Erectile dysfunction (ED), sometimes called
as impotent, is the inability to get or keep an erection firm enough during
sexual intercourse. The condition has become highly visible in recent years,
but that doesn’t make it any more welcome for the 5% to 15% of Australian men
whose sex lives are affected.
The disorder can be occur at any age, but
is more common in people over age 70, according to the Australian Academy of
Family Physicians. In middle aged men, ED can signal risk of a ischemic heart
disease.
Since sexual arousal is a complex process
involving various hormones, emotions, nerves, muscles, blood vessels and the
brain. Any malfunction of these can lead to ED. Stress, exhaustion and
psychological issues have higher contribution, and anxiety over maintaining an erection can actually make it harder to attain. In short, any condition which
impairs blood flow to the penis can lead to erectile dysfunction.
Aging is a large part of erectile
dysfunction, but according to the AAFP, ED can also be caused by:
• Heart
disease or clogged blood vessels
• High
blood pressure
• Diabetes
• Obesity
• Metabolic
syndrome, a grouping of conditions that include high blood pressure,
cholesterol and insulin levels and excess fat around the waist
• Multiple
sclerosis
• Parkinson's
disease
• Low
testosterone
• Peyronie's
disease, which is scar tissue inside the penis
• Certain
prescription drugs, such as antidepressants and high blood pressure medication
• Smoking
• Alcoholism
or drug addiction
• Prostate
treatments
• Brain
or spinal cord injuries
• Stroke
• Radiation
therapy to the testicles
• Certain
types of surgery on the prostate or bladder
The vast majority of erectile dysfunction
cases are caused by systemic disease, according to the National Institutes of
Health (NIH), while due to drug side effects account for 25 percent.
Low libido, which is a low interest in
having sex, should not be confused with ED. People often have drops in
testosterone levels as they age, often called male menopause or "menopause,".
Diagnosis & tests
Doctors have to rule out various systemic
causes of erectile dysfunction with a physical examination. Breast enlargement
in men (gynecomastia), for instance, can indicate hormonal issues, while
decreased pulses in the wrists or ankles can suggest blood flow problems,
according to the NIH.
Beyond that, several tests can lead to an
erectile dysfunction diagnosis, these include:
• Blood
tests to check cholesterol, testosterone and glucose levels
• Urinalysis
to look for signs of diabetes mellitus
• Ultrasound
scan to check blood flow to the penis
• Overnight
erection test to monitor erections during sleep. Physical causes of erectile
dysfunction can be ruled out if the patient has an involuntary erection while
sleeping.
Medication & treatment
A variety of pharmacological and
non-pharmacological treatments are available for erectile dysfunction, from
simple pills to complex surgeries. The cause and severity of erectile
dysfunction will determine which treatment is recommended, according to the
AAFP. Some treatments can have significant side effects.
Psychotherapy is a main option to treat
anxiety-related erectile dysfunction. The partner can help in the process of
developing intimacy and stimulation.
Oral medications successfully treat impotent in many people. These include sildenafil (Viagra),
tadalafil (Cialis), vardenafil (Levitra) and avanafil (Stendra). Each works by
enhancing nitric oxide level, which relaxes muscles in the penis and increases
blood flow to it.
However, these medications should not be
taken by people who take blood anti-coagulants, high blood pressure medicines,
nitrate drugs for ischemic heart disease, or alpha-blockers for prostatic
enlargement. The combination of erectile dysfunction pills with these other
prescription medications can cause a sudden, drop in systemic blood pressure.
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