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Erectile dysfunction (commonly abbreviated as ED, and sometimes referred to as impotence) can show up unexpectedly in times of stress and duress, or frequently manifest and cause problems in the patient’s sex life. Erectile dysfunction is the name given to the inability to engage in sexual intercourse, specifically due to the penis failing to have, keep, and maintain an erection firm or long enough for sex.
An erection is facilitated and maintained by blood flow to the penis, the balance and pressure of which determines the relative hardness or erectness of the penis. While experiencing ED, either sporadically or in a progressive and recurring manner, either the penile arteries or nerves that facilitate this actively block the blood flow or are harmed altogether. This results in trouble getting or keeping an erection and while erectile dysfunction and its symptoms differ from poor sex drive – it can affect the libido and desire to have sex itself.
Finding out what’s causing erectile dysfunction is a key component as the very nature of ED is chemical. Nerves from the brain, as well as the genitals, cause chemicals to release blood into the two erection chambers of the penis, the corpora cavernosa. The resulting blood pressure is responsible for getting the penis erect by causing it to expand and stiffen due to the spongy tissues of the chambers trapping the blood inside. Post-orgasm, the erection should come down due to the blood being released back into circulation via the penile veins when the tissues contract.
Occasional ED should not be a cause of concern, particularly when under duress or psychological pressure (either to perform or otherwise). Frequent and consistent ED, however, can be a sign of a bigger issue, including poor mental health (including psychological or emotional difficulties), relationship problems, or a host of physical disorders including cardiovascular disease, atherosclerosis, diabetes, hyperlipidemia, or damage from excessive drug use, alcohol use, or even cancer.
Erectile dysfunction is the highest-reported sexual problem in males, with over 30 million men affected in the US, or at least 1 in 5. It can arise from either and any of the vascular, nervous, and endocrine systems.
In many cases, ED can simply start as a side-effect of certain medication. A list of examples of these that frequently contribute to ED are anti-depressants, antihistamines, appetite suppressants, blood pressure and ulcer medicines, diuretics, or even many common painkillers.
While ED has traditionally been linked with age, and the percentage of males with ED grows in proportion to it, it is not inevitable, and neither does aging cause ED. However, the fact remains that 30% of males above 70 are affected, while only 12% of men younger than 60 are.
The analysis of the leading cause of ED in younger men (particularly those under 40, reported to be 1 in 4) suggests it to be lifestyle choices; since an erection is so closely linked to blood flow in the penis, anything that affects blood pressure is also linked to potential erectile dysfunction due to reduced penile blood flow.
While infrequent ED is chalked up to emotional factors, progressive ED can also set in solely due to these factors that are able to “short-circuit” the entire sexual process, regardless of whether the ED started off from a physical problem. Psychological issues such as fear, guilt or anxiety about sexual performance and failure, low self-esteem, and anxiety and depression, have all been linked to both periodic and progressive ED.
The risk factors can start from emotional and mental problems in lifestyle and relationships, and extend to pre-existing medical conditions (diabetes or heart disease), obesity, smoking, illicit drug use or heavy drinking, complications from medical treatments, injuries, and medication.
The symptoms for erectile dysfunction are not hard to miss, particularly if they have lasted for more than a few weeks or around two months. Regular and recurring difficulty in maintaining interest in sexual activities or an erection during said sexual activities is the primary symptom of ED. This includes being unable to keep your penis rigid or stiff enough for sexual intercourse or finding that your erections do not last for as long as you would have come to expect them to.
Any of these symptoms is enough to consult a doctor, crucially so when compounded with another sexual issue such as anorgasmia or premature or delayed ejaculation.
Diagnosis for erectile dysfunction begins with a physical test, including your doctor taking your medical history, and details of symptoms. Here it is important to be as open and honest as possible so as to leave out the possibility of something going undiagnosed or mistreated, and to accurately assess the need for advanced tests.
In cases where the risk is greater than usual or the symptoms have gone untreated for a long period that has worsened them, advanced tests are employed to gauge erectile function. A penile doppler is possible, as well as a nocturnal penile tumescence test, which stores data on nocturnal erections that can be tracked and analyzed to determine the functional health of the penis.
The essential physical and lab tests can include checking your blood pressure, penis, and testicles, as well as the health of your heart and lungs. Blood tests and urine samples can also be taken to measure testosterone and blood sugar. These tests are non-invasive, non-painful, and a small step necessary for treatment.
Erectile dysfunction can be treated in one or more of the three ways: therapy, drugs, and surgery. A combination of any methods is common, as well as changes in lifestyle such as quitting smoking or changing your diet and couples counseling.
Both the diagnosis and treatment of erectile dysfunction should be done with the help of a professional, and even alternative remedies and causes should be discussed with your primary healthcare physician before proceeding further. Complications are common as a result of mismanagement of penile health and can cause either side-effects or new problems altogether.
Surgery mostly involves penile implants or artery reconstruction and should only be considered as a last resort after completing a medication run. It is important to note that there are currently only four FDA-approved oral supplements for treating ED, and none of them should be taken without consulting with your doctor first, particularly for patients taking nitrates for heart diseases, who run the risk of a sudden drop in blood pressure by combining these.
These medications are Viagra, Cialis, Levitra, and Stendra, recommended to be taken one to two hours before having sex. Natural herbs and supplements that show similar results over time include ginseng, L-arginine, and certain other herbal aphrodisiacs. In any case, consulting with your doctor beforehand is crucial.