Erectile dysfunction (ED) or impotence is the inability to achieve and keep an erection necessary for sexual intercourse. One very common myth about ED is that it is a direct consequence of aging, but this, in fact, is not true. Many older men experience ED only because they also tend to have any one of several physical disorders more common in aging individuals that contribute to their erection problems. It is therefore important to remember that ED may be a sign of more serious health concerns. In addition, psychological stressors as well as external factors such as medications or lifestyle choices may also cause erectile dysfunction.
Anatomy of an erection A successful erection depends on a healthy synergy among hormones, nerves, blood vessels, and muscles. All these things work together to be able to produce a good blood flow into the penis. The brain sends nerve signals to the penis during sexual arousal which causes the penile muscles to relax and become engorged with blood. Pressure keeps the blood in the penis, and the veins prevent it from flowing out of the muscles so that the penis can sustain the erection.
Causes of erectile dysfunction Between 80 to 90 percent of all cases of erectile dysfunction are caused by physical disorders. Many such disorders are conditions that affect the heart and blood vessels. These include: • Diabetes • Atherosclerosis and other heart diseases • Hypertension (high blood pressure) • High Cholesterol • Obesity
Other cases of ED are caused by nerve damage resulting from neurological diseases and injuries. These include: • Stroke • Alzheimer’s disease • Parkinson’s disease • Multiple sclerosis • Injuries to the spinal cord • Nerve damage from treatments for prostate cancer, including radiation and surgical removal of the prostate.
Sometimes, men also develop ED because of unhealthy lifestyle habits, which include: • Alcoholism, tobacco use, drug abuse, and other forms of substance abuse • Lethargic lifestyle and overeating
Other physical causes of erectile dysfunction include low testosterone levels and other hormonal imbalances, Peyronie’s disease (which causes the development of fibrous scar tissues inside the penis), as well as the use of medications like diuretics, blood pressure drugs, antidepressants, antihistamines, prostate cancer medications and non-steroidal anti-inflammatory drugs (NSAIDS).
In other cases, psychological factors may also interfere with sexual arousal and cause or worsen the symptoms of ED. Stress, fatigue, depression and anxiety may all contribute to a man’s capacity to develop an erection.
Diagnosing erectile dysfunction Because erectile dysfunction has a panoply of possible causes, your doctor will most likely review your medical history first and ask you general questions about your health, as well as questions about your relationship and sexual history. Just be cool with the questions; many of them will seem very intrusive but are actually important part of the diagnosis.
It will help your doctor if you prepare several things in advance, including an inventory of the medicines and supplements you are taking, a list of the symptoms you are currently experiencing (include specifics like when you started feeling them, how often, etc.), or even a list of things that are stressing you or causing you anxiety. It’s a good idea to bring your spouse or partner along, too.
Depending on what is most likely causing your ED, your doctor will order tests to be made on you or refer you to a specialist such as a urologist, a cardiologist or an endocrinologist. You may even be referred to a clinical psychologist if your concerns are mainly emotional or psychological. Some of the tests that may be conducted on you include the following:
• Visual and physical examination of your penis and testicles. This may include a bulbocavernosus reflex test, which could determine an abnormality in nerve sensation in the penis.
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• Nocturnal penile tumescence test, to detect the nature of the problem. If you are experiencing erections while sleeping, it could indicate that your erectile dysfunction is being caused by a psychological factor and not by a physical disorder.
• A series of blood tests, which may include complete blood count, blood hormone tests, liver and kidney function tests and cholesterol profile.
• Urinalysis, which can help reveal diabetes, kidney dysfunction and low levels of testosterone, all of which may be the culprit behind your erectile dysfunction.
• Ultrasound, to check if the blood flow in your penis is normal and to check if other underlying conditions like venous leak, atherosclerosis or Peyronie’s disease exist. It may include the injection of solutions into the penis to check the blood flow.
• Cavernosography, which involves the injection of a special dye into the penis to check via X-ray if you are experiencing venous leak.
Treating erectile dysfunction The appropriate treatment for your erectile dysfunction will depend on the origin and severity of your condition. In addition, your doctor will consider the underlying disorders that may be causing your ED. For example, ED pills that may otherwise solve your problem will not be recommended if you are also taking nitrates for heart disease medication. The following are some of the treatments offered to ED patients:
• Medicines – These include prescription treatments like Viagra, Levitra and Cialis, which help by increasing blood flow to the penis. These medicines are generally not for people who take nitrate drugs, anticoagulants, medicines for high blood pressure, and alpha blockers as prostate medication. Similarly, they aren’t recommended for people who have had a stroke or who have heart disease, diabetes, and low blood pressure. On the other hand, your doctor may also recommend other medications like testosterone replacement therapy and the like.
• Surgery – People diagnosed with venous leak may require blood vessel surgery.
• Vacuum penile pumps
• Surgical implants – These are usually considered a last resort option when it comes to ED.
If your erectile dysfunction is being caused by psychological causes like depression, stress or anxiety, you may need to visit a psychologist and undergo counselling. It will help if your spouse or partner goes with yo, too.
In addition, simple lifestyle changes will also help a lot. Avoid smoking, drinking too much and other forms of substance abuse. If you’re not getting enough exercise, are overweight, and feeling depressed, then it’s about time you take up the gauntlet and start working to become fitter and healthier.
Remember that although erectile dysfunction may be a sign of underlying health problems, there are many treatments available today which can help you manage them. Furthermore, you can also see this as an opportunity to build a stronger relationship with your spouse or partner. Maintain open communication and always involve your better half in working through the challenge.