Erectile Dysfunction: Symptoms, Causes, and Treatment

A lot of us think that we don’t have to worry about erectile dysfunction because we’re too young to fall under the risk category. Unfortunately, erectile dysfunction can happen at any age, and although it is pretty rare at a young age, by the age 45 most men have experienced erectile dysfunction at some point. Erectile dysfunction is treatable at any age, therefore it is important to know what erectile dysfunction is, what its symptoms are and how it can be treated.

Erectile dysfunction, also known as impotence, is a repeated inability to achieve or sustain erection long and firm enough to engage in sexual intercourse. Having trouble maintaining an erection occasionally isn’t a cause for concern, unless it is a continuing problem. Erectile dysfunction used to be considered a purely psychological issue or something that is just part of getting old. Recent studies revealed that erectile dysfunction is caused by physical problems (such as chronic disease or side effects of a medication) more often than by psychological ones and it is not an inevitable consequence of aging.

The process of penis arousal is complex and involves brain, hormones, nerves, muscles and blood vessels. If something interferes with any one of these systems, it can result in erectile dysfunction. Let’s take a closer look at how an erection occurs.

Your penis consists of two cylindrical sponge-like chambers called Corpora Cavernosa that run along its length. Corpora Cavernosa are surrounded by a membrane called Tunica Albuginea. The urethra is the tube that carries semen and urine and runs along the side of Corpora Cavernosa.

When a man becomes sexually aroused due to sensory and/or mental stimulation, nerve impulses from the brain and local nerves cause the muscles of Corpora Cavernosa to relax thus allowing the blood flow to it to increase several times the usual amount. This sudden inflow of blood expands the sponge-like tissue, fills the spaces, and produces an erection. The Tunica Albuginea traps blood in the Corpora Cavernosa, which helps sustain an erection. After ejaculation or when the sexual excitement passes, the blood drains out of the Corpora Cavernosa and the penis returns to the normal size and shape as before the erection.

Since an erection requires an exact order of events to take place, it can happen when any one of these events is disrupted. The most common cause of erectile dysfunction is damage to nerves, arteries, muscles or tissues as a result of a disease such as diabetes, heart disease, atherosclerosis, high blood pressure, vascular disease, hormone disorders, and the like. It is important that you take your medications for the above mentioned problems just as prescribed by your doctor. Some medicines can be the cause of erectile dysfunction. In that case your doctor may take you off the medication altogether or replace it with a different one.

Smoking, abusing drugs, obesity and lack of exercise can contribute to heart and/or vascular disease and thus can also be the cause of erectile dysfunction.

Surgery or injuries affecting the pelvic area or spinal cord are another common reason for erectile dysfunction.

Recent studies revealed that up to 20% of erectile dysfunction cases happen due to psychological reasons. Depression, feeling stressed either from work or family issues, fatigue, being nervous because of previous bad sexual experiences, feeling self-conscious, thinking that your partner is reacting negatively to you, guilt, and anxiety can all lead to erectile dysfunction.

There are several ways to diagnose erectile dysfunction. The first step would be to have a physical examination. The doctor will check if your penis is sensitive enough to the touch which reflects if your nervous system is functioning properly, he/she will also check if you have any secondary sex characteristics such as enlarged breasts or excessive hair which can mean hormonal imbalance, another thing that might come up is the circulatory issues which can be discovered by checking your pulse. Your doctor will also look at your health history to see if you might have any diseases or are taking any medications that can potentially lead to erectile dysfunction.

There are certain tests for systemic diseases that can reveal erectile dysfunction. Among these tests are blood counts, lipid profile, urinalysis, and measurements of creatinine and liver enzymes.

To reveal the psychological causes of erectile dysfunction you would have go through an interview and a questionnaire. It is a good idea to have your partner participate in this process as well.

The treatment for erectile dysfunction depends on what the cause of it is. If it is caused by psychological factors your best option is counseling and/or sex therapy. This could be especially helpful if your partner participates.

If erectile dysfunction is caused by physical issues the most popular method of its treatment is prescription oral medications such as Viagra, Cialis or Levitra. All three of these medications work in the same way by enhancing the effects of chemicals responsible for relaxing the penis muscles, which results in natural increase of blood flow to the penis which in turn causes an erection to occur. There are certain side effects and incompatibilities with other medications so you should always consult with your doctor before taking these drugs.

Another common drug used in treating erectile dysfunction is alprostadil, which is a synthetic version of hormone prostaglandin E, which helps increase the blood flow and thus enables an erection. You can either inject alprostadil into the base or side of your penis or use a special disposable applicator to insert alprostadil suppository into the tip of your penis. The side effects of this method are pain, minor bleeding, or formation of fibrous tissue. The cost of injections can be pretty high therefore alprostadil is often mixed with other drugs to decrease the price and increase the effectiveness.
You can also use vacuum devices to manually create an erection to last long enough for you and your partner to have sex. The penis is inserted into a plastic tube with a pump attached to it. The pump sucks out the air and thus creates a vacuum that draws blood into the penis, causing it to become engorged. Once the penis is erect the tube is removed and a soft rubber ring is placed around the base of the penis to trap blood and sustain the erection. This method works best for men who are able to achieve at least partial erection.

Those men who suffer from erectile dysfunction due to surgery or injury can undergo vascular surgery. The goal of such surgery is to normalize the blood flow and allow erections to occur naturally. It may be very hard to find surgeons performing this procedure since it is still considered experimental. The side effects can include nerve damage and creation of scar tissue.

Penile implants involve surgical insertion of a silicon-covered flexible metal rod into both sides of the penis which keep the penis in a rigid state and allow the erection to occur whenever desired. This method is rather expensive and is usually not recommended unless all other methods have already been tried.

For those men whose erectile dysfunction is caused by hormonal imbalances testosterone replacement therapy may be an option.

Although all men experience difficulties with erection at some point, you can take measures to prevent this from happening – limit or avoid alcohol, smoking, and illegal drugs, exercise on a regular basis, reduce stress, get plenty of sleep, and see your doctor for regular checkups and screening tests. Most important, don’t let one episode of erectile dysfunction interfere with your sex life.