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ERECTILE DYFUNCTION |
Erectile dysfunction (ED), or impotence, is the inability to achieve or maintain an erection firm enough to begin or complete sexual intercourse.
It occurs when a man has difficulty with either getting an erection or with keeping an erection for long enough to allow satisfactory sexual activity. It is one of the most common sexual problems and affects around half of all men over 40 at some point. It becomes more common and severe as men get older. However, only a fraction of affected men seek help. |
Cause of Erection Problems |
There are a number of causes of erectile dysfunction (ED). In around two thirds of cases, there are physical problems affecting the blood supply. However, there is a complex relationship between physical and psychological aspects of sexual function.
Physical health- Several conditions prevent sufficient blood getting into the penis and so cause ED. These include diabetes and vascular disease (furred-up blood vessels). Problems with the nervous system can affect the transmission of signals from the brain to the blood vessels in the penis.
Psychological Aspects-Psychological problems can also influence the ability to get and maintain erections. Anxiety and guilt are common causes of ED. Unsatisfactory sexual and relationship experiences may lie behind these issues. Stress at work, depression, boredom with current sexual practices, partner conflicts, and unresolved issues about sexual orientation may all cause problems.
Medicines-The side-effects of medicines such as some treatments for high blood pressure can cause ED. Medicines can also affect sexual drive and desire (libido), or cause problems with ejaculation and orgasm. These can have a knock-on effect on erections.
Lifestyle-Drinking too much alcohol commonly affects the ability to get and maintain an erection. In the longer term, it interferes with the production of the male hormone testosterone, which can reduce libido. Nicotine damages the circulation, so smoking increases the risk of erection problems. Similarly, being physically inactive, which contributes to poor cardiovascular fitness, may increase the risk of ED. |
Treatment |
Treatment depends on the cause. Testosterone supplements may be used for cases with hormonal deficiency. However, usually the cause is lack of adequate penile blood supply as a result of age-dependent damage of inner walls of blood vessels.
Most physicians suggest that treatments for impotence proceed along a path moving from least invasive to most invasive. This means cutting back on any harmful drugs is considered first. Psychotherapy and behavior modifications are considered next, followed by vacuum devices, oral drugs, locally injected drugs, and surgically implanted devices and, in rare cases, surgery involving veins or arteries.
Psychotherapy: Experts often treat psychologically based impotence using techniques that decrease anxiety associated with intercourse. The patient's partner can help apply the techniques, which include gradual development of intimacy and stimulation. Such techniques also can help relieve anxiety when physical impotence is being treated.
Drug Therapy: Drugs for treating impotence can be taken orally or injected directly into the penis. Oral testosterone can reduce impotence in some men with low levels of natural testosterone. But no scientific studies have proved the effectiveness of these drugs in relieving impotence. Some observed improvements following their use may be examples of the placebo effect, that is, a change that results simply from the patient's believing that an improvement will occur.
Many men gain potency by injecting drugs into the penis, causing it to become engorged with blood. These drugs may create unwanted side effects, however, including persistent erection (known as priapism) and scarring. Patients should ask their doctors about the latest advances.
Vacuum Devices: Mechanical vacuum devices cause erection by creating a partial vacuum around the penis, which draws blood into the penis, engorging it and expanding it. The devices have three components:
- a plastic cylinder, in which the penis is placed;
- a pump, which draws air out of the cylinder;
- and an elastic band, which is placed around the base of the penis, to maintain the erection after the cylinder is removed and during intercourse by preventing blood from flowing back into the bod.
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One variation of the vacuum device involves a semi-rigid rubber sheath that is placed on the penis and remains there after attaining erection and during intercourse.
Surgery: Surgery usually has one of three goals:
- To implant a device that can cause the penis to become erect;
- To reconstruct arteries to increase flow of blood to the penis;
- To block off veins that allow blood to leak from the penile tissues.
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Lifestyle changes & prevention- A healthier lifestyle can often be beneficial and can help prevent any further deterioration caused by underlying medical conditions.
- If you smoke, make a plan to stop.
- Take moderate-intensity exercise (so you feel warm and
slightly out of breath - brisk walking for instance -
for half an hour on most days of the week.
- Eat a balanced diet rich in fruit and vegetables and
low in fat.
- Drink alcohol in moderation. Other recreational drugs
can cause ED.
- Aim to reduce stresses in your life by looking at the
balance between your work and your home/leisure time.
Relaxation techniques may be helpful.
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