What does Erectile Dysfunction mean?
Erectile Dysfunction (ED), also known as impotence, is a serious sexual disorder. Precisely, it means that in more than two thirds of cases a man cannot get or maintain an erection that is sufficient for sexual intercourse. The penis does not become hard enough or flaccidity prematurely. These problems persist for at least six months. So if „it does not work “once every now and then, it is not immediately a disorder in need of treatment.
With age, erectile dysfunction becomes more frequent. Among the 40- to 49-year-olds, almost one in ten men is affected, and among the 60- to 69-year old, one in three. A study by the University by Cologne in 2000 showed this, and many other studies in numerous countries came to similar results.
In the majority of cases, physical causes are behind erectile dysfunction. Purely, psychological triggers occur above all in younger men.
Even if this is a very private problem, shame is inappropriate. Those affected should not be afraid to go to a doctor. The reason is that the disorder can be a warning sign – especially beyond the age of 50 – of an imminent heart attack or stroke. This is because erectile dysfunction is often caused by arteriosclerosis, which means that the blood vessels can’t supply the penis with blood. This arteriosclerosis does not stop at other vascular segments in the body. The blood vessels that supply the heart with blood could also be affected. In the worst case there is a high risk of a heart attack or a cerebral infarct.
The term “impotence” was used in medicine in the past, but is rarely used today. Because it embraces various disorders that do not necessarily belong together: On the one hand, erectile dysfunction or premature ejaculation, and on the other the infertility.
What are the Erectile Dysfunction causes?
In most of the cases, physical causes are responsible for erectile dysfunction. Most often the penis blood circulation is disturbed and/or the penis musculature itself is diseased. Either too little blood arrives the penis, because of the hardening of the arteries (arteriosclerosis). Or the blood flows out too quickly through the veins. In any case the amount of blood in the cavernous body isn’t sufficient for satisfactory penile erection.
Physical causes of erectile dysfunction
1. Circulatory disorders
There are various diseases, which supports circulatory disorders, increase the risk for erection problems: Diabetes mellitus, high blood pressure, dyslipidemia. Also, the lifestyle influences erections a lot: smoking, overweigh, physical inactivity, and unhealthy food can raise potency problems. Erectile dysfunction is often the first warning sign of angiopathy and thus a possible harbinger of heart attack and stroke.
2. Testosterone deficiency
Recent researches has shown that testosterone level has a big influence on erection. A testosterone deficiency can be considered as a possible cause for erectile dysfunction. Generally, men with a low testosterone level are often tired, don’t have desire for sex and erection problems. A sufficiently high hormone level is obviously a very important prerequisite for a satisfactory erection. With the years of life, the testosterone level in the blood usually decreases in men.
3. Side effects of medication
It’s important to know that there are numerous medications, which has erectile dysfunction as a side effect, for example beta-blockers against high blood pressure, lipid-lowering agent or medicine against depression. Patients should talk to their doctor asking for other medicine if the package insert of a medicine can cause erectile dysfunction.
4. Other causes
Not only the blood circulation in the penis has to be right for an erection. All the nerves involved—from the penis to the spinal cord to the brain—must also be intact. Disc prolapses, injuries, radiation or operations on the pelvis or spinal cord can lead to erection problems. The same applies to diseases that can cause damage to peripheral nerves (neuropathy)—such as diabetes or chronic alcohol abuse. Other possible causes of erectile dysfunction are diseases affecting the central nervous system for example: multiple sclerosis, Parkinson’s disease, Alzheimer disease or a stroke.
Serious diseases such as cancer, severe kidney or liver diseases can always also affect potency.
Physical causes and psychological triggers can diffuse. If men suffer from physically caused erectile problems, this can easily lead to additional psychological problems. Psychologically conditioned causes are more often found by younger men. In addition to conflicts in partnership, stress, problems or anxiety disorders, depression is very often associated with erectile dysfunction.
What are the symptoms?
If men have an erectile dysfunction they cannot get an erection, have problems to maintaining an erection or are less in the mood for sexual intercourses. Also sexual disorders like premature ejaculation and delayed ejaculation can related to erectile dysfunction. Please find out a doctor if any of those symptoms appear.
How can you diagnose erectile dysfunction?
