Erectile dysfunction (ED) occurs when a man is incapable of having an erection firm enough for sexual intercourse. While occasional inability to have an erection is considered normal, frequent or prolonged difficulty to get or keep an erection, along with reduced sexual desire, is classified as erectile dysfunction. The condition often leads to an unsatisfactory sex life and may result in other problems such as low self-esteem, embarrassment, anxiety, depression and relationship problems.
Causes of Erectile Dysfunction
Erectile dysfunction is caused by physiological (physical) factors, psychological (mental) factors, or a combination of both. Generally, psychological problems are more likely to cause ED in younger men while physical problems are often the cause in older men.
The major psychological causes of ED are:
1. Depression
2. Stress at work or home
3. Worries about sexual performance with a new sexual partner or new situation
4. Unresolved relationship conflicts
5. Fatigue
6. Temporary issues such as loss of a job, studying for exams or financial concerns
7. Deep-rooted negative attitudes about sex, intimacy, or strict religious beliefs
8. History of sexual abuse
For a man to have a normal functioning erection, it helps to have self-confidence and arousing behavior or thoughts while being free of anxiety. If at least one of these conditions is chronically absent, a man’s inability to perform sexually can become a lasting issue.
The major physiological causes of ED are:
1. Diseases such as diabetes, liver disease, kidney disease, multiple sclerosis, high blood pressure, atherosclerosis, chronic alcoholism, neurological disease, and vascular disease.
2. Drugs for treating hypertension (high blood pressure), depression, anxiety and psychosis, and regular consumption of alcohol, marijuana, cigarettes and other recreational drugs.
3. Injuries such as spinal cord injury and nervous system injury (like pinched nerves due to slipped vertebral discs).
4. Atherosclerosis (hardening of arteries due to a buildup of fat/cholesterol deposits inside arterial walls).
5. Hormonal imbalances such as low testosterone levels or due to diseases of the pituitary, adrenal or thyroid gland.
6. Cigarette smoking.
The main risk factors for erectile dysfunction are:
1. Age over 50
2. Lack of exercise
3. Diabetes (high blood sugar)
4. High cholesterol
5. High blood pressure
6. Smoking
7. Obesity
8. Cardiovascular disease
9. Drug and alcohol abuse
10. Cancer radiation therapy
11. Prostate surgery
12. Medicines such as antihistamines, antidepressants and blood pressure drugs.
Men spending a lot of time bicycling are also at risk of ED because bicycle seats can damage the nerves and blood vessels involved in erections.
Treatments for Erectile Dysfunction
The treatment for erectile dysfunction depends on the cause. Often, the urologist will suggest a change of certain habits or recommend that you stop smoking, using drugs or stop alcohol use. The urologist may also recommend treatments for emotional problems, depression, performance anxiety or relationship conflicts.
The most common treatments for ED are:
1. Oral medications (erection pills) such as Cialis (tadalafil), Levitra (vardenafil), Stendra (avanafil) and Viagra (sildenafil).
2. Counseling and psychotherapy if your ED is related to psychological problems.
3. Injection of drugs in the penis: If oral medications fail, the urologist may recommend the injection of Caverject (alprostadil) in the penis. Suppositories of the same drug may also be placed in the urethra as an alternative to injection.
4. Vacuum erection devices: These devices create a low-pressure vacuum around erectile tissue, resulting in erection.
5. Testosterone replacement therapy may be recommended for a man with below-normal testosterone hormone.
6. Surgery: Surgery is usually recommended by a urologist when other treatments fail to improve the ED. The operation is performed to either fix blood vessel issues or for penile implants (like inserting penile prostheses, bendable implants or inflatable implants).
7. Penile arterial revascularization: A surgery for men under 45 years of age who have pelvic or penile injuries, helping to fix blocked or injured blood vessels in the penis.
8. Venous ligation surgery: Aimed at improving the firmness of the penis, this surgery corrects leaky penile vessels that cause softening of the penis during an erection. This technique is rarely used for correcting ED due to its low success rate of around 5%.
Are you having difficulties with sexual performance? Talking with an experienced urologist at St Pete Urology might help you solve the problem. For more information on dealing with erectile dysfunction, visit the website of St Pete Urology in St Petersburg, Florida.
