Introduction to Erectile Dysfunction

Erectile dysfunction, sometimes referred to as “impotence”, is the repeated inability to get or keep an erection firm enough for sexual intercourse. Other problems that interfere with sexual intercourse and reproduction are also sometimes called “impotence”, so the term “erectile dysfunction” is used to clarify the issue.

Erectile dysfunction can be present in the total inability to achieve erection, an unpredictable ability to achieve an erection, or a tendency to sustain erections only briefly. Due to these varieties of erectile dysfunction, it is sometimes difficult to define and even more difficult to estimate its incidence.

However, it is commonly understood that the incidence of  erectile dysfunction increases with age. A 5% of 40 year old men and between 15-25% of 65 year old men experience erectile dysfunction. In the older generations of men,  erectile dysfunction usually has a physical reason such as disease, injury, or side effects of drugs. Also, any disorder that might cause nerve damage or impairs blood circulation (including to the reproductive organs) have been known to cause  erectile dysfunction. Yet,  erectile dysfunction does not have to be an expected part of aging.  erectile dysfunction is treatable at any age and the numerous men who have sought help are returning to their normal sexual activity because of improved, successful treatments.

Anatomy of Erection

There are two chambers that run the length of the penis. These chambers are filled with a spongy tissue which contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The urethra runs along the underside of the chambers and carries urine and ejaculate from their originating organs to the outside.

The process of an erection can be categorized into four simple steps:

  1. Erection begins with a sensory or mental stimulation, or both.
  2. These impulses from the brain cause the muscles of the penis to relax, allowing blood to flood the spaces.
  3. The large quantity of blood creates considerable pressure and causes the penis to expand
  4. The blood is caught in the penis, sustaining an erection.

An erection is reversed when the muscles in the penis contract to stop the inflow of blood and open outflow channels, which decreases the pressure in the penis.

Causes of Erectile Dysfunction

Erectile dysfunction can be caused by either physical, chemical, or psychological factors.

  • Physical Factors-Any number of problems can occur when the required steps of an erection are disrupted. The most common cause of  erectile dysfunction is any damage to nerves, arteries, smooth muscles, and fibrous tissues which are often as a result of disease. The most common diseases which cause erectile dysfunction are diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurological disease. These 7 diseases account for about 70% of all erectile dysfunction cases. And 35-50% of men with diabetes experience erectile dysfunction, so you are not alone if you experience similar erectile dysfunction characteristics.
  • Chemical Factors- Many common medicines have been known to have a possibility of producing erectile dysfunction as a side effect. These various medicines tend to file under blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug).
  • Psychological Factors- 10-20% of erectile dysfunction cases are due to factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure. Some of these factors might have even been caused by the initial physical factor.

How is My Erectile Dysfunction Diagnosed?

Each diagnosis that Dr. Allen makes is unique and patient-specific to the problems and needs of the individual patient. Dr. Allen is able to do this by gathering information from a series of places. Listed below are some of the histories and tests Dr. Allen might need to cover before truly understanding your erectile dysfunction and how to best treat it.

  • Patient History- By obtaining and gathering different facets of your medical and sexual histories will help Dr. Allen to define the degree and nature of erectile dysfunction. By disclosing such personal information, Dr. Allen will be able to distinguish if your sexual activity is related to or distinct from problems relating to sexual desire, erection, ejaculation, or orgasm. Also, the chemical reaction of certain prescription or illegal drugs account for 25% of all erectile dysfunction cases, so make sure you are open and honest about any and all medical history.
  • Physical Examination- An exam may give clues to a systemic problem. For example Dr. Allen might find a problem in the nervous system if the penis is not sensitive to touch. A hormonal problem might be to blame if there are abnormal secondary sex characteristics such as hair pattern or breast enlargement. This would mean the endocrine system was involved. Dr. Allen might discover a circulatory problem which would not allow adequate blood flow into the penis in order to become erect.
  • Laboratory Tests- Testing for several systemic problems is used to measure and monitor various levels of hormones, enzymes, as well as blood cells in the body. These tests could verify problems with the endocrine system as they test blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes.

How is  Erectile Dysfunction Treated?

The treatment of erectile dysfunction usually proceeds from least to most invasive. Dr. Allen might have you follow some of the suggestions listed below, but regardless of what his page states, please always follow the medical advice and instructions given to you by the physician, Dr. Allen.

  1. Cutting back of any drugs with harmful side effects.
  2. Psychotherapy and behavior modifications- The goal is to decrease anxiety associated with intercourse.
  3. The use of drugs (oral or locally injected) and vacuum devices are usually the third steps in treating  erectile dysfunction.  The drugs Viagra, Levitra, and Cialis are the most popular and common oral medications for erectile dysfunction.   A mechanical vacuum device creates an erection by creating a vacuum which allows the penis to engorge and expand due to the increase of blood.

Erectile dysfunction is not uncommon.  Dr. Allen has gathered a lot of information and a multitude of experience dealing with  erectile dysfunction over the years. If you are having any of these signs or symptoms, or would just like to get a few answers for your questions, make an appointment with Dr. Allen today.  See this article for more information on erectile restoration.

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