At the beginning, the doctor will get an exact picture of the disorder with concrete questions about the sexual life, symptoms and health history of the patient. Sometimes the potency problems are also a side effect of a drug, so the doctor will ask what drugs the patient is taking. The doctor will also ask whether spontaneous erections are noticed in the morning or in the night. Erections occur in every healthy man during certain sleep phases.
This is followed by a physical examination where the blood pressure will be checked. The doctor will focus especially on checking the sex organs and prostate. Since man erection problems are due to circulatory problems, the doctor will also check the vascular pulses in the arms and legs and the blood pressure.
Additionally, a blood test provides information on possible risk factors such as elevated blood sugar or unfavorable blood lipid levels. With the help of the blood test the doctor can find out if there is lack of the male sex hormone testosterone.
The blood flow in the vessels of the penis can be checked with the doppler ultrasonography. The doctor may inject a medication into the penis that triggers an erection, which is known as the combined intracavernous injection and stimulation (CIS) test. Whether and how well an erection is achieved in this test provides additional information. Spontaneous erections during sleep can be registered with a portable measurement device, that the patient wears his thigh while he sleeps. This method is called nocturnal penile tumescence (NPT) test.
If the erectile dysfunction occurs rather suddenly, possibly after stressful life events, and predominantly in certain situations, and if the patient is younger than 50 years, this speaks for psychological triggers. Some mental illnesses such as depression or anxiety disorders can also result in erectile dysfunction. The doctor will try to identify such reasons for erectile dysfunction and refer them to specially trained therapists.
How can erectile dysfunction can be treated?
There are many treatments options. Depending on which concrete cause the doctor can remedy the erectile dysfunction, if possible.
One option it to prescribing patients PDE-5 (phosohodiesterase-5) inhibitors. PDE-5 is an endogenous enzyme. The drugs effect that the circulation in the penis increases, which occurs an erection or let an erection lasts longer. Best known PDE-5 ’s are sildenafil, vardenafil, tadalafil and avanafil. They are all prescription. Sildenafil, Vardenil and Avanafil take effect after about 12 to 60 minutes. Their effect lasts about four to twelve hours. Tadalafil takes effect after about 30 minutes for about 24 to 36 hours.
PDE-5 inhibitors only work when the man is sexually aroused. So you’re not raising the lust. The erection ends, as without medication, with the orgasm or ejaculation. However, further erections are possible within the duration of effect.
Possible side effects include headaches, facial flushing, heartburn and stuffy nose. Sildenafil and vardenafil can trigger temporary changes in color vision and tadalafil might trigger muscle and back pain. Detailed information can be found in the package insert or the doctor can be asked.
There are various treatments to buy on the internet for ED. One well-known and effective product is Poliva EDAM. It’s a completely natural product. EDAM is made of Panax ginseng, Eurycoma longifolia, oyster, Gnychthodes officinalis, and Ophiocordyceps sinensis.
2. Vacuum therapy
In this method, a transparent plastic cylinder with a suction pump is placed on the penis and a vacuum is created. Blood flows more strongly into the corpus cavernosum, resulting in an erection. A rubber ring at the root of the penis prevents the blood from flowing back again. It must be removed after 30 minutes to prevent circulatory disorder and thus damages to the penis.
In some cases, only implants made of silicone are helpful. The implants are inserted to the corpus cavernosum. This procedure is irreversible and should therefore be well considered and planned. The most commonly used implants are refillable. A reservoir containing saline is implanted in the lower abdomen. The doctors insert a small pump into the scrotum. At the touch of a button, men can fill the implant to create a sort of erection.
4. Counseling or psychotherapy
Talking to sex therapists helps with psychologically caused erectile dysfunction. Cognitive-behavioral therapy, a famous method of psychotherapy, can improve mental health. But also man with physically caused erection problems often benefit from it. Because in most cases, the physical and psychological causes of erectile dysfunction cannot be separated in detail.
5. Changing your lifestyle
Patients themselves can contribute to maintaining or even improving their potency for a long time. Something that keeps the blood vessels fit also prevents erectile dysfunction. In detail this means: do not smoke, eat balanced diet, drink only a little alcohol, exercise a lot, reduce obesity, check blood pressure, blood sugar and blood lipid regularly.