Erectile Dysfunction

Erectile Dysfunction
Erectile dysfunction occurs when men experience recurrent difficulties in maintaining an erection that is suitable for sexual intercourse. Men may not be able to get an erection, or only have them for a short amount of time, or have erections inconsistently.
This condition is common in older men, but can occur at any age. Erectile dysfunction can result in stress, which may result in self-esteem and relationship issues.
The cause of erectile dysfunction is often related to psychological issues. However, recent research has shown that the problem is psychological in only about 20% of sufferers. The majority of cases are now thought to be the result of physical illness.
You may feel self-conscious talking about sexual issues with health professionals, but it is well worth the effort to seek help for erectile dysfunction. There is a wide range of successful treatments for erectile dysfunction.

Erectile Dysfunction Signs and symptoms
Erectile dysfunction is defined as the inability to sustain an erection (adequate for sexual intercourse) for at least 25% of the time. Most men will occasionally have difficulty in maintaining an erection, and this is normal. If erection problems are ongoing, this may be a sign of erectile dysfuntion. It is important to evaluate the underlying problem, as erectile dysfunction can be the first sign of another health condition that requires attention.

Erectile Dysfunction Causes
Maintaining an erection is a complicated process which involves many parts of the body – including the brain, emotions, hormones, muscles, nerves, and blood vessels. An imbalance in any of these systems can result in erectile dysfunction.
Underlying causes can be both physical (such as side effects of a medication, or a chronic health problem) and psychological. Erectile dysfunction can often be the first sign of an underlying health problem.
The following are common physical causes of erectile dysfunction:

• Obesity
• High blood pressure
• Heart disease
• Clogged blood vessels (atherosclerosis)
• Diabetes
• Metabolic syndrome
• Certain prescription medications, such as antidepressants, antihistamines, pain and blood pressure medications, tranquillisers, and sleeping aids.
• Tobacco use
• Alcoholism
• Drug abuse
• Treatments for prostate cancer
• Parkinson's disease
• Multiple sclerosis
• Hormonal disorders such as low testosterone (hypogonadism)
• Peyronie's disease
• Surgeries or injuries that affect the pelvic area or spinal cord
• Injuries to the pelvic area or spinal cord, and surgery to treat bladder, rectal or prostate cancer can increase your risk of erectile dysfunction.
• Prolonged bicycling, which can constrict nerves and blood flow to the penis, leading to temporary erectile dysfunction and penile numbness.

Many psychological factors may interfere with sexual feelings and cause erectile dysfunction. These include:

• Depression
• Anxiety
• Stress
• Fatigue
• Poor communication or conflict with your partner

The physical and psychological causes of erectile dysfunction are interrelated. For example, a small physical condition that slows down sexual response can cause anxiety, which in turn worsens erectile dysfunction.
Another common risk factor for developing erectile dysfuntion is getting older. Many men experience sexual changes as they get older. Erectile dysfunction is often present in older men because they’re more likely to have an underlying health condition that alters erectile function.
See your doctor if erectile dysfunction is more than a temporary or short-term problem. They will be able to determine the underlying cause, and work with you to help you understand and decide on the right treatment for you.

Erectile Dysfunction Treatment
There are now a wide range of treatment options for erectile dysfunction, such as medications, surgery, and counselling.

1. Prescription medications that treat erectile dysfunction include:

• Sildenafil (Viagra)
• Tadalafil (Cialis)
• Vardenafil (Levitra)

These medications are very similar in terms of the way they work. They increase the effects of nitric oxide, which relaxes muscles in the penis. This allows the amount of blood flow to increase, and allows the natural process of an erection to occur. Sexual stimulation is required before the effect can occur, and the medication will not produce an erection on its own.
Most men report an improvement in their condition, no matter what the underlying cause may be.
Even though these medicines can help many men, not all people can take these medications. If you are currently taking the following drugs, you should consult with your doctor before commencing treatment:

• nitrate drugs for angina
• blood-thinning medication
• alpha blockers for enlarged prostate (benign prostatic hyperplasia) or high blood pressure

Also, if you have had heart or blood pressure problems, or if you have diabetes, medicines such as viagra may not be suitable for you.

2. Needle-injection Therapy
A fine needle is used to inject a medication called alprostadil into the penis. This produces an erection that will last for approximately an hour. This may sound painful, but the needle used is very fine, and pain is usually very minor. There can be side effects, and the cost per injection can be expensive.

3. Self-administered Intraurethral Therapy
A very small suppository is inserted into the tip of the penis, which is absorbed by erectile tissue. This leads to an increase in blood flow, and causes an erection. This method can be uncomfortable, and there are possible side effects, such as pain, minor bleeding, and dizziness.

4. Hormone replacement therapy
If your erectile dysfunction is caused by a testosterone deficiency, a suitable option is testosterone replacement therapy.

5. Penis Pumps
This requires the use of a tube with a pump attached to it. The pump is positioned over the penis, which creates a vacuum, drawing blood into the penis. Once an erection is achieved, a ring is placed around the base of the penis, to maintain an erection. The tension ring is removed after intercourse.

6. Surgery
Vascular surgery is an option if your blood flow has been impaired after an injury to the pelvic area.

7. Penile Implants
This method involves the surgical placement of a device into the two sides of the penis, and is an inflatable device. The device can be controlled in terms of when and how long you want to maintain an erection. This treatment is expensive, and is usually not recommended until other options have been tried first.

If your symptoms are psychological, it may help to talk to a counsellor who has experience in treating sexual problems. It can also be helpful for your partner to participate.

Natural Therapies
There are quite a few alternative treatments that have been shown to alleviate erectile dysfunction, including:
- Acupuncture
- DHEA (Dehydroepiandrosterone), which is a hormone that is a building block for testosterone
- Ginkgo
- Antioxidants: recently, evidence has come to light, showing that antioxidants are beneficial in treating erectile dysfunction. This is due to the fact that antioxidants combat free radicals, which disrupt normal circulatory function.
- L-arginine

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© 2008 Rachelle Kazenbroot