Erectile dysfunction (ED, “male impotence“) is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance.
To achieve and maintain and erection, you need
1. Healthy penile nerves
2. Strong blood flow to penis
3. Sexual stimulus to the brain
Due to this complex mechanisms, the causes of Erectile Dysfunction (ED) vary greatly. From lack of stimulus to the brain, stress, medications, diseases, also injury directly to the penis or the spinal cord.
In general, the cause of erectile dysfunction is divided into 2 types:
- Psychological (mental) causes
- Physical or organic (having to do with a bodily organ or an organ system) causes
Erection problems usually produce a significant psychological and emotional reaction in most men. This is often described as a pattern of anxiety and stress that can further interfere with normal sexual function. This “performance anxiety” needs to be recognized and addressed by your doctor.
For some men, erectile dysfunction develops with age or may be related to depression or another psychological cause, such as widower syndrome.
Certain feelings can interfere with normal sexual function, including feeling nervous about or self-conscious about sex; feeling stressed either at home or at work; or feeling troubled in your current relationship. In these cases, psychological counseling with you and your sexual partner may be successful. One episode of failure, regardless of cause, may propagate further psychological distress leading to further erectile failure.
Physical (Organic) Causes
In determining a physical (or organic) cause, your doctor will first rule out certain conditions, such as high blood pressure, high cholesterol, heart and vascular disease, low male hormone level, prostate cancer, and diabetes, which are associated with erectile dysfunction. In addition to these conditions, certain systemic and respiratory diseases are known to result in erectile dysfunction:
- Scleroderma (stiffening or hardening of the skin)
- Kidney failure
- Liver cirrhosis
- Hemachromatosis (too much iron in the blood)
- Chronic obstructive pulmonary disease
Often, one can restore sexual health by treating a condition such as high blood pressure with diet and/or exercise or by controlling diabetes or other chronic diseases. Nutritional states, including malnutrition and zinc deficiency, may be associated with erectile dysfunction and can also be treated with diet.
Almost any disease can affect erectile function by altering the nervous, vascular, or hormonal systems. Various diseases may produce changes in the smooth muscle tissue of the penis or influence mood and behavior.
- Diseases that affect the nervous system and are commonly associated with erectile dysfunction include:
- Multiple sclerosis
- Guillain-Barré syndrome
- Alzheimer disease
- Parkinson disease
- Vascular diseases account for nearly half of all cases of erectile dysfunction in men older than 50 years.
- Vascular disease includes atherosclerosis (fatty deposits on the walls of the arteries, also called hardening of the arteries), a history of heart attacks, peripheral vascular disease (problems with blood circulation), and high blood pressure.
- Prolonged tobacco use (smoking) is considered an important risk factor for erectile dysfunction because it is associated with poor circulation and its impact on cavernosal function.
- Blood diseases, such as sickle cell anemia and leukemias, are also associated with erectile dysfunction.
- An imbalance in your hormones, such as testosterone, prolactin, or thyroid, can cause erectile dysfunction. The following hormonal (or endocrine) conditions are commonly associated with erectile dysfunction:
- Hyperthyroidism (overactive thyroid gland)
- Hypothyroidism (underactive thyroid gland)
- Hypogonadism (leads to lower testosterone levels)
Medications used to treat other medical disorders may cause erectile dysfunction. If you think erectile dysfunction is caused by a medication, talk with your doctor about drugs that might not cause this side effect. Do not just stop taking a prescribed medication before talking with your doctor. Common medications associated with erectile dysfunction are:
- Antidepressants (for depression)
- Antipsychotics (for psychological illness)
- Antihypertensives (for high blood pressure)
- Antiulcer drugs, such as cimetidine (Tagamet)
- Medications to treat prostate cancer, such as goserelin (Zoladex) and leuprolide (Lupron), and medications to treat benign enlargement of the prostate, such as finasteride (Proscar) and dutasteride (Avodart)
- Drugs that lower cholesterol (More studies are needed to determine if erectile dysfunction is actually due to the high cholesterol in the blood vessels or the drugs to lower the high cholesterol.)
- Alcohol abuse
- Mind-altering agents, such as marijuana and cocaine
Surgery in the pelvic area may injure the nerves and the arteries near the penis, resulting in erectile dysfunction. Also, surgical procedures on the brain and the spinal cord may cause erectile dysfunction. Those procedures often associated with erectile dysfunction include:
- Aortoiliac or aortofemoral bypass
- Abdominal perineal resection
- Radical prostatectomy
- Radiation therapy for prostate cancer as well as for other cancers, such as bladder cancer, colon cancer, or rectal cancer
- Brachytherapy (seed implants) for prostate cancer
- Cryosurgery of the prostate
- Cystectomy (removal of the urinary bladder)
Trauma or injury to the penis and/or the pelvic blood vessels and nerves is another potential factor in the development of erectile dysfunction.
- Peyronie’s disease is a condition associated with erectile dysfunction. With this disease, scar tissue forms inside the penis, and the penis is usually bent or curved during an erection. Injuries to the penis may also result in scar tissue formation as well as penis curvature during an erection.
- Bicycle riding for long periods has also been implicated as a cause of erectile dysfunction. Some of the newer bicycle seats have been designed to soften pressure on the perineum (the soft area between the anus and the scrotum).
If you have an ED, you may want to contact your doctor immediately, because in order to cure erectile dysfunction, you must know first what is the cause of it. Then you and your doctor will then talk about the best possible solution for your problem.
Talking self medications such as sildenafil (viagra), tadalafil (cialis), or vardenafil (levitra) may help, but they should be used after your consultation with your doctor and shouldn’t be taken freely without any supervision.
If the cause of your ED is due to lack of stimulation, you shouldn’t take any medication, but need to refresh yourself, and variate yourself in your sexual life with your partner.
Usually, diet and exercise may improve your sexual life without needing of any special treatment. So start your healthy life style from now.
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