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Erectile dysfunction (ED) affects the lives of many middle-aged men and their partners to one degree or another. The term erectile dysfunction covers a range of disorders, but usually refers to the inability to obtain an adequate erection for satisfactory sexual activity.
Erectile dysfunction, formerly called impotence, is more common in men older than 65, it can occur at any age. An occasional episode of erectile dysfunction happens to most men and is normal. As men age erections may take longer to develop, may not be as rigid or may require more direct stimulation to be achieved. Men may also notice that orgasms are less intense, the volume of ejaculate is reduced and recovery time increases between erections.
Erectile dysfunction may also be a sign of a physical or emotional problem that requires treatment. Erectile dysfunction was once a taboo subject, but more men are seeking help. Patterns of erectile dysfunction include:
Occasional inability to obtain a full erection
Inability to maintain an erection throughout intercourse
Complete inability to achieve an erection
The penis contains two cylindrical, sponge-like structures that run along its length, parallel to the tube that carries semen and urine (urethra). When a man becomes sexually aroused, nerve impulses cause the blood flow to the cylinders to increase about seven times the normal amount.
This sudden influx of blood expands the sponge-like structures and produces an erection by straightening and stiffening the penis. Continued sexual arousal or excitation maintains the higher rate of blood flow, keeping the erection firm. After ejaculation, or when the sexual excitation passes, the excess blood drains out of the spongy tissue, and the penis returns to its nonerect size and shape.
Specific steps take place to produce and sustain an erection:
Arousal. The first step is sexual arousal, which men obtain from the senses of sight, touch, hearing and smell, and from thoughts.
Nervous system response. The brain communicates the sexual excitation to the body's nervous system, which activates increased blood flow to the penis.
Blood vessel response. A relaxing action occurs in the blood vessels that supply the penis, allowing more blood to flow into the shafts that produce the erection.
If something affects any of these factors or the delicate balance among them, erectile dysfunction can result.
Nonphysical causes
Nonphysical causes may account for impotence. They may include:
Psychological problems. The most common nonphysical causes are stress, anxiety and fatigue. Impotence is also an occasional side effect of psychological problems such as depression.
Negative feelings. Feelings that you express toward your sexual partner - or that are expressed by your sexual partner - such as resentment, hostility or lack of interest also can be a factor in erectile dysfunction.
Physical cause's
Physical causes account for many cases of erectile dysfunction and may include:
Nerve damage from longstanding diabetes (diabetic neuropathy)
Cardiovascular disorders affecting the blood supply to the pelvis
Certain prescription medications
Operations for cancer of the prostate
Fractures that injure the spinal cord
Multiple sclerosis
Hormonal disorders
Alcoholism and other forms of drug abuse
In fact, erectile dysfunction may be one of the first signs of an underlying medical problem.
The physical and nonphysical causes of erectile dysfunction commonly interact. For instance, a minor physical problem that slows sexual response may cause anxiety about attaining an erection. Then the anxiety can worsen your erectile dysfunction.
A wide variety of physical and emotional risk factors can contribute to erectile dysfunction. They include:
Physical diseases and disorders.
Surgery or trauma.
Medications.
Substance abuse.
Stress, anxiety or depression.
MEDICAL TREATMENT
A wide variety of options exist for treating erectile dysfunction. They include everything from medications and simple mechanical devices to surgery and psychological counseling. The cause and severity of your condition are important factors in determining the best treatment or combination of treatments for you. You and your doctor may also want to consider how much money you're willing to spend and the personal preferences of you and your partner. If erectile dysfunction is the result of a medical condition, the cost of treatment may be covered by insurance.
Erectile dysfunction may also be a sign of a physical or emotional problem that requires treatment. Erectile dysfunction was once a taboo subject, but more men are seeking help. Patterns of erectile dysfunction include:
