Erectile dysfunction is the repeated inability to get or keep an erection firm enough for sexual intercourse. Impotence is used as a general term for erectile dysfunction, lack of sexual desire, problems with ejaculation and orgasm. Erectile dysfunction is a taboo theme in our world. Several hundred million men have this problem. Erectile dysfunction can be a sign of a health condition which needs treatment and it may be heart disease or poorly controlled or not yet diagnosed diabetes. There may be psychological factors also for this problem.

The brain, nerves, muscles, blood vessels, hormones and emotions play a vital role in male’s sexual arousal and this process is very complex. Problems with any of these can cause erectile dysfunction. Physical and psychological problems can also cause erectile dysfunction or even worsen it.

The physical causes include:

• Low testosterone
• High blood pressure
• Clogged blood vessels
• Diabetes
• Heart disease
• Overweight and obesity
• Excess alcohol
• Smoking or other tobacco use
• Drugs abuse
• Many prescription medications
• Damage to nerves, arteries, smooth muscles and fibrous tissues
• Diseases like multiple sclerosis, Parkinson’s disease, prostate cancer, Peyronie’s disease etc.
• Injuries or surgeries which affect the pelvic area and the spinal cord
• Prolonged bicycling

The psychological causes of erectile dysfunction include:

• Stress
• Fatigue
• Depression, anxiety or other mental diseases
• Relationship problems
• Poor communication with partner leading to misunderstandings and problems

Side effects of prescribed medicines can cause erectile dysfunction. More than 100 mostly used drugs have this side effect. These prescribed medicines include antidepressants, antihistamines, medicines to treat high blood pressure, pain killers or medicines to treat prostate cancer.

The illegal drugs like, amphetamines, party drugs, barbiturates, cocaine, cannabis, heroin and others can cause erectile dysfunction.

Erectile dysfunction is a serious problem which can cause an unsatisfactory sex life for the couple, marital or relationship problems, stress, anxiety and low self-esteem. Another big problem is the inability to get his wife pregnant.

Erectile Dysfunction is treatable at all ages.

If you have problems it is better to contact your family doctor and he can send you to a urology specialist. Physical examination, blood test, urine analysis, ultrasound and overnight erection test are the usual procedures to begin with.

The treatments must proceed from least to most invasive. Quitting smoking, avoiding excess alcohol, losing excess weight and increasing physical activity may help some men to regain sexual function. If erectile dysfunction is a side effect from your medicine consult with your doctor to change that medicine. This is possible with high blood pressure drugs.

The treatments include:

• Psychotherapy – is used to decrease or remove the anxiety associated with love making. Here the patient’s wife can help for the gradual development of intimacy and stimulation.
• Drug therapy – the drugs can be taken orally, injected directly into the penis or inserted into the urethra at the tip of the penis. We all know well about Viagra, Levitra and Cialis. The tablet can be taken an hour before sexual activity. These drugs enhance the effects of nitric oxide, a chemical which relaxes smooth muscles in the penis during sexual stimulation and allows increased blood flow. Only one tablet should be used in a day. All these have side effects and so the doctor must be consulted before taking. Persons using medicines to decrease blood pressure must be very careful, otherwise it can cause sudden drop in blood pressure which can be fatal. Testosterone, the male sex hormone is often ineffective and may cause liver damage. Many men achieve stronger erections by injecting drugs into the penis. These drugs widen the blood vessels, thus a good blood supply to penis. There is a system available to insert a pellet of alprostadil into the urethra and the erection begins within 8 to 10 minutes and may last 30 to 60 minutes. Intensive research is going on in this sector to develop better medicines.
• Vacuum Devices – mechanical vacuum devises can cause erection by creating a partial vacuum which draws more blood into the penis and expanding it.
• Surgery – very invasive, consult with your doctor.

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