Erectile Dysfunction Definition:

Erectile dysfunction (ED) is defined as the inability to develop or maintain an erection rigid enough for satisfactory sexual performance. Although the incidence of erectile dysfunction increases with age, ED affects both young and older men with some statistics reporting up to 50% of men between the ages of 40 and 70.

Erectile dysfunction can have severe psychological consequences on the men it affects. Men suffering from erectile dysfunction often feel a poor sense of well being and can have negative consequences on their self esteem and feeling of worth. Additionally, erectile dysfunction can negatively affect a man's relationship with his partner by inhibiting his ability to make an physical and emotional connection. Unfortunately, although discussions regarding erectile dysfunction have become less taboo in recent years, cultural stigmas continue to serve as impediments for many men who would benefit from simple and effective medical or surgical interventions to resolve their erectile dysfunction.

Men suffering from ED will often retract from their relationships and can lead to irreparable damage leading to separation or divorce. Erectile dysfunction may cause some men to avoid social interactions and live a more solitary existence for fear of embarrassment associated with their sexual shortcomings.

Restoring normal erectile function can have tremendous consequences on a man's self esteem and emotional stability and can even save some failing relationships. The principal objective in erectile dysfunction treatment is to restore a man's confidence and emotional distress that has resulted from the physical manifestation of erectile dysfunction.

Normal Erectile Function:

Normal penile erection or tumescence is caused by the hydraulic effect of blood as in enters and fills the two sponge like bodies of the penis called the corpus cavernosum. The bodies are surrounded by a dense fibrous sheath or tunica that when filled with blood results in a rigid erection. The initiation of this process can be caused by signals transmitted from the brain as a result of sexual thought or directly though tactile stimulation.

Erectile Dysfunction Causes:

Normal penile function is a complex and dynamic process and dysfunction can occur for many different reasons. More often then not, the etiology for ED is multifactorial. The two main categories causing ED include psyschogenic erectile dysfunction and organic erectile dysfunction although often the cause is both concurrently.

Psychogenic erectile dysfunction occurs and a result of conditions that affect a man's emotional state such as depression, stress at work or anxiety as a result of marital conflicts or financial burdens. These conditions inhibit a man's ability to feel sexual and transmit the necessary neurological signal from the brain to the penis during attempted intercourse. During times of relaxation such as during vacation, when these stressors are lifted, men will often notice improved libido and sexual performance.

Performance anxiety falls under the category of psychogenic erectile dysfunction and is a major factor affecting a man's ability to perform sexually. Once a man has an experience when he is not able to perform during a sexual encounter it may lead to tremendous fear and anxiety during a subsequent sexual experience. This fear leads to the secretion of adrenaline causing a physiological response in the body similar to that which would occur if a person was being attacked or for some people when giving a public speech. When the body has entered the classic "fight or flight" mode initiated from fear the body tightens blood vessels and shunts blood away from organs such as the stomach and penis towards the muscles of the arms and legs as well as the brain so that the body is prepared to "fight or run" as opposed to engage in a sexual act. This real physiologic response caused by psychological fear compounds itself during each subsequent sexual encounter and becomes a vicious cycle for patients. Simply advising these patients to relax and don't think about their fear is not helpful and these patients benefit tremendously from a medical intervention typically by prescribing a PDE-5 inhibitor such as Viagra, Levitra or Cialis.

Organic caused of impotence include those medical conditions which affect the blood flow to the penis or nerve signal to the penis resulting in erection. Medical conditions such as high blood pressure, diabetes, high cholesterol, peripheral vascular disease, and smoking can result in narrowing of the small arteries supplying blood flow to the penis during erection resulting in inability to fill the spongy erectile bodies sufficiently to result in a rigid erection. In fact, erectile dysfunