Erectile dysfunction is the most commonly reported sexual problem in men. It affects as many as 30 million men in India. Erectile Dysfunction is defined as trouble getting or keeping an erection firm enough for sexual activity.
Though it is not uncommon for a man to have some problems with erections from time to time, ED that is progressive or happens routinely with sex is not normal, and it should be treated.
ED can happen:
- Usually when blood flow in the penis is limited or nerves are damaged
- Due to stress, depression, or emotional reasons
- As an early warning of a more serious illness, like atherosclerosis(blockage in the arteries), heart disease, high blood pressure, or high blood sugar from Diabetes
- Finding the main cause of your ED will help treat the problem better
How do Erections Work?
During sexual arousal, nerves release chemicals that raise the blood pressure allowing blood to flow into the penis. Blood flows into the erection chambers of the penis, which are soft muscle tissue called the corpus cavernosum.
During an erection, the spongy tissues relax and hold blood in the chambers. This creates blood pressure in the chambers which makes the penis erect and firm. After a man has ejaculated, the second set of nerve receptors activate, causing the muscular tissues in the penis to contract and return blood to the man’s circulation and the erection wears off.
When you are not sexually aroused, the penis is soft and flaccid. Men may notice that penis size varies with heat, cold, or worry; this is normal and represents the balance of blood going in and out of the penis.
Erectile Dysfunction makes it difficult to get or keep an erection that is firm enough to have sex. ED can be a major cardiovascular disease warning sign, indicating that blockages are building up in a man’s vascular system. ED also causes:
- Low self-esteem
- Distress for the man and his partner
When erectile dysfunction is affecting a man’s well-being or relationships, it needs treatment. Treatment is aimed at correcting or improving erectile function, supporting circulatory health, and improving the man’s quality of life.
ED can be the result of health problems, emotional problems, or both. Some known risk factors are:
- Men over 50 years of age
- Having high blood sugar levels
- Having high blood pressure
- Having cardiovascular disease
- Having high cholesterol
- Using drugs or drinking too much alcohol
- Being obese
- Lack of exercise
Although erectile dysfunction becomes more common as men age, aging does not always result in erectile dysfunction. Some men remain sexually functional until their 80s. Erectile dysfunction can be an early sign of a more serious health problem so finding and treating the primary cause of ED is an important first step.
Physical Causes of ED
The physical causes of erectile dysfunction occur when:
- There is an insufficient blood supply to the penis.
- Many health problems can affect blood flow to the penis, such as hardened arteries, high blood sugar, heart disease, and smoking.
- The penis is not able to contain blood during arousal.
- If blood does not remain in the penis, a man cannot maintain an erection.
- Nerve signals from the brain or spinal cord cannot reach the penis.
- Certain diseases, injuries, or operations in the pelvic area can affect the penile nerves.
- Diabetes can lead to small vessel disease or damage the penile nerves.
- Cancer treatments near the pelvis can affect erectile functionality
- Surgery in the lower abdomen or pelvis can cause ED.
- Drugs used to treat other health problems can adversely affect erectile function.
- Patients should discuss the side effects of medication with their family doctor.
Emotional Causes of ED
Normal sex requires body and mind to work together. Emotional or relationship problems can also cause erectile dysfunction.
Some emotional problems that can cause ED are:
- Relationship conflicts
- Stress at home or work
- Stress from social, cultural, or religious conflicts
- Concern about sex performance
Erectile dysfunction treatment begins with taking care of your heart and vascular health. Your doctor can tell you risk factors that can be changed or improved.
You may be asked to change certain food and lifestyle and stop using drugs or alcohol. They may also offer you alternatives to the medicines you are taking.
Your doctor may also suggest therapy for emotional problems, anxiety or depression, due to previous erectile dysfunction problems.
The following treatments are available to help Treat erectile dysfunction directly.
Oftentimes, non-invasive treatments are tried first. Most of the popular erectile dysfunction treatments work well and are safe. However, it is helpful to ask your doctor about the side effects that could result from each option:
- Testosterone therapy
- Penile Injections
- Intraurethral medication
- Vacuum Erection Devices
- Penile Implants
- Surgery to repair penile artery damage if younger men with a history of severe pelvic trauma.
Oral Drugs are the first line of treatment for ED. Drugs known as PDE type 5 inhibitors increase blood flow to the penis. These are the only oral agents approved for treatment in the United States by the Food and Drug Administration. Some of the effective PDE5 inhibitor drugs are:
For best results, men with ED take these pills about an hour before sexual activity. The drugs require intact nerve function in the penis. PDE5 inhibitors improve normal erectile responses helping the blood flow into the penis. Use these drugs as directed. 7 out of 10 men do well and can achieve erections. Response rates of oral medications are lower for Diabetics and cancer patients.
If you are taking medicines containing nitrates, you should not take any ED medications. Always speak with your doctor before using a PDE5 inhibitor to learn how it might affect your health.
Usually, the side effects of PDE5 inhibitors are mild and often last for a few hours. The most common side effects are:
- Stuffy nose
- Facial flushing
- Muscle aches
These effects are related to the effects of PDE5 inhibitors on other tissues in the body, which means that they increase blood flow to your penis while affecting other vascular tissues in your body. These are not allergic reactions.
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