Erectile dysfunction (ED), also known as impotence, can be a big problem — particularly as men age. ED can make you feel embarrassed, inferior, frustrated and trapped. Medication alone is not the cure, but there is hope in treatments that combine medical and natural remedies.

This article summarises important facts about erectile dysfunction.

How erection occurs

Erection occurs when blood flow increases to the penis, causing it to become engorged with blood and stiffen in response to sexual arousal.

This process is controlled by the nervous system, specifically the parasympathetic and sympathetic systems. For example, the parasympathetic nervous system is activated when the brain signals the penis to erect. This causes the smooth muscle tissue in the penis to relax and allow blood to flow in.

With the activation of the nervous system, the penile arteries start to dilate and increase blood flow. The resulting increased blood flow causes the penis to become erect and stiff.

What is erectile dysfunction?

Erectile dysfunction, also known as impotence, is a condition in which a man cannot achieve or maintain an erection sufficient for sexual intercourse.

ED can be a short-term or long-term problem. It also can be one form of following,

• Can get an erection sometimes, but not every time you want to have sex
• Can get an erection, but it does not last long enough for satisfactory sex
• Are unable to get an erection at any time

ED can be either organic or psychogenic. In organic impotence, there is a physical cause. In contrast, psychogenic ED is caused by anxiety, guilt, depression, or various sexual issues.

Some people can never attain or sustain an erection; this condition is primary ED. Secondary impotence acquired later in life previously who could attain the erection.

Signs and symptoms of erectile dysfunction

The main symptom of erectile dysfunction is the inability to achieve or maintain an erection sufficient for sexual intercourse. This can happen consistently or only occasionally. Other features of impotence are,

• Difficulty getting an erection
• Reduced sexual desire
• Trouble getting or keeping an erection during sexual activity
• Reduced sexual pleasure and satisfaction
• Difficulty getting an erection after ejaculation

It’s important to note that erectile dysfunction can be an early warning sign of other health problems such as diabetes, heart disease and circulation problems. So, you must talk to your doctor if you experience any of these symptoms.

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What is the problem of having Erectile dysfunction

Erectile dysfunction can be a frustrating and embarrassing problem for men. It can have a negative impact on a man’s self-esteem and self-confidence. It can strain relationships and lead to problems affecting a man’s overall quality of life.

For some men, impotence may be a temporary problem caused by stress or other factors. In contrast, for others, it may be a long-term condition that requires medical treatment. ED can also be an early warning sign of other health problems like diabetes, heart disease, and circulation problems. Addressing ED may help identify and treat these underlying conditions.

Psychological factors like stress, anxiety, or depression can also cause it. These conditions may need to be treated separately from the ED.

With treatment and proper management, many men with impotence can improve their sexual function and enjoy a better quality of life.

Causes of erectile dysfunction

Even though ED becomes more common as men age, growing old will not always cause it. Some men stay sexually functional into their 80s.

Erectile dysfunction can have a variety of causes. However, some of the most common reasons are:

• Cardiovascular disease – Atherosclerosis (hardening of the arteries) can reduce blood flow to the penis, making it difficult to achieve or maintain an erection.
• Diabetes – High blood sugar levels can damage nerves and blood vessels, leading to ED.
• High blood pressure – High blood pressure can damage blood vessels that supply blood to the penis.
• Hormonal imbalances – Low testosterone levels or other hormones can contribute to ED.
• Neurological disorders – Certain conditions, such as multiple sclerosis, Parkinson’s disease, and spinal cord injuries, can affect the nerve impulses needed to achieve an erection.
• Medications – Many medications, including antidepressants, antihistamines, and blood pressure drugs, can cause ED as a side effect.
• Psychological factors – Stress, anxiety, and depression can all affect a man’s ability to get and maintain an erection.
• Lifestyle factors – Smoking, alcohol consumption, and drug use can also contribute to ED.

How to diagnose erectile dysfunction

Diagnosing erectile dysfunction usually begins with a thorough medical history and physical examination. Next, your doctor may ask you questions about your symptoms. This may include how often you experience difficulty getting or maintaining an erection and any underlying health conditions or medications you are taking. They may also ask about any psychological or relationship issues contributing to the problem.

During the physical examination, your doctor will check your vital signs and look for any abnormalities causing ED. They may also perform a genital exam to check for any physical problems with the penis or testicles.

Several diagnostic tests are used to evaluate erectile dysfunction,

1. Blood tests – These are used to check for hormonal imbalances or underlying health conditions such as diabetes or heart disease.
2. The nocturnal penile tumescence (NPT) test involves monitoring the erections during sleep to determine if they are normal or if a physical problem causes them.
3. Penile duplex ultrasonography – This test uses ultrasound to evaluate blood flow to the penis and identify any blood vessel problems.
4. Psychological evaluation or counselling
5. Rigiscan test – This test uses a device that measures the number of erections that occur during sleep.

Discussing your symptoms and concerns with your doctor to obtain a proper diagnosis and treatment plan for ED is essential.

What are the treatment options available for erectile dysfunction

There are several treatment options available for erectile dysfunction.

1. Medications: The most commonly prescribed medication for ED is phosphodiesterase type 5 (PDE5) inhibitors such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). These drugs help increase blood flow to the penis, making it easier to achieve and maintain an erection.
2. Hormone therapy: If the ED is caused by a hormonal imbalance, such as low testosterone levels, hormone replacement therapy may be an option.
3. Vacuum erection devices: This treatment involves using a vacuum pump to create an erection.
4. Penile Implants: Penile implant or Prosthetic surgery is a last-resort option when other treatment methods have failed.
5. Psychological Counseling: If psychological issues such as depression, anxiety or relationship problems contribute to ED, psychological counselling may be beneficial.
6. Lifestyle changes: Making lifestyle changes, such as quitting smoking, exercising regularly, eating a healthy diet, and managing stress, can also help improve ED.

It is important to note that not all treatments are appropriate for all men. The best treatment will depend on the underlying cause of the ED and the individual patient’s preferences and medical history. So, it’s essential to consult with a healthcare professional to determine the best treatment plan for you.

The Bottom Line

You should probably see a doctor about erectile dysfunction. Still, many other men have had good results treating mild or temporary ED by changing their lifestyle and diet. For example, if you have a higher body weight, cutting down on junk food and losing weight will help. So getting more exercise and improving overall health can help a lot.