The Intricacies of Erectile Dysfunction


The Intricacies of Erectile Dysfunction

Erectile Dysfunction – Definition

Erectile Dysfunction in short ED is the inability of a male to maintain an erection of the penis during sexual activity. Erectile Dysfunction can be a sign of a physical or psychological condition that can cause stress and strains in the marital relationship leading to low self confidence in men.

The main symptom of erectile dysfunction is a man’s inability to get or keep an erection firm for or during sexual intercourse. However, it should be noted that not all male sexual problems are caused by ED even though there exist other types of male sexual dysfunction that include-

  • Premature ejaculation
  • Delayed or absent ejaculation
  • Lack of interest in sex

Cases of Erectile Dysfunction – Psychogenic and Organic

Psychogenic erectile dysfunction in simple terms is a psychological condition where a person or patient has inability to achieve or maintain an erection during sexual intercourse owing to predominantly or exclusively due to psychiatric, psychological or interpersonal factors.

The Psychogenic Erectile Dysfunction is considered to be the most common cause of ED even though psychological causes may coexist with physical/organic or functional reasons for ED. The various ways in which the brain functions during sexual intercourse usually results in Psychogenic ED.

The main causes of psychogenic erectile dysfunction are-

  • The release of chemicals (catecholamine) by the brain may result in the tightening of the penile muscles thereby preventing these muscles from relaxing.
  • A negative memory or difficult situation that occured during a previous sexual encounter can be replayed in the mind of the male during future sexual events.
  • Feeling of nervousness or being extremely self-consciousness about sex.
  • Stressed due to work pressures at office or home
  • Familial issues pertaining to monetary or societal matters may result in a troubled sexual relationship between the spouse/partner.

Some of the causes of Organic or Physical causes of Erectile Dysfunction are-

Erectile Dysfunction due to organic or physical causes is usually treatable even though less commonly curable. Some of the causes of organic erectile dysfunction include-

  • History of Arterial Trauma
  • High blood pressure
  • Diabetes
  • Heart and vascular diseases
  • Low male hormone levels
  • Prostate cancer
  • Scleroderma (stiffening or hardening of the skin)
  • Kidney failure
  • Liver cirrhosis
  • Hemochromatosis (too much iron in the blood)
  • Chronic Obstructive pulmonary disease
  • Usage of certain drugs such as cimetidine, atorvastatin, recreational drugs such as cocaine, marijuana etc.
  • Alcohol abuse can result in affecting the penile nerves of the penis.

Evaluation of Erectile Dysfunction (ED) – An Overview

The evaluation or diagnosis for Erectile Dysfunction consists of the Andrologist or urologist diagnosing ED with medical, sexual history, mental health and physical health of the concerned patient. The following tests or examination are carried out for evaluating Erectile Dysfunction or ED of the concerned patient after an extensive clinical history has been taken:

  • Physical examination – Physical exam consists of a careful examination of the penis and testicles for its sensitivity to touch.
  • Blood testsBlood tests helps in discovering whether the patient is having diabetes, atherosclerosis, chronic kidney disease and other hormonal problems that may be the cause of ED.
  • Urine tests (urinalysis)Urine tests like blood tests are helpful in looking for the signs of diabetes and other underlying health conditions.
  • Ultrasound – Ultrasound test involves using transducer device that is held over the blood vessels which supply blood to the penis. The sound waves of the device are reflected back when they contact relatively dense structures, such as blood vessel walls or fibrous tissue which are then converted into pictures of the internal structures for further study.
  • Other Tests – Tests such as Nocturnal Penile Tumescence test (NPT) through portable battery powered devices helps in evaluating the quality of nocturnal erections in sleep labs. These devices record electronically the duration, rigidity, circumference and number of penile erections. Neurological along with psychological tests help in determining the causes of Erectile Dysfunction.

Link between Diabetes and Erectile Dysfunction – A Summary

Diabetes is one of the most common causes of ED with men who have Diabetes being three times more likely to have ED than those who are not diabetic. The risks of ED increase with the number of years the patient or person has Diabetes or severity of Diabetes. Diabetes can damage penile nerves and vessels that control erection leading to failure in achieving a firm erection. It is a known fact that majority of men with Diabetes have ED even though it can be successfully managed by almost all men.

Treatment Available for Erectile Dysfunction – Methods

There are different types of treatment options available for erectile dysfunction and the therapy usually depends upon the cause or causes of ED. A combination of treatments for treating Erectile Dysfunction includes –

  • Psychological counseling – Psychological counseling by a psychologist or counselor may help the patient in lowering his anxiety or stress related to sexual intercourse. The counselor may also suggest bringing his spouse or partner to counseling sessions to learn how to support the concerned patient.
  • Oral medications (MUSE) such as Viagra, Levitra, Stendra etc in pill form followed by sexual stimulation exercises to achieve the desired results. A point to be noted when taking these medications is to check with the Doctor as each of the above medications have to be taken an hour or 2 before sexual intercourse and can have other side effects which should be informed to the patient in advance.
  • Urethral Suppository (MUSE) – Medicated Urethral System for Erection is often used when oral medications are ineffective. In this type of treatment or approach – a small suppository of medication is placed inside the penile urethra without needles and this suppository is absorbed helping in producing an erection.
  • Penis pumps, vibrators and penile implants– Where medications are ineffective – doctors may recommend using penis pumps and vibrators to get an erection that long lasts for a couple to have sex. Penis implants involve surgically placing inflatable (bendable) devices into both sides of the penis that allows the patient to have control on his erection.

Finally, it can be said that the type of treatment for ED depends upon many factors such as the person’s health and his ability in tolerating the treatment. It is better to take advice of a professional Andrologist and Sexual Medicine specialist to determine the best treatment for ED. Andrology Center now offers confidential and safe Online Consultations with an Andrologist and Sexual Health doctor at your convenience.

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