Erectile Dysfunction: General Description

Erection - What is it?

Erection is the ability to achieve and maintain penis firmness, sufficient for successful performance and completion of sexual intercourse. Male penis consists of two parallel longitudinal ridges of erectile tissue, the so-called cavernous bodies (corpora cavernosa), and a small tube - spongy body (corpus spongiosum), which surrounds urethra and forms balanus (glans penis). Cavernous and spongy bodies are composed of spongy tissue surrounded by dense fibrous tunic. Blood inflow and outflow in cavernous and spongy bodies is regulated by special mechanisms, so that penis could rapidly be filled with blood, increase in volume and become firm. This condition is called erection.

How does Erection Happen, and Why?

Erection is a consequence of complex neural and vascular interactions usually associated with sexual excitement. At excitement signals transmitted from brain to sacral part of spinal cord and then to local nerves, which cause smooth muscles relaxation in penile arterial walls. This provides increased blood flow and filling cavernous and spongy bodies spongy tissue with it. Filled with blood cavernous and spongy bodies compress efferent veins so blood outflow is reduced. Penis is filled with blood, swells and becomes firm. As long as erection lasts, blood is “trapped” in penis. Erection is terminated after ejaculation, or as a result of any violation signals that caused it cease to come. Blood flow and cavernous bodies pressure on blood efferent veins decreases, blood outflows from cavernous and spongy bodies, and penis returns to its normal relaxed state. During erection there is 6 times more blood in penis than at rest state. erectile dysfucntion

About the Problem

Erectile dysfunction is inability to achieve and maintain erection sufficient for satisfactory sexual intercourse. Once this disorder was known as impotence. Today, this term is rarely used, is considered obsolete and has condemning undertone. Erectile dysfunction occurs in various forms:
  • as permanent inability to achieve erection;
  • as inability to achieve erection sufficient for penetration;
  • as inability to maintain erection long enough for successful sexual intercourse completion.

How Common is Erectile Dysfunction?

Many men experience erection problems. Some people observe these problems not clearly expressed and not frequently, and some – on the contrary. erectile dysfucntionOne in ten men aged from 18 to 40 years is experiencing erectile dysfunction. Every second man aged from 40 and 70 years is experiencing erectile dysfunction. This statistics is made by Canadian Health&Care Mall specialists. At the same time a lot of drugs and supplements (BAA) for erectile dysfunction treatment are being bought without prescription or consulting a doctor – this statistics is impossible to be estimated. There are two main types of erectile dysfunction:
  1. primary – erection, sufficient for sexual intercourse, has never occurred;
  2. secondary – previously, patient had normal erection, but now in 25% of cases and more erection is insufficient for sexual intercourse.
Erectile dysfunction is one of the main men's health indicators. An important factor in ED development is stress that leads to depression, depressed mood, decreased sexual desire. ED incidence among smokers is 15 - 20% higher than that among non-smokers.

Erectile Dysfunction Causes

Erectile dysfunction is more often caused by organic causes. The reasons may be psychogenic or mixed (combination of organic and psychogenic causes). erectile dysfucntion Psychogenic erectile dysfunction often occurs at young men, they are more prone to stress at work, depression, family conflicts. Risk of erectile dysfunction increases with excessive alcohol consumption, smoking and overweight. Causes of erectile dysfunction:
  • psychogenic (40%);
  • organic (29%);
  • mixed (25%);
  • unknown causes (6%).
This Canadian Health&Care Mall statistic reflects the fact that men are much more prone to stress, which directly affects their sexual health. Psychogenic form is divided into two types: generalized and situationally dependent. Generalized form is the result of initial lack of sexual desire, decreased sexual desire (associated with aging), permanent libido suppression. Situational type can be connected to:
  • the partner (lack of sexual desire in certain situation, because of sexual preferences of the partner, fear of conflict with the partner);
  • directly sexual intercourse (premature ejaculation, set-up-to-fail syndrome);
  • depressed mood or stress.

Diseases and Medications that can Cause Erectile Dysfunction

Diseases that often cause erectile dysfunction:
  • atherosclerosis;
  • arterial hypertension;
  • diabetes;
  • hormonal dysfunction;
  • obesity;
  • genitourinary system inflammatory and infectious diseases (cystitis, pyelonephritis, epididymitis, prostatitis, abscess);
  • pelvic area injuries, surgeries on organs located in pelvis;
  • spinal cord injuries;
  • multiple sclerosis;
  • Parkinson's disease.
Medicines that may cause or worsen erectile dysfunction:
  • drugs affecting heart and blood vessels (for treating high blood pressure, digitalis preparations);
  • psychotropic drugs (antipsychotics, antidepressants, anxiolytics);
  • other drugs (e. g. finasteride for enlarged prostate treatment, antiepileptics).

