Definition Of ED
Erectile Dysfunction (ED) is the inability to achieve and/or maintain an erection firm enough for penetration and sexual performance despite being sexually stimulated.
The root causes can be vascular, psychological, neurologic, and/or hormonal. Common diseases which may contribute to ED include diabetes mellitus, hypertension, obesity, hyperlipidemia, testosterone deficiency, and treatment of prostate or testicular cancers.
Common psychological causes are relationship problems, anxiety and depression. Other conditions can be tobacco use, substance abuse or medications such as antidepressants.
SYMPTOMS OF ED
Having temporary erection trouble isn’t necessarily an important concern. Some causes of ED are temporary, and the dysfunction will no longer exist after the condition is relieved. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. ED can also be a sign of an underlying health condition and a risk factor for heart disease.
ED symptoms might include persistent
Trouble getting an erection
Trouble keeping an erection
Reduced sexual desire
WHEN TO SEE A DOCTOR
If you’re concerned about erectile dysfunction, talk to your doctor. Do not feel embarrassed; you are not alone.
ED is a very frequent problem many men may experience specially as they get older, but it might also be seen in men in their 40’s, 30’s or even 20’s! In fact, it is the most common sex problem men report to their doctor! The good news is that today we can say most cases are effectively treatable.Your family doctor may be the first person you should see when you have erectile problems.
You do not need a referral for coming to “MedAmor Men’s Health Clinic”, and here you will be visited by a family physician. Seek help from your doctor if:
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You have problems with erections or you’re experiencing other sexual problems such as premature or delayed ejaculation
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You have diabetes, heart disease or other health conditions that might contribute to erectile dysfunction
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You have other symptoms along with erectile dysfunction
Causes
Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Any of these can cause ED. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.
Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.
Testosterone is the hormone responsible for deep voices, muscle mass, and facial and body hair patterns found in males. As men get older, the level of testosterone in the body and production of sperm gradually becomes lower, and they experience physical and psychological symptoms as a result of these low levels. This is part of the natural aging process and it is estimated that testosterone decreases about 10% every decade after men reach the age of 30. Andropause is a condition that is associated with the decrease in the male hormone testosterone. Approximately 30% of men in their 50s will experience symptoms of andropause caused by low testosterone levels. A person experiencing andropause may have a number of symptoms related to the condition and could be at risk of other serious health conditions such as osteoporosis without proper treatment. These are the major symptoms of andropause:
PHYSICAL CAUSES
ED can have physical or psychological causes. One of the major causes of ED is vascular which is characterized by restricted blood flow to the penis.
Since this flow is the mechanism of the formation of an erection, the amount of firmness may not be enough when restricted. This type of ED is called vascular erectile dysfunction.
In many cases, erectile dysfunction is caused by some physical problem or disease. Common causes include but are not limited to:
- Diabetes
- High blood pressure
- Heart disease
- Obesity
- Atherosclerosis (clogged blood vessels)
- High cholesterol
- Metabolic syndrome (a condition involving increased blood pressure, high insulin levels, high cholesterol and body fat around the waist)
- Some medications
- Tobacco Use
- Alcoholism and other forms of substance abuse
- Sleep disorders
- Peyronie’s disease (scar tissue formed inside the penis usually due to previous fracture)
- Parkinson’s disease
- Multiple sclerosis (MS)
- Treatments for prostate cancer or enlarged prostate
- Surgeries or injuries that affect the pelvic area or spinal cord
PSYCHOLOGICAL CAUSES
The brain plays a significant role in triggering a series of physical events that cause erection, starting with feelings of sexual excitement. Some conditions can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:
- Anxiety, depression or other mental health conditions
- Stress
- Relationship problems due to poor communication or any of the above conditions
RISK FACTORS
Aging men experience erections that might take longer to develop and/or not be firm enough for sexual performance. More direct touch or stimulation to the penis may be needed to get and keep an erection.
Various risk factors can contribute to erectile dysfunction, including:
Medical conditions:
diabetes or heart diseases in particular
Psychological conditions:
stress, anxiety or depression
Certain medical treatments:
such as prostate cancer treatment with radiation or surgery
Medications:
many antidepressants, pain killers, antihistamines and medications to treat prostate conditions or hypertension
- Being overweight and specially obesity
Tobacco use:
restricts blood flow to arteries and veins, and over time can cause chronic conditions that lead to ED
Drug and alcohol:
especially long-term drug use or heavy drinking
Trauma:
particularly injury of pelvic area and the nerves or arteries that control erections
COMPLICATIONS
Complications resulting from erectile dysfunction can include:
- Unsatisfactory sex life
- Low self-esteem
- Relationship problems
- Development or worsening of stress, anxiety and/or other mental conditions
- Impotence
PREVENTION
The best way for prevention is lifestyle modification such as regular check-ups and medical screening tests, stopping smoking, limiting or avoiding alcohol and not using drugs, and management of existing health conditions like diabetes, heart disease or other chronic health conditions, anxiety, depression or other mental health concerns
A WORD WITH PARTNERS
Erectile dysfunction (ED) disturbs not only the patients, but also their partners and can cause relationship problems. Men affected by ED may lose their confidence. This may cause stress and anxiety, which in turn makes a vicious circle that deteriorates erection and sex performance.
ED is very frequent, and there’s no need to keep this problem in heart and suffer. Although it is hard for men to talk about ED and they may feel embarrassed, there are a lot of partners seeking help from healthcare professionals. The good news is with new treatments and technology, most of erectile dysfunctions are now treatable. A high percentage of patients regain dramatic improvement in their erections. So, they start to experience good sex relationships again, and this improves their confidence and heals their stress and anxiety.
ED has several physical and psychological causes, and most of the times a simple treatment resolves the problem. On the other hand, ED can be a sign for other serious illnesses such as coronary heart disease. Therefore, it is essential to see a doctor, and it’s worth the effort.
Your encouragement will give your partner the confidence to look for the cure. They may be treated with the first prescription or need to try different kinds of treatment and even combination therapies. This may be frustrating, so they need your support throughout the way.
Treatment
Since there are different causes, there is no single treatment. Depending on the cause of the condition, several possible treatment options may be used, and new therapies are always being added to this list. The problem must be considered holistically and treated with one or more options. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications and/or other direct treatments might be needed.
A commonly used group of drugs are the Phospho-Di-Esterase 5 Inhibitors (PDE5-I) such as Viagra®, Cialis®, and Levitra®. These drugs are an effective treatment for most men with erectile dysfunction, but many men including diabetic patients, those with history of pelvic surgery or radiation for prostate, colorectal or bladder cancer have low response rates to erection pills. On the other hand, these medications must be taken about an hour before intercourse, so they take the spontaneity out of sex and can be accompanied by unpleasant side effects. The most frequent side effects are headache, nasal discharge, muscle cramps and visual impairment.
Other treatment options are direct injection of drugs into penis shaft, using vacuum pumps and in very rare cases, surgery. In some severe cases of erectile dysfunction, an inflatable device can be implanted surgically in the penis shaft to replace the spongy tissue.
“Shock Wave Therapy” or LI-ESWT is a novel and innovative non-drug non-invasive treatment with almost no side effects and high success rates.
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