What is erectile dysfunction?
Erectile Dysfunction, also known as impotence, is the inability to get and maintain an erection. When a man becomes sexually excited, the brain sends signals to the nerves in his penis, resulting in increased blood flow, causing the penile tissue to expand and harden, which is known as an erection.
Not being able to get or maintain an erection can be due to a combination of physical and psychological factors. It is quite common, particularly in older men. Half of all men between the ages of 40 and 70 are estimated to have erectile dysfunction to some extent.
It can cause stress, affect one’s self-confidence, contribute to relationship problems and result in the man avoiding sexual intimacy altogether due to embarrassment and shame.
Erectile dysfunction occurs when a man experiences the following;
- Trouble getting an erection
- Trouble keeping an erection
- Reduced sexual desire
It can also result in other sexual problems, such as ejaculatory dysfuntion, or premature/delayed ejaculation during intercourse.
Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels, working together. Anything that interferes with the nervous system or the blood circulation causing the penis to expand and harden leads to erectile dysfunction. Factors effecting sexual desire can also cause dysfunction as a reduced libido makes it difficult for the brain to trigger or maintain an erection.
There can be many causes, such as certain medical conditions, stress and anxiety or even medicines. It is important to identify the cause and treat any underlying conditions. Erectile dysfunction is usually caused due to a combination of physical and psychological problems faced.
- Conditions affecting blood flow to the penis, such as cardiovascular disease, high blood pressure or diabetes
- Conditions affecting the nervous system, such as multiple sclerosis, Parkinson’s disease or stroke
- Conditions affecting hormone levels, such as an overactive thyroid or hypogonadism resulting in low levels of testosterone.
- Conditions affecting the physical structure of the penis
Injuries in the area and certain medicines such as diuretics for hypertension, fibrates for cholesterol, antipsychotics or antihistamines for allergies can also cause erectile dysfunction in the short-term.
You might face an increased risk towards erectile dysfunction if you lack exercise, are obese, smoking excessively or have high cholesterol levels.
Erectile dysfunction can be diagnosed by your GP based on your symptoms, overall physical and mental health, consumption of alcohol or smoking and any current medication. Your GP might also ask about your sexual history.
Further investigation may be carried out;
Testing a sample of your urine for signs of diabetes.
To assess the condition of blood vessels that supply the penis.
Assessing cardiovascular health
Checking blood pressure, heart rate, BMI, diet and lifestyle and blood tests for glucose and lipids to asses cardiovascular health.
Your penis might be physically examine to check for issues with the tissue and muscle.
To check for depression and anxiety.
Treatment for erectile dysfunction will depend on what is causing it.
If it is caused by an underlying health condition, such as heart disease or diabetes, those need to be addressed. In addition, to lifestyle changes, such as losing weight, giving up smoking and reducing stress can also ease up the condition.
We can prescribe Phosphodiesterase-5 (PDE) inhibitors, the most widely used and effective type of medication for treating the condition. It works by temporarily increasing the blood flow to your penis. They are designed to work on demand and can last for longer periods of time. Further, they enhance the effect of nitric oxide, a natural chemical that relaxes muscles in the penis allowing for increased blood flow and hence an erection.
These include Cialis, Sildenafil, Spedra and Viagra.