Erectile Dysfunction (Impotence) |
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What Is Erectile Dysfunction (ED)?
Men usually unable to achieve
erection in erectile dysfunction and there might be inconsistent erection or
sustain brief erection. About 15 million to 30 million men are affected by
erectile dysfunction according to National Institute of Health. It was thought
to be due to physiological problems in the past but now it is clear that 80 to
90 percent impotence is due to physical problems which are related to blood
supply of penis. There is improvement in diagnostic and treatment of erectile
dysfunction.
What Are the Risk Factors for ED?
The level of circulation
testosterone decreases as men age which obstructs normal erection. The low
level of testosterone can cause erectile dysfunction and it is major
contributing factor in men who risks of ED. Different medical problems like
hypertension, vascular disease, high level of blood cholesterol and diabetes
are other risk factors for ED. ED can also be due to smoking and other alcohol
abuse.
What Are the Causes of Erectile Dysfunction?
The symptom of ED can be due to many
disorders and diseases. Some major causes of erectile dysfunction are:
- premature ejaculation (PE).
The inability to maintain erection long enough for mutual satisfaction
leads to immature ejaculation which is divided into primary and secondary
forms. The learned behavior of primary ejaculation begins when male first
becomes sexually active impotence. The duration of intercourse grows
progressively shorter after years of normal ejaculation in secondary
ejaculation. The physical causes involving penile arteries, veins or both
are some causes of secondary premature ejaculation.
- performance anxiety.
The stress or anxiety can cause performance anxiety which is form of
physiological impotence.
- depression.
Depression is an important cause of psychological impotence. There can be
erectile failure due to some antidepressant medications.
- organic impotence.
Penile arteries, veins or both involved in organic impotence which is the
most common cause of impotence in older men. IT can be due to
arteriosclerosis or hardening of arteries. Being overweight, lack of
exercise, cigarette smoking and high blood pressure which are controllable
factors for arteriosclerosis can cause erectile failure before progressing
the effect of heart. There can be vascular problem when veins are the
cause due to venous leak.
- venous leak.
There can be venous leak if blood can not prevent from leaving the penis
during erection. It can be due to result from damage to the veins of the
penis or congenital.
- diabetes.
Impotence can be due to diabetes. 35 percent of the people with diabetes
have impotence problems. The arteries can become severe hard and premature
ejaculation in diabetes. Peripheral neuropathy, with involvement of the
nerves controlling erections, is commonly seen in persons with diabetes.
- neurologic causes.
the impotence can be due to many neurological problems. There can be
damage to pelvic operations causing ED with diabetes, heavy metal
poisoning, spinal cord injuries, chronic alcoholism and multiple
sclerosis.
- hormone-induced impotence.
the impotence can be due to some hormonal abnormalities like steroid abuse
by body builders, increased prolactin, too much or too little thyroid
hormones and hormones administered for prostate cancer.
- peyronie's disease.
the scarring of erectile tissues is rare due to peyronie’s disease which
may result in curvature of penis. The sexual function can be impaired by
this condition.
How
is ED Diagnosed?
The men with ED will require simple
medical history, physical examination and few blood tests. The extensive
testing is not required before beginning treatment.
Diagnostic procedures for ED may
include the following:
- patient medical/sexual history – some conditions which
lead to impotence and distinguished among problems with ejaculation,
orgasm, erection and sexual desire;
- physical examination – to find systematic problems
like:
- Nervous system problems involved in penis don’t
respond as expected certain touching;
- Some Secondary sex characteristics like hair pattern
can point to hormonal problem which are involved in endocrine system;
- Circulatory problems could be indicated by an
aneurysm;
- Unusual characteristics of the penis itself can be the
basis of the impotence.
- lab tests - to diagnose impotence for urinalysis, lipid
profile, blood counts and measurements of liver enzymes and creatinine. Measurement
of testosterone in blood can give information about the problems with
endocrine system when sexual desire is low;
- psychosocial examination - to reveal different psychological
factors. The expectations can also be determined from the sexual partner during
sexual intercourse.
Treatment
for ED:
The treatment for erectile
dysfunction is determined by physicians on the basis of:
- your age, overall health, and medical history;
- extent of the disease;
- tolerance for specific procedures, therapies and medications;
- expectations for the course of the disease;
- your opinion or preference.
The treatments available for ED are following:
- medical treatments
- sildenafil citrate (Viagra®)
ED treatment can be done with Viagra which is taken orally. It can affect
the response to sexual stimulation and does not directly cause penile
erection.
- vardenafil citrate (Levitra®)
Men can improve sexual function quickly with help of Levitra. It is good
for men of all ages, diabetes patients and in men who have taken surgical
procedures called radical prostatectomy.
- tadalafil citrate (Cialis®)
Cialis stays longer in the body than other medications. The erection
occurs within 30 minutes in men who take this medication and effects of
this medication may last up to 36 hours.
Men need
to follow general precautions before taking medications for ED. Men should not
use Viagra, Levitra or Cialis if they are taking medications containing
nitrates and nitroglycerin. There can be decrease in blood pressure if you take
nitrates with these medications. The alpha blockers should also not be used by
men with these medications as it can cause hypertension. Men should tell
complete medical and sexual history to their doctor including over the counter
medications. The men should not take these medications if they have stomach
ulcers, heart attack or stroke and bleeding disorder.
These
medications might not be good for men with medical conditions causing sustained
erection like multiple myeloma, and sickle cell anemia. These medications
should not be taken by men if they have liver disease or a disease of retina
like retinitis pigmentosa or muscular degeneration.
The women
and children should not use these medications. There can be some side effects
of these medications in elderly men.
- hormone replacement therapy
There can be increase in mood, energy, increase in muscle mass and weight,
and heighten sexual interest in older men with testosterone replacement
therapy. Testosterone supplements should not be used by men with normal
testosterone levels due to risks of prostate enlargement and side effects.
This therapy is available in oral form and as skin patch.
- penile implants.
There are
three types of implants used to treat ED:
- hydraulic pump – It consists on a pump and two
cylinders which are placed within the erection chambers of the penis.
There can be erection due to release of saline solution; it can also
remove the solution to deflate the penis.
- prosthesis – It consists of two semi-rigid but
bendable rods are placed within the erection chambers of the penis which are
responsible for erect or non-erect position.
- interlocking soft plastic blocks - these are placed
within the erection chambers of the penis and can be inflated or deflated
using a cable that passes through them.
The penile
implant failure can be due to infection and is treatable with antibiotics. The
infected implant can be replaced by new plant. The implants can be considered
only when other treatment proved failure.
Coping
with ED:
There can be strain on couple with
erectile dysfunction. Men normally avoid sexual situations due to emotional
pain and cause their partners feel rejected or inadequate. Men should
communicate openly with their partners in this situation. They need to seek
treatments for erectile dysfunction. There can be barrier for seeking treatment
due to lack of communication. There can be profound effects on men due to loss
of erectile capacity. The ED can be treated safely and effectively which is
good news.
Many men prevent seeking treatment
for ED simply because they feel embarrass. Impotence can be sometimes due to
underlying problem like heart disease, liver disease, diabetes and other
medical conditions.
The impotence can be forewarning
symptoms for progressive coronary disease therefore men should tell their
doctors about symptoms of ED. The doctors can find problems by asking directly
about sexual function or with questionnaire check up to find health conditions.
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