Erectile dysfunction, often referred to as ED or impotence, is a sexual dysfunction. It is a condition humans undergo that is characterized by the lack of ability to achieve or maintain an erection during sexual activities. Erections are developed through a hydraulic process undergone by penis. This occurs during sexual arousal, in which blood flows into sponge-like erectile tissues in the penile chamber. The penis swells with and traps blood to elongate and stiffened the penis for sexual intercourse. Sexual arousal initiates this process by cerebral transmutations from the brain to the nerves of the penis.
Organic Causes of Impotence:
- Cardiovascular Disease
- Neurological Problems
- Hormonal Insufficiencies
- Drug Side Effects
Psychological impotence is an occurrence that causes erection or penetration failure due to underlying psychosomatic reason as opposed to physical incapacity. Essentially, thoughts or feelings are leading the determining factor of the impotence. This is a bit more rare than ED linked to physical causes, but is treatable in some cases. Masculine self-image and relationship difficulties are some of the severe psychological consequences of erectile dysfunction.
Signs and Symptoms of ED
The diagnosis of clinical erectile dysfunction is based upon specific characteristics. This is indicated by a consistent recurrence of an inability to achieve or maintain an erection. Typically, nocturnal penile tumescence (night time erections) indicate that the penis is functioning on a physical level. Diabetes mellitus, which causes neuropathy, is one of the leading factors that cause erectile dysfunction.
Causes of Erectile Dysfunction
- Cavernosal Disorders – Peyronie’s disease
- Drugs – Most commonly anti-depressants (SSRIs) and nicotine
- Neurogenic Disorders
- Kidney Failure
- Psychological Causes – Mental disorders, stress and performance anxiety
- Disease – Most commonly diabetes mellitus and multiple sclerosis (MS)
- Lifestyle – Smoking causes impotence due to arterial narrowing
- Aging – Men are 4 times more likely to develop ED in their 60s than their 40s
Diagnosing erectile dysfunction cannot be done via a formal test, like that of a disease. However, blood work can be involved to narrow down the cause by excluding potential underlying disease. Impotence may be related to:
- General Poor Physical Health
- Poor Dietary Habits
- Disease – Cardiovascular, coronary artery and peripheral vascular disease
Through physical examination, it is possible to diagnose impotence. One typical preliminary investigation includes some simple questions. For example, if a patient has never had an erection is most likely to be a physiological condition. If a patient has sometimes had an erection, the issues could be physical or mental. Currently, the diagnostic and statistical manual of mental disease (DSM-IV) has a section including impotence.
Current Testing Procedures Include:
- Duplex Ultrasound
- Penile Nerves Function
- Nocturnal Penile Tumescence (NPT)
- Penile Biothesiometry
- Dynamic Infusion Cavernosometry (DICC)
- Corpus Cavernosmetry
- Magnetic Resonance Angiography
Treatments of erectile dysfunction is determined by the underlying cause. Exercise, such as aerobic exercise, is recommended in midlife is effective in the prevention of erectile dysfunction. For smokers, significant improvements is verified once cessation of tobacco smoking occurs. First-line treatments include oral pharmacotherapy and vacuum erections. This is followed by penile implants and drug injections.