age, growing old is not always going to cause ED. Some men stay sexually functional in their 80s. ED can be an early sign of a more serious health problem. Finding and treating the reason for ED is a vital first step.
Symptoms
With Erectile Dysfunction (ED), it is hard to get or keep an erection that is firm enough for sex. When ED becomes a routine and bothersome problem, The primary care provider or a Urologist can help.
ED may be a major warning sign of cardiovascular disease indicating blockages are building in a man’s vascular system. Some studies have shown men with ED are at significant risk of getting a heart attack, stroke, or circulatory problems in the legs. ED also causes:
● Low self-esteem
● Distress for the man and his partner
If ED is affecting a man’s well-being or his relationships, it should be treated. Treatment aims to fix or enhance erectile function, help circulatory health, and help the quality of a man’s life.
Treatment
There are several different ways that erectile dysfunction can be treated. For some men, making a few healthy lifestyle changes may solve the problem. The urologist will help determine the most effective course of treatment for the condition.
Treatment options for ED include:
● Avoid nicotine, alcohol, and other drugs.
● The doctor may change the prescriptions if a medication has caused erectile dysfunction.
● Psychological counseling may be recommended when erectile dysfunction has an emotional or psychological cause.
● Testosterone injections or skin patches are given if blood testosterone levels are low.
● Hyperthyroidism or hypothyroidism is treated if necessary.
● Bromocriptine therapy is given to correct elevated prolactin levels.
● Three oral medications are currently available for treating erectile dysfunction: Viagra (sildenafil), Levitra (vardenafil), and Cialis (tadalafil). All three drugs treat erectile dysfunction by permitting blood to flow into the penis during sexual stimulation – the drugs do not produce erections in the absence of sexual stimulation. Viagra and Levitra improve erections for about four hours; Cialis is effective for 24 to 36 hours. Side effects of the three drugs are slightly different. The drugs are not recommended for men who take nitrate-containing medication (such as nitroglycerin) or men who have recently had a stroke, heart attack, or life-threatening arrhythmia.
● A special vacuum device may be used to produce an erection. Air is pumped out of a plastic tube placed securely over the penis, and the resulting vacuum pulls blood into the corpora cavernosa within a few minutes. The device is removed and a rubber band is placed at the base of the penis to maintain the erection.
● Self-administered injections of alprostadil, a vasodilator drug, dilate the blood vessels in the penis to produce an erection. The doctor will instruct you on the correct injection technique.
● Surgical implants for the penis are available. In one procedure, an inflatable device with a small fluid reservoir is inserted. In another, flexible rods are implanted that can be either bent upward to produce an erection or tucked close to the body.
● In rare cases of erectile dysfunction, the doctor may advise vascular surgery to improve blood flow to the penis.
How is erectile dysfunction diagnosed?
ED is usually easy to diagnose. If you are tempted to self-diagnose, talk to your doctor. He or she will want to make sure it isn’t related to another health condition.
Your doctor will do a physical exam and ask you questions about your symptoms. He or she may do a blood or urine test. Your doctor may consider other tests to rule out other conditions.
Can erectile dysfunction be prevented or avoided?
This depends on whether you know what it is causing your ED. There are some things you can do that may help prevent ED, including:
• Avoid drinking too much alcohol, smoking, or abusing drugs.
• Ask your doctor if ED is a side effect of a new or current medicine you are taking. He or she may have alternative medicine.
• Control your blood sugar and blood pressure.
• Try to relax and avoid stress.
Source
https://www.uwhealth.org/urology/erectile-dysfunction-ed/20537
https://www.urologyhealth.org/urologic-conditions/erectile-dysfunction(ed)
https://allianceurology.com/service/erectile-dysfunction-low-testosterone/
