Erectile Dysfunction

Erectile dysfunction (also called impotence) is the inability of a man to achieve or maintain an erection to satisfy hi sexual needs or those of his partner. Most men suffer from erectile dysfunction at some point in their lives, usually when they reach their forties, but do not experience psychological problems.

Erectile Dysfunction – Complete or Brief

Some suffer from chronic and complete erectile dysfunction (impotence) or have only partial and brief erections. Frequent erectile dysfunction can give rise to emotional problems and relationship issues and this often leads to a loss of self-esteem. Erectile dysfunction has many causes, most of which can be treated. Contrary to popular belief, impotence is not an inevitable consequence of aging.

Incidence of Erectile Dysfunction

The incidence of impotence increases with age. Chronic erectile dysfunction affects about 5% of men in their forties and around 15 to 25% of men between the age of 40 and 65. Erectile dysfunction and temporary erection problems affect nearly 50% of men aged between 40 and 70.

Causes of Erectile Dysfunction

Diseases such as diabetes, kidney problems, alcoholism and atherosclerosis account for about 70% of chronic erectile dysfunction and psychological factors like stress, anxiety and depression are responsible for 10 and 20% of cases . Between 35 and 50% of men with diabetes suffer from erectile dysfunction.

What Happens During an Erection?

The physiological process of erection begins in the brain and therefore erectile dysfunction involves the nervous and vascular systems. Neurotransmitters in the brain (eg adrenaline, acetylcholine and nitric oxide) are examples of chemicals that trigger an erection. Physical or psychological stimulation (arousal) allows nerves to send messages to the vascular system, which in turn sends blood flow to the penis. Penile arteries carry blood to the erectile tissue and the corpora cavernosa, which become engorged  and stretch due to increased blood flow and blood pressure.

Because blood must stay in the penis to maintain an erection, the erectile tissues are surrounded by elastic fibrous tissue that contract to prevent blood from leaving the penis during erection. When the stimulation ends, or following ejaculation, pressure in the penis decreases, and the penis returns to its normal form.

What are the main causes of erectile dysfunction?

There are many physical and psychological factors underlying erectile dysfunction. The reduced blood flow to the penis and nerve damage are the most common physical causes.  The following health problems can be associated with erectile dysfunction:

• vascular disease
• Diabetes
• Certain medications
• Hormonal problems
• Neurological problems
• Pelvic trauma, surgery or radiotherapy
• Diseases of the fibula
• Blood loss
• Psychological problems

When a doctor suspects that psychological factors are involved in any type of sexual dysfunction, he will advise his patient to consult a sexologist. This may include individual sessions and couples. These sessions will help ease frustration and marital conflicts or tension caused by difficulties experienced in sexual life. They will also help to increase self-esteem, and this is something which is often overlooked by more aggressive methods of treating erectile dysfunction.