Asked for male, 33 years old from Mumbai
Erectile dysfunction (ED) is a condition in which man has trouble in keeping or getting an erection. It is a common male sexual dysfunction. It becomes more common as you get older but it is not a part of aging.
MECHANISM OF ERECTION
An erection starts in the brain. Physical and mental stimulation is required for an erection to begin. This stimulation causes nerves in the brain to send chemical messages to nerves which are present in the penis which results in the free flow of blood into the penis. This leads to high pressure in the penis which in turn traps the blood within both corpora cavernosa and then the penis expand. This causes the penis to sustain an erection.
When the inflow of blood is stopped, then it opens outflow channels and then penis becomes soft. Then an erection is said to be reversed.
CAUSES OF ERECTILE DYSFUNCTION
Erection is a complex process which involves hormones, brain, emotions, muscles, nerves and blood vessels. Problem with any one of these can lead to erectile dysfunction. Sometimes stress and mental health can also lead to erectile dysfunction. Combination of Physical and Psychological issues can lead to erectile dysfunction.
PHYSICAL CAUSES OF ED
• Heart disease, high blood pressure, High cholesterol.
• Parkinson's disease, obesity, alcoholism, atherosclerosis.
• Use of tobacco, surgeries that affect the pelvic area or spinal cord.
• Treatments for prostate cancer.
PSYCHOLOGICAL ISSUES OF ED:
Depression, anxiety, stress and other mental health conditions are some of the psychological issues which causes erectile dysfunction.
SYMPTOMS OF ERECTILE DYSFUNCTION
• Trouble in getting erection
• Difficulty in keeping erection
• Reduced sexual desire
HOW CAN ERECTILE DYSFUNCTION BE PREVENTED?
By decreasing the chances of developing several diseases like diabetes, heart disease and hypertension, chances of developing erectile dysfunction can be decreased to some extent. By eating healthy diet, erectile dysfunction can be managed. By doing Exercise daily and by avoiding smoking, risk for developing erectile dysfunction can be decreased.
Erectile dysfunction (ED) or impotence is condition characterized by the inability to develop or maintain an erection of the penis during sex. A penile erection is the effect of blood entering and being retained in sponge-like bodies within the penis. The process is most often initiated as a result of sexual arousal when signals are transmitted from the brain to nerves in the penis. The most important organic causes are heart disease and diabetes, neurological problems (for example, trauma from prostatectomy surgery), hormonal insufficiencies and side effects to certain drugs
Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility; this is somewhat less frequent but can often be helped. Notably in psychological impotence, there is a strong response to placebo therapy. Erectile dysfunction can have severe psychological consequences as it can be tied to relationship difficulties and masculine self-image generally.
Most men have occasionally experienced some difficulty with their penis becoming hard or staying firm, but this is not erectile dysfunction, which is a concern only if satisfactory sexual performance has been impossible on a persistent number of occasions for some time.
Broadly, two forms of erectile dysfunction can affect men's sex lives - the main cause is either medical or psychosocial.
Here, psychosocial means psychological effects - including the effects of social relationships - on sexual performance. Of course, medical conditions can also affect psychological wellbeing, and while the main cause of sexual impotence will be medical or psychological, there can be overlap between the two.
Erectile dysfunction used to be known more widely as 'impotence' before the causes became better understood and successful treatments came into use. Impotence is a term that is still in use, however.
Signs and symptoms
Erectile dysfunction is characterized by the regular or repeated inability to obtain or maintain an erection. It is analysed in several ways:
• Obtaining full erections at some times, such as night time erecting when asleep (when the mind and psychological issues, if any, are less present), tends to suggest that the physical structures are functionally working. Other factors leading to erectile dysfunction are diabetsic neuropathy.
• Drugs (anti-depressants (SSRIs) and nicotine are most common)
• Neurogenic disorders
• Cavernosal disorders (Peyronie's disease)
• Psychological causes: performance anxiety, stress, and mental disorders
• Aging. It is four times more common in men aged in their 60s than those in their 40s.
• Kidney failure
• Diseases such as diabetes mellitus and multiple sclerosis (MS). While these two causes have not been proven they are likely suspects as they cause issues with both the blood flow and nervous systems.
• Lifestyle: smoking is a key cause of erectile dysfunction. Smoking causes impotence because it promotes arterial narrowing.
Surgical intervention for a number of conditions may remove anatomical structures necessary to erection, damage nerves, or impair blood supply. Erectile dysfunction is a common complication of treatments for prostate cancer, including prostatectomy and destruction of the prostate by external beam radiation, although the prostate gland itself is not necessary to achieve erection.
ED can also be associated with bicycling due to both neurological and vascular problems due to compression. The increase risk appears to be about 1.7-fold.
Fast facts on erectile dysfunction
Here are some key points about erectile dysfunction. More detail and supporting information can be given on personal or private chat .Erectile dysfunction is a persistent problem getting an erection sufficient to have sex.
Causes are usually medical but can also be psychological.
Organic causes are usually the result of an underlying medical condition affecting the blood vessels or nerves supplying the penis.
Numerous prescription drugs, recreational drugs, alcohol and smoking can all be causes, too.
Diagnosis with the help of a doctor will differentiate the likely cause by including a number of questions, blood tests for conditions such as diabetes and heart disease, and physical examination.
First-line treatment of erectile dysfunction is with drugs called PDE-5 inhibitors, including the well-known pill sildenafil (Viagra).
Mechanical devices are also available to help achieve an erection, and occasional cases that do not respond to medical treatment may be candidates for surgery, to fit a penile implant.
What causes erectile dysfunction?
To understand the causes of erectile dysfunction, it helps to understand how an erection happens physically.
Relaxation of muscle (in parts of the penis and the walls of the arteries supplying it) allows blood to rush into the cylinder-shaped spongy tissue of the so-called erection chambers, and valves prevent the venous loss of this pressure. The resulting hardness persists until after stimulation has stopped or an ejaculation has happened.4
This blood flow process is led by nervous and hormonal triggers activated when the brain is stimulated by touch or other stimuli, and these brain signals can be suppressed by anxiety.4
A healthy lifestyle can prevent erectile dysfunction since the problem can be caused by preventable conditions such as diabetes and vascular disease.
Effects against any of the following normal physiological contributions needed for an erect penis could affect normal erectile function:1
Vascular causes that affect blood flow, and neurological causes that affect nerve signals are the major medical causes of erectile dysfunction, often due to the underlying disease processes of atherosclerosis and diabetes.5
Smoking and diabetes often cause atherosclerosis, and this narrowing or 'clogging' of arteries in the penis is the most common vascular cause of erectile dysfunction.5
Diabetes can also lead to neuropathy - damage to the nerves. Diabetic neuropathy is a common neurological cause of erectile dysfunction, as is nerve damage resulting from various types of surgery around the pelvis. Less common neurological causes are stroke, a type of epilepsy (partial complex seizures), multiple sclerosis, non-diabetic neuropathy, and spinal cord injury.5
Reducing well-established risk factors for diabetes and atherosclerosis - including diet, physical activity and other lifestyle factors such as smoking - could also prevent erectile dysfunction.