All You Need to Know About Erectile Dysfunction
Erectile dysfunction is defined as the lack of ability to achieve and maintain an erection sufficient enough to have satisfactory sexual interactions. In males, this develops progressively with aging. This disorder is also referred to as “impotence.” It can cause disturbances in a person’s physical and psychological health along with leading to social isolation because of a lack of confidence or self-esteem.
The normal sexual response in males has four stages. With Erectile Dysfunction (ED) there is a disturbance in the erection and ejaculation phases because of a parasympathetic disturbance or abnormality of neurotransmitter cascading and it leads to an inability to maintain an erection.
Symptoms of Erectile Dysfunction – ED Symptoms
Erectile Dysfunction Symptoms are:
- Trouble achieving erection
- Inefficient maintenance of an erection during sexual intercourse
- Inability to get an erection by psychological or physical stimulation
- Decreased interest in sex
Other associated conditions with impotence include:
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Common Risk Factors of Erectile Dysfunction
Age is the major and direct risk factor for the erectile disorder (ED). The prevalence regarding age groups is approximately 5% at age 40, and 15%-25% at age 65 or older.
Risk factors for Erectile Dysfunction
ED risk factors can be an indicator of systemic disease such as:
- Cardiovascular (heart) diseases
- High blood pressure
- Diabetes mellitus (DM)
- Tobacco use
- Alcohol use
- Hyperlipidemia (obesity)
- Hypogonadism
- Lower urinary tract disorders
- Metabolic problems
- Depression
Diagnostic measures used to determine Erectile Dysfunction
Physical exam:
- Inspection of genitalia
- History of trauma
- Questioning of psychosocial stressors
- Neurological assessment
Blood test:
- To investigate for low testosterone levels
- To check other comorbidities
- Endocrine dysfunction like glucose level in diabetes
Duplex Ultrasound:
- To check blood flow to the penis
- To check for atherosclerosis
Overnight erection test:
- To check if an erection occurs during the dream cycle of sleep
- To check other psychogenic causes
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Types of Erectile Dysfunction
Erectile dysfunction is unsatisfactory penile erection consistently over time that leads to lack of sexual activity and causes psychological distress. There are three types of erectile dysfunction:
- A psychogenic erection that occurs due to fantasy/imagination
- A nocturnal erection occurs during the dream stage of sleep.
- A reflexogenic erection that occurs by physical stimulation
Erectile dysfunction can occur because of an abnormality in any of the above erection types. Many times it is associated with male aging but it can also be caused by a medical or psychological problem.
Erectile Dysfunction Causes
The main pathophysiological causes of Erectile Dysfunction include:
- Psychosocial issues
- Neurological problems
- Vascular issues
- Traumatic experiences
- Surgical side effects
- Drugs associated
- Endocrine
Psychosocial causes:
- Stress
- Relationship problems
- Performance anxiety
- Depression
- Other psychological associated disorders
Physiological/vascular causes:
- Atherosclerosis
- Hypertension leading to damage of vessels
- Diabetes mellitus
- Hyaline arteriosclerosis
- Chronic renal or liver failure
Neurological causes:
- Stroke
- Multiple sclerosis
- Back trauma leading to nerve damage
- Parkinson’s Disease
- Dementia
Endocrine dysfunction:
- Hypogonadism leading to low testosterone levels
- Thyroid dysfunction
- Hyperprolactinemia
Effects of medications:
- Use of anti-hypertensive drugs like diuretics and beta-blockers
- Antidepressants
- Methadone
- Alcohol or tobacco smoking
Traumatic Erectile Dysfunction:
- Pelvic or penile fractures
- Pelvic radiation
- Priapism
- Spinal Cord Injury
Surgical causes:
- Radical prostatectomy
- Porto-iliac vascular surgery
- proctocolectomy
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Complications of Erectile Disorder
- Relationship difficulties
- Lack of intimacy
- Decreased ability for inducing pregnancy
- Elevated stress
- Depression
- Anxiety
- Low self-esteem
- Social withdrawal
- Frustrated sex life
Preventive Measures for Erectile Dysfunction
Erectile Dysfunction (ED) can be prevented by some simple measures like:
- Avoidance of alcohol abuse
- Losing weight
- Seeking help for relationship issues
- Getting evaluated
- Avoiding smoking
- Getting a healthy and nutritional diet plan
- Exercising properly and remaining active
- Changing prescribed medications or avoiding illicit drug use
- Getting involved in healthy mind related activities
- Going for routine medical checkups
Erectile Dysfunction Treatment Options – ED Treatment
Medications that can help with erectile dysfunction treatment:
- Sildenafil (Viagra)
- Vardenafil (Levitra)
- Tadalafil (Cialis)
These medications work by responding to sexual stimulation.
Other methods that may help to promote an erection in 5 to 20 minutes include:
- A vacuum erection device. This applies negative pressure around the penis to increase blood flow
- Intraurethral suppository
- Alprostadil (MUSE)
Self-injections:
- Phentolamine
- Papaverine
- Atropine
- Alprostadil
Surgical treatment:
- A penile implant. This is a prosthetic device that does not cause an erection but helps keep the penis rigid
Couples therapy:
Erectile dysfunction can lead to depression and other psychological co-morbidities. Couples therapy with you and your partner can help gain a better understanding of the disorder, the root causes, and how to promote and maintain physical and emotional intimacy while managing erectile dysfunction.
Physiotherapy for Erectile Dysfunction:
Kegel exercises:
- Physiotherapists can help by giving exercises to help strengthen pelvic floor muscles.
- These exercises have urinary and sexual health benefits and are easy to perform.