Since the discovery that the drug sildenafil (Viagra) – originally a heart drug – had an effect on men’s penile erections, most people have become aware of erectile dysfunction as a medical condition.
Men who have a problem with their sexual performance may be reluctant to talk to their doctor, seeing it as an embarrassing issue. However, modern medicine has revealed numerous medical and psychological explanations for erectile dysfunction, including the possibility of serious underlying conditions that it is important to address.
Doctors are used to dealing with potentially embarrassing issues in private consultations, and not only is erectile dysfunction now more clearly understood, there is also often a solution for the condition. If you or someone close to you has a problem with getting or maintaining an erection, this article offers helpful information.
What is erectile dysfunction?
A man is considered to have erectile dysfunction when he has regular difficulty in getting or maintaining a firm enough erection to be able to achieve sexual penetration, or which interferes with non-penetrative sexual activity.
Most men have occasionally experienced some difficulty with their penis becoming hard or staying firm, but this is not normally cause for a diagnosis of erectile dysfunction. This condition is only considered a concern if satisfactory sexual performance has been impossible on a persistent number of occasions for some time.
Broadly, two forms of erectile dysfunction can affect men’s sex lives – the main cause is either medical or psychosocial.
Here, psychosocial refers to the psychological effects – including the effects of social relationships – on sexual performance. Medical conditions can also affect psychological wellbeing, meaning that, while the primary cause of sexual impotence is typically either medical or psychological, there is often overlap between the two.
Erectile dysfunction used to be known more widely as ‘impotence’ before the causes became better understood and successful treatments came into use. Impotence is a term that is still in use, however, although it can be seen as pejorative.
Physical causes of erectile dysfunction
It is always worth consulting a physician about persistent erection problems as the cause of erectile dysfunction could be any one of a number of serious medical conditions. Whether the cause is simple or serious, a proper diagnosis can help to address any underlying medical issues and can help resolve sexual difficulties.
The following list summarizes many of the most common physical/organic causes of erectile dysfunction:
- Heart disease and narrowing of blood vessels
- High blood pressure
- High cholesterol
- Obesity and metabolic syndrome (which are also risk factors for diabetes)
- Parkinson’s disease
- Multiple sclerosis
- Hormonal disorders including thyroid conditions and testosterone deficiency (hypogonadism)
- Structural/anatomical disorder of the penis, such as Peyronie disease
- Smoking, alcoholism and substance abuse, including cocaine use
- Surgical complications (surgeries include radical prostatectomy, cystectomy, transurethral resection of the prostate and rectal cancer surgery)
- Injuries in the pelvic area or spinal cord
- Radiation therapy to the pelvic region.
- Treatments for prostate disease
Psychological causes of erectile dysfunction
In rare cases, erectile dysfunction has always been present, with a man never having achieved an erection. This is called primary ED, with the cause almost always psychological if there is no obvious anatomical deformity or physiological issue that could be causative; such psychological factors can include:
- Fear of intimacy
- Severe anxiety.
Most cases of erectile dysfunction are ‘secondary’, i.e. erectile function has been normal, but is now problematic. Causes of a new and persistent problem are usually physical; less commonly, psychological factors cause or contribute to erectile dysfunction, with such factors ranging from treatable mental health illnesses, to everyday emotional states that most people experience at some time or another.
Some psychological causes can also cause temporary erection problems that would not be classed as erectile dysfunction, while others may be related to a particular place, time, or partner.
The psychological causes include:
- Depression – which can cause a loss of interest in sex (lower libido) as well as erectile dysfunction – and other mental health disorders
- Stress, fear, anxiety, or anger
- Stress can include work, financial, and emotional problems
- Performance anxiety – repeated feelings of doubt and failure in which worrying about getting an erection can cause a cycle of anxiety that prevents one from being possible
- Poor communication with a sex partner
- Other relationship problems such as pressure from a sex partner – for example, because expectations make sex a task instead of a pleasure.
Drug treatments for erectile dysfunction
The first option for the treatment of erectile dysfunction – once the condition has been established as a persistent problem, rather than a one-off or temporary one – is a group of drugs called PDE-5 (phosphodiesterase-5) inhibitors.
All except one of these pills are taken 30 to 60 minutes before sex – the best known being the blue-colored pill sildenafil (Viagra). Other options are vardenafil (Levitra), tadalafil (taken as a once-daily pill; Cialis), and avanafil (Stendra).
PDE-5 inhibitors must be prescribed by a doctor, who may check for heart conditions and use of other medications. For example, a cardiologist may need to advise on the best timing for the use of erectile dysfunction drugs in men who keep nitrate drugs for rare occasions of angina chest pain caused by coronary artery disease.
There is a range of potential adverse side-effects associated with PDE-5 inhibitors, including flushing, visual abnormalities, hearing loss, dyspepsia and headache.
Less commonly used drug options include prostaglandin E1, which is applied locally, into the penis (either injected into it or inserted down the opening into the urethra, as with the suppository alprostadil, brand named Muse). Most men prefer a pill, however, so these locally acting drugs tend to be reserved for men who cannot take oral treatment.
Other sure methods to combat premature ejaculation include:
- Eating watermelons
- Kegel Exercises
- The stop-and-stop method
- Focusing on pleasuring the lady more
- Breathing deeply while having sex
- Allowing the lady to be on top
- Using desensitizer sprays or creams
- Using condoms.
Author: Akwesi Osei
An avid reader and writer who has written articles for HypeNationGh, LoudsoundGh and akwesiosei.wordpress.com.
Currently the blogger and owner of The Health Bro