Erectile Dysfunction Symptoms

Erectile dysfunction causes may be different, but disease symptoms manifest themselves always in the same way. After noticing the first symptoms, patient should seek professional help, often erectile dysfunction symptoms are also other diseases markers. erectile dysfucntionCommon erectile dysfunction symptoms:
  • weak erection: in the morning penis is slightly erected, even during sexual intercourse it does not get firm enough;
  • during sexual intercourse penis loses its firmness, which makes it impossible to finish intercourse;
  • ejaculation occurs at weak erection or prematurely;
  • total or partial lack of erection during sexual intercourse.
Erectile Dysfunction Diagnostics
  • Talking with a specialist, filling in questionnaire - expert should collect information about previous surgical interventions on urinary and genital systems organs, rectum, prolonged drugs administration and alcohol abuse.
  • At the beginning examination is conducted to assess cardiovascular, nervous, endocrine and reproductive systems state.
  • It is necessary to exclude serious diseases such as diabetes, hypogonadism, hypertension, atherosclerosis, renal insufficiency, neurological and mental disorders.
  • The next step will be thorough examination by specialist: penis, prostate examination (to exclude adenoma, prostatitis, tumors, cancer), testicular size measurement (the smaller the size is, the less male hormones are produced). It is also necessary to check sexual reflexes to avoid neurological impotence causes.
  • Intracavernous vasoactive test - to determine blood supply to penis drugs in test dosage are used, this method measures blood flow in penile vessels.
  • Observing nocturnal erections. Nocturnal spontaneous erections monitoring is conducted for differential diagnosis of organic and psychogenic ED types. Normally, men must have 5 - 6 erections per night.
  • Determining blood glucose, lipid profile and total testosterone levels on an empty stomach.
  • Doppler penile arteries ultrasound.
Erectile Dysfunction Prevention To make erection stable and preserve sexual health for many years and without problems it is necessary: erectile dysfucntion
  • increase physical activity, best option is jogging, swimming, contrast shower. Spend more time in the fresh air;
  • adhere to proper diet. Exclude fatty foods, which contributes to excessive weight, and as a result, leads to erectile dysfunction. Products that increase potency: peanuts, pistachios, oranges, lemons, pomegranates, onions, dairy, meat, fish, molluscs, shrimps and other shellfish;
  • refuse from or reduce strong coffee and tea consumption;
  • limit alcohol intake, give up smoking and taking drugs;
  • get rid of psychological stress, anxiety, stop quarreling with partner, do not focus on past failures;
  • monitor blood pressure, because pressure is a major cause of erectile dysfunction;
  • do not take drugs without doctor's advice, as some of them have negative effect on potency;
  • refuse from tight underwear. Synthetic underwear, especially tight leads to overheating and as a consequence to ovarian, prostate functioning violation, and eventually reduced potency. Underwear must be loose made of natural linen fabric;
  • keep regular sex life. The more sex a man has (optimally 2 - 3 times a week), the less problems with potency there are. Regular ejaculation is a good prostate edema prevention.

Psychological Causes

If you are asked a question: “Are you healthy or not?” - what will you say? During initial consultation, a doctor won't give you a specific answer, he will tell you: “You are not sufficiently examined.” If in process of patient with ED comprehensive examination a decision is made that ED was caused not by organic, but by psychological reasons, a patient is sent to sexologist or therapist. How male psychology affects erection? The fact is that brain plays a key role in starting physiological processes leading to erection, starting with sexual excitement. Therefore, various psychological problems can lead to erection reduction (weakening). Interesting fact: In Europe, according to European Association of Urology, 10% of cases of erectile dysfunction arise due to psychogenic reasons. Thus, psychological ED treatment is particularly important issue, because ED increases physical dissatisfaction by more than 4 times, and by more than 2 times - emotional dissatisfaction of life in general, thus reducing its quality. The following factors may influence erection degree and quality:
  • depression, prolonged stress, fatigue;
  • poor general health, dissatisfaction with oneself;
  • impossibility to perform sexual intercourse with one partner (wife), with constant success with others (mistress);
  • impossibility perform sexual intercourse with condom;
  • random failure during sexual intercourse causes very strong anxiety during the next intimacy with a partner;
  • long-lasting conflict with regular partner on domestic causes.
Canadian Health&Care Mall decided to reveal some factors in more detail. erectile dysfucntion Young men, who became sexually active relatively recently, erectile dysfunction can be caused by previous experiences in childhood, because in this period, parents often inspire teenagers sexual relations shamefulness. It happens that by the time of the first sexual experience excitement is so great that erection disappears before intercourse is started. And if at that moment a man hears rebuke from a woman - it can affect on his mind so much, that it will cause problems with erection in future. Another reason is “set-up-to-fail syndrome”. Even a single failed sexual experience can lead to erection reduction or even disappearance, as a man begins to doubt his “male power”. Fear greatly increases immediately before sexual intercourse, resulting in loss of erection. A reason, that could be called “ failure with other partners” is more common at older men. In this age category ED is more common with one partner (wife, with whom he lives for more than ten years), although they have constant success with other women (mistress). “ED caused by condoms use” is also falls into psychological reasons category. It manifests itself in erection decrease when both thinking about using it, and when actually using it. In the latter case, erection may completely disappear, which will necessarily lead to stress for men. It can be enhanced by partner's reaction, which may take this situation negatively, as personal insult and increase this stress with their emotional comments. In situations, described above, a man should contact a therapist or sexologist. It should also be said about partner's role in the process - their support, understanding and patience are key factors for positive therapy results. It is desirable that partner participates in psychotherapy sessions, visits sexologist together with a man, because basis of ED caused by domestic conflicts may lie in contradictions and mutual claims that partners can not resolve on their own. According to Canadian Heath&Care Mall statistics, in most cases, this therapy is successful - it is important to start treatment!

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