Erectile dysfunction or ED is the failure to attain and sustain an erection required for sexual intercourse. This condition cannot be deemed as normal at any age and must be distinguished from other problems like not having a sexual desire or trouble with ejaculation.
Occasional failure to attain an ejection is quite common in men and it can be due to many reasons like over drinking or extreme tiredness. If the problem occurs less than 20% of the time, it is normal and no treatment is required. If the failure to get an erection is more than 50% then it indicates a problem and needs treatment.
Three things must occur to achieve an erection. The nerves moving to the penis must be functioning appropriately, the blood flow to the penis should be sufficient and there should be a stimulus from the brain. If there is some interference with any condition, a complete erection will not occur.
Symptoms
Causes of Erectile Dysfunction
The problems of achieving an erection are complex and they can be psychological or physical.The physical reason behind Erectile Dysfunction is linked to interruption to the series of events causing an erection. The chain takes into account nerve impulses in the brain, spine, and penis and muscle response. The problem in sequence has an effect on the arteries, muscles, and neighboring tissues of the penis, and this problem occurs due to a disease. The diseases that cause ED are:
Kidney disease: Kidney disease results in certain chemical changes that influence hormones, blood circulation and energy. These changes decreases a person's sex desire and drive .The treatment of kidney ailments can cause ED.
Vascular disease: Vascular diseases hinder the flow of blood to penis and are responsible for about 70% of physical reason behind ED. These diseases affect the blood vessels. They include atherosclerosis which is hardening of the arteries, high blood pressure and unmanaged cholesterol.
Diabetes: Diabetes can destroy the nerve and artery that can make the erection quite difficult. Around 40-50% men with diabetes suffer from ED.
Prostate cancer: The treatment options of prostate cancer that is radiation, hormonal problems, or surgery can cause erectile dysfunction.
Neurological Problems: The nerves in the body play an important role in achieving and upholding an erection. ED is particularly common in men with problems like multiple sclerosis (MS), heart disease, Alzheimer's disease and spinal cord injuries. These ailments interrupt the spread of nerve impulses between the brain and the penis.
Other causes are:
Surgery: The surgery that is done to treat prostate or bladder cancer needs the exclusion of nerves around the affected area leading to ED. Certain surgeries result in temporary ED while in those where a permanent damage is done in permanent ED.
Injury: Any type of injury to the pelvis, bladder or spinal cord can cause ED.
Hormonal discrepancy: At times, imbalance of hormones like thyroid hormone, prolactin, or testosterone can change the sexual stimulation rate in men. They can occur as a result of certain health ailments like tumor and they lead to erectile dysfunction.
Venous leak: It occurs as a result of an injury. Here the veins in the penis cannot stop the blood from leaving the penis in an erection causing inability to maintain erection. It occurs as a result of an injury.
Prescription Drugs: there are many prescription drugs that can cause ED.Psychological factors are accountable for about 20%-40% of all cases of ED. The most common psychological causes of ED include stress, anxiety, guilt and low self-esteem
Diagnosis of Erectile Dysfunction
The doctor may need different tests to diagnose the problem and find its cause. Prior to any test, the doctor will evaluate your medical history and carry out a complete physical examination. The doctor will also ask questions about your personal and sexual history. The doctor will check the medications that you are currently using. It’ll include prescription drugs, over-the-counter drugs, dietary and herbal supplements and illegal drugs.
The doctor will ask you about any previous psychological problems involving stress, nervousness and depression. You need to tell about the frequency, quality, and length of erections you have had. The doctor will also ask few questions to sexual partner as she might provide better insight of the problem you are facing.
After the physical examination, the doctor will get the following tests done:
Complete blood count (CBC): It is used to check for the presence of anemia. Anemia can cause fatigue, which can lead to ED.
Liver and kidney function tests: These blood tests are used to check whether ED is due to proper functioning of kidneys or liver
Lipid profile: This blood test measures the lipid level of blood. This is done to check whether atherosclerosis is affecting blood circulation in the penis.
Thyroid function test: Certain thyroid hormones work is to control the release of sex hormones. A lack of these hormones can cause ED.
Blood hormone: Testosterone or prolactin levels in the blood are checked for any imbalance leading to ED.
Urinalysis: Analysis of urine can provide a wealth of information, including information on protein, sugar, and testosterone levels. Abnormal measurements of these substances can indicate diabetes, kidney disease, or a testosterone deficiency, all of which can cause ED.
Duplex ultrasound: It is the most accurate manner to diagnose ED. An ultrasound is used to assess blood flow and look for symptoms of venous leak or tissue scarring. A drug that stimulates erection is used prior to this test.
Nocturnal penile tumescence (NPT): This test checks a man's erectile function during the sleep. Generally, a man has 5-6 erections while sleeping. If they are absent, it points towards some problem with nerve function or circulation to the penis.
Penile biothesiometry: In this test, electromagnetic vibration is used to discover sensitivity as well as nerve function. A reduced sensitivity might point towards nerve damage.
Treatment
There are basically three oral drugs to treat erectile dysfunction: Cialis, Levitra, and Viagra. They function by enhancing the blood flow into the penis. It allows the person to attain and erection when sexually stimulated. Levitra works for a longer time as compared to Viagra. They show effect in about 30 minutes. The effects lasts for about 5 hours with Levitra and with Viagra, they last for about 4 hours. Cialis starts working in 15 minutes and the effects last for about 36 hours.A regular exercise schedule and a well balanced diet can also treat the ED to some extent.