What is Erectile Dysfunction?
Erectile dysfunction (ED) also commonly known as impotence is experienced by adult men of any age but usually above 40 years of age. Erectile dysfunction is when a man is not able to get an erection or is unable to maintain an erection for long enough to have sex. The mechanism of getting an erection is when the flow of blood to penis increases suddenly, resulting in it enlarging, strengthening, and becoming hard or firm to be able to complete successful sexual intercourse.
Types of Erectile Dysfunction:
The cause of ED may be psychogenic (no physical abnormality) or organic (physical abnormality present).
There are several types of Organic erectile dysfunction, among them, the most common type of ED is vascular erectile dysfunction.
1. Vascular Erectile Dysfunction:
In this erectile dysfunction type the vessels which deliver blood to the penis get blocked / damaged or severely narrowed and are not able to supply adequate blood to the penis to attain a firm erection. Reasons for Vascular ED include high amount of cholesterol and abnormal lipid profile, high blood pressure, diabetes, Radiation, and surgery for prostate cancer.
2. Neurogenic Erectile Dysfunction:
Erections occur when the messages triggered by the brain travel with the help of nerves reach the penis. In case these nerves get damaged or diseased then the message sent by the brain is not able to reach the penis due to which erection does not occur. Some of the common causes of the neurogenic erectile dysfunction are:
• Stroke
• Spinal Cord Trauma
• Also, certain diseases like multiple sclerosis and Parkinson’s disease.
• Cancers which affect the central nervous system.
• Surgery and radiation
• Diabetes
• Kidney or Liver failure
• Polyneuropathy (Widespread nerve disease).
3. Hormonal Erectile Dysfunction
Hormones are chemical messengers within the body. Testosterone is a male sex hormone produced within the testicles that promotes sex drive in males and plays a vital role in sperm production within them. If you have a low testosterone level, you may lack interest in sex, which may result in erectile dysfunction. Also, normal testosterone levels are necessary to maintain a firm erection.
Few other hormones also have a role in ED including Thyroid hormone.
4. Psychogenic Erectile Dysfunction:
Psychological problems may cause the body’s immune system response to be overly active, which may interfere with the work of nerves needed to cause an erection. A few main causes of psychogenic erectile dysfunction include:
• Performance anxiety (fear that you will not be able to satisfy the partner during sex)
• Relationship problems
• Feeling shy about sex
• Fear of sexually transmitted disease
People having psychological problems may also face the risk of developing erectile dysfunction. Take for example if one is facing depression in life the risk of developing erectile dysfunction is 40% greater than someone who is not depressed.
In the older days, doctors believed psychological problems as the main cause of erectile dysfunction or, with older men, the aging process. Now with time, many things have changed. With the increasing age, if it takes longer to get aroused, regular erectile dysfunction needs medical attention. The problem is not completely psychological. Urologists now think that some physical problems also contribute to most long-lasting cases of erectile dysfunction in men over 50.
Erection Dysfunction Symptoms
The symptoms of erection dysfunction may differ from person to person. These symptoms may be:
• Not getting an erection.
• Getting erections sometimes like when you wake up and not otherwise.
• Having problems keeping an erection firm for a long-time during sex.
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Having an adequate erection but early ejaculation, sometimes even before penetration. This problem is called premature ejaculation (PME or PE). It is also seen commonly with Erectile dysfunction.
• Lack of desire for sex
Erectile Dysfunction Treatments
The treatment of erectile dysfunction depends upon what causes it and depends upon the couple and what they think will work best for them. Treatments include
1. Certain Lifestyle Changes: Your doctor may suggest you lose weight or follow a regular exercise routine to improve erection dysfunction. They might also request you to stop smoking, taking alcohol, or taking marijuana.
2. Counselling: If stress, depression, or relationship problems are causing erection dysfunction then taking the help of a counsellor will work.
3. Medication: Various drugs are helpful in improving the erections. These medicines increase the blood flow within the penis and can help in getting an erection when the person gets sexually excited.
4. Hormone Replacement: The doctor may prescribe testosterone hormone in the form of tablets, injections, or gel form in case the level of this hormone is low. Testosterone may not help in case of bad circulation or nerve problems are causing this problem.
5. Intra cavernosal injections: Injecting a medicine named alprostadil into the penis helps it in filling with blood and quickly causing an erection. This medicine could also be inserted into the urethra (a small hole in the penis from where urine comes out) as a suppository. It is a solid form of medicine that gets dissolved from the heat of your body.
6. Vacuum Device: A vacuum device is also called a penis pump; it is a tube fitted over the shaft of the penis. This device uses a pump which creates vacuum inside the tube. This pulls blood into your penis and causes an erection. It also includes an elastic ring that is placed at the bottom of the penis to keep it erect. After sex, the ring is removed to end the erection.
7. Surgery: The surgical procedure is done in patients where medical therapy fails or in cases of severe organic ED.
Nowadays, various implantable devices or prosthesis are available which are implanted inside the penile shaft. On pressing a small switch or button placed inside the scrotum, the fluid gets filled into the implant cylinders and patient gets a firm erection. Once done with the sexual activity, again the pressing of the button causes the fluid to drain out of penile shaft and leading to resolution of erection.
Another surgery for erectile dysfunction may include the repair of the arteries to boost blood flow into the penis. This is a challenging surgery and is not done frequently now since the advent of penile prostheses.
In conclusion, Erectile dysfunction is a common problem in the population and the incidence is increasing due to stressful lifestyle. Unfortunately, people don’t come forward and take medical opinion as there is still taboo and hesitation among men to discuss their sexual problems.
There are modern treatments available for any type of sexual dysfunction and most of ailments can be treated well, even without a surgical procedure.
