Since the discovery that the drug sildenafil – originally a heart drug – had an effect on men’s potency, there was a global awareness that erectile dysfunction (ED) is a very common medical condition ever since.
So many men who suffer a problem with their sexual performance are too reluctant to talk to their doctor, because of embarrassment and some take it as a shameful thing to discuss. Nevertheless, the recent breakthroughs in medicine have discovered numerous medical and psychological explanations for erectile dysfunction, including the likelihood of serious underlying ailments that it is important to manage, as well as various effective treatments.
Such potentially-embarrassing complaints are always discussed in private medical consultations, and not only is erectile dysfunction now more clearly understood, there is also often an effective solution for the condition. If you or someone close to you has a problem with getting or maintaining an erection, this article offers helpful information.
What is Erectile Dysfunction?
A man is considered to have ED when he has consistent difficulty in getting or maintaining a firm enough erection to be able to achieve intimate penetration.
As a matter of fact, most men may occasionally experience some difficulty with their male reproductive organ becoming hard or staying firm, but this is not habitually considered as a medical diagnosis of erectile dysfunction. This is only considered as a medical concern if satisfactory intimate performance has been impossible on a persistent number of instances over a period of time.
Generally speaking, there are 2 forms of erectile dysfunction that can impact men`s intimate life; it`s either medical or psychosocial!
Psychosocial refers to the emotional elements and its impact on man`s libido -desire for intimacy- such as stress and family conflicts. Medical conditions such as diabetes and hypertension are world-wide known killers of man`s potency, and they can also affect psychological wellbeing; that is, while the primary cause of erectile dysfunction is typically either medical or psychological, there is often an overlap between both.
Causes of Erectile Dysfunction
To understand the causes of erectile dysfunction, let`s first discuss briefly how an erection happens:
Relaxation of muscles (within the male reproductive organ and the walls of the arteries feeding it) allows blood to rush into the cylinder-shaped spongy tissue of the erection chambers, creating increased tissue pressure and an erection. Valves within the veins prevent the blood from flowing back out through the veins (which would cause a venous loss of pressure), and the resulting hardness persists until stimulation stops or ejaculation occurs.
This blood flow process is regulated by nervous and hormonal triggers activated when the brain is stimulated.
Accordingly, the normal mechanism of erection can be negatively impacted by any problem that compromises any of the normal physiological contributions necessary for an erection; blood flow, nerve supply, male hormones.
A. Medical Causes of Erectile Dysfunction
The most common medical causes for erectile dysfunction are those that impact the blood flow (vascular causes) as well as those that impact the nerve supply of the male reproductive organ. The commonest of all is Diabetes Mellitus with its associating process of atherosclerosis (narrowing or ‘clogging’ of arteries in the male reproductive organ, causes them to narrow and lose elasticity, thus restricting blood flow), as well as the associating neuropathy (damage to the nerves).
Other common medical problems that can negatively impact man`s ability to have a normal erectile function include:
- High blood pressure
- High cholesterol
- Obesity and metabolic syndrome (which are also risk factors for diabetes)
- Hormonal disorders including thyroid conditions and testosterone deficiency
- Structural abnormalities of the male reproductive organ (such as Peyronie`s disease)
- Surgical complications (e.g. radical prostatectomy and transurethral resection of the prostate)
- Certain medications to control high blood pressure (e.g. beta-blockers such as Tenormin)
B. Psychological causes of erectile dysfunction
Less common than medical causes, psychological factors impacting man`s ability to get or maintain a satisfactory erection have always been present, with such factors ranging from treatable mental health illnesses, to everyday emotional states that most men experience at some time or another.
Some of the common psychological causes can be listed here:
- Depression. It can cause a loss of interest in sex (lower libido) as well as erectile dysfunction.
- Stress. It can be job-related, money-related, or the result of marital problems, among other factors.
- Guilt. A man may feel guilty that he is not able to please and satisfy his partner.
- Performance anxiety. Repeated feelings of doubt and failure, in which worrying about getting a satisfactory erection can cause a closed circuit of anxiety.
- Low self-esteem. This can be due to previous incidents of erectile dysfunction (thus a feeling of inadequacy).
- Other marital relationship problems such as pressure from wife (for example, because expectations make the intimacy a task instead of a pleasure)
All men at one time or another may experience some form of ED. Only if the problem becomes persistent — occurs more than half the time — or becomes a source of distress for you, should you get concerned and consider help.
The first step in addressing your concern about ED is to be honest with yourself, and your trusted doctor. Once ED has been brought out into the open, coping with it as you go through treatment will be easier and less stressful. Communication is essential for a successful diagnosis and treatment.
Whichever route you take, keep in mind that ED is a very common condition that’s also very treatable.
I wish you everlasting health,
Prof. Ralf Herwig
Consultant of Urology & Man’s Health
University of Vienna Austria