Erectile dysfunction

Erectile dysfunction ?

Erectile dysfunction (ED) is the inability to acquire or maintain a satisfactory erection. The prevalence of erectile dysfunction varies according to the patient’s age. About 18% of men from 50 to 59 years of age will suffer from erectile dysfunction and 37% of those aged 70 to 75 years will, too.

There are three types of erections — those caused by tactile stimulation, those caused by mental stimulation, and those that men experience while sleeping. This classification can be important when the cause of erectile dysfunction is yet to be determined.

In order to have an erection, men need stimuli; they need blood arriving from the arteries and a veins capable of locking the blood in place. Each of the numerous steps in this system can fail making erectile dysfunction a complex problem for investigation.

What causes erectile dysfunction?

There are numerous potential causes of erectile dysfunction.

Neurologic causes include:

  • Stroke
  • Spinal cord or back injury
  • Multiple sclerosis
  • Dementia
  • Pelvic trauma
  • Prostate surgery (even with nerve-sparing surgeries it can take up to 24 months to regain normal sexual function)
  • Priapism
  • Nervous system tumor
  • Epilepsy
  • Diabetic neuropathy

Vascular causes include:

  • Arteriovenous fistula
  • Diabetes
  • Atherosclerosis
  • Congenital anomaly

Hormonal causes include:

  • Low testosterone blood level (The patient can achieve an erection but it won’t always be turgid enough for vaginal penetration.)
  • Hyperprolactinemia
  • Hyperthyroidism
  • Hypothyroidism
  • Cushing’s disease
  • Addison’s disease

Pharmacological causes include:

  • Antidepressants (mainly SSRIs)
  • Spironolactone
  • Sympathetic blockers (clonidine, guanethidine, or methyldopa)
  • Thiazide diuretics
  • Ketoconazole
  • Cimetidine

Penile dysfunction causes include:

  • Peyronie’s disease

Psychiatric causes include:

  • Loss of feeling toward the other person
  • Stress
  • Fear of non-performance

Functional causes include:

  • Bicycling irritating the nerves and tissue of the penis

What are the symptoms of erectile dysfunction?

Erectile dysfunction will cause the penis to be unable to acquire or maintain a satisfactory erection. It is important to specify to the doctor the rapidity of onset, the presence of nocturnal erections, and the quality of the erection if it can be attained but not maintained. The quality of an erection can be judged according to the rigidity and the functionality (Is the penis erect enough to allow for vaginal penetration?).

Erectile dysfunction with sudden onset and no previous history of sexual dysfunction suggests a psychogenic cause, unless there was a previous surgery or a genital trauma. The loss of nocturnal erections will suggest a neurologic or vascular cause. Finally, when an erection is not sustained, its loss may be due to an underlying psychological cause or vascular problem. Talk to your doctor if you have noticed any problems with your erectile function.

What is the treatment for erectile dysfunction?

Nowadays, there are many options for men who suffer from erectile dysfunction. Before suggesting pharmacological help, the doctor may suggest a change in lifestyle habits. Since many causes of erectile dysfunction are disorders in which lifestyle changes will have a positive effect, addressing these issues can be helpful. Therefore, regular exercise, a healthy diet, smoking cessation, and limiting alcohol consumption can all have an impact on erectile function. Lifestyle changes can also include the use of a more genitalia-friendly bicycle seat.

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