An Overview of Erectile Dysfunction
Erectile dysfunction can be defined as not being
able to get and/or keep an erection which enables intercourse to take place. Erection
problems occur in any age group: they happen to all men at some point, but for a
man not be able to get an erection every time he wishes to have sex is uncommon
under forty years of age. However, over this age, there is an increasing
occurrence of erection problems, so that about six men in ten over the age of 75
have erection problems. The main reason for this is that vascular problems -
blocked penile arteries or leaking veins - occur very much more frequently as
men age, and although ageing itself does not cause erectile
dysfunction, the physiological changes associated with ageing certainly do. The
occurrence of erection problems occurs about ten years earlier on average in
diabetic men.
Of course, most men need to be physically
stimulated to become erect as they get older, erections become less hard, loss
of erection becomes more common, sexual intercourse takes place less often, and
the refractory period increases. Indeed, older men may not ejaculate every time
they have sex. This does not mean that men are less satisfied with sex as they
get older, and it remains an important part of a man's self-esteem. The main
causes of erection problems are smoking,
hypertension (high blood pressure) and other cardiovascular problems. In
addition, diabetes and abuse of alcohol are all potential causes of erection
problems.
Physiology of an erection
A non-erect penis is caused by the action of sympathetic innervation of the smooth muscle
found in
the corpora cavernosa and the penile arteries. Sensory stimulation and tactile
stimulation to the penis will both increase parasympathetic activity and this
will result in the penile smooth muscles relaxing, a process which is mediated
by
activation of the Nitric Oxide / cyclic GMP biochemical system with a
concomitant increase in blood flow
into and along the penile arteries. This increase in penile blood flow results
in an increase in volume of the penile chambers, and an increase in the intracavernous pressure:
this increase in pressure in turn causes the penile veins to be compressed
against the fibrous capsule (the tunica albuginea) around the internal chambers
of the penis, thereby blocking the venous
outflow. This is the veno-occlusive mechanism.
Causes of erectile dysfunction (origin of
erection problems)
The main points to note are these: if you have erectile dysfunction
you should seek help. We know that most men do not, for those men who have
participated in research on treatment are found to have had the problem for more
than a year before they are identified. Smoking,
high blood pressure, and circulatory or cardiovascular problems, the presence of diabetes and alcohol abuse all
add to the potential for erection problems. Erection problems need to be distinguished from
penile curvature or Peyronie's disease.
Two categories of
erection problems are commonly recognized:
• erectile dysfunction with clinical manifestations which imply a physical cause
• erectile dysfunction clinical manifestations which imply a psychological cause.
Physical causes of erection problems
When a man shows the following signs, it may well
be that his erection problems have a physical cause:
- the onset of his erection problem is
gradual and there is no obvious cause
-
the onset is sudden and there is an obvious
cause such as spinal injury or prostate surgery
-
if his erection problems occur all the time
-
if a man is over 65 years of age
-
orgasm and ejaculation usually
maintained
- erectile dysfunction risk factors
present - such as hyperlipidemia, hypertension, diabetes.
Psychological causes of erection problems
The psychological causes of erection problems
include the following symptoms
- there is sudden onset without injury in
a young man
- the erection problems only occur in
certain situations or with certain partners
- there are relationship or interpersonal
problems
- the man is under forty years of age
- orgasm and ejaculation patterns have
changed
- there are no relevant risk factors such
as diabetes or hyperlipidemia.
Diagnosis of erectile dysfunction
The story of your experience usually reveals
everything behind your erectile dysfunction. First of all, you are not alone -
the number of men with erection problems is astounding - up to one man in ten at
any time. There are many approaches to treatment and so most men can be treated
successfully. There is a service which offers free online advice on this
website:
Erectile dysfunction and treatment
Remember that you may have other problems like premature ejaculation or
Peyronie's disease, which need to be treated first. Furthermore, if you have
diabetes, hypertension, multiple sclerosis, psychiatric issues for which you are
being medicated, high cholesterol, or any other physical condition, then you
should also seek treatment for those conditions.
In general, the relative importance of physical and psychological factors is not
hard to establish. When erection problems are physically based, there is often a gradual and
continuing loss of erection, although a man's sex drive continues to be strong,
and his capacity to ejaculate continues unchanged. If you're in the position of
being assessed for erection problems, an assessment of your general health and
indeed your psychological health is crucial to working out why you have
developed an erection problem -
hypertension and diabetes are obvious and common causative factors.
Hyperlipidemia, depression, and other psychological issues need to be
investigated, as does the possibility of hypogonadism and drugs
which can can cause some form of erectile dysfunction - these include major
tranquillizers, antidepressants, antihypertensives, beta blockers, some ACE
inhibitors, vasodilators,
diuretics, and some lipid lowering drugs.
Continued here: summary of erection
problems
[ Home ] [ Background information on erection problems ] [ Erection problems ] [ Erection problems in young men ] [ Erection problems in young men (2) ] [ Overview of erection problems ] [ Overview of erection problems continued ] [ Erection problems - tests for erection problems ] [ Erectile dysfunction and diabetes ] [ Erectile dysfunction: summary ]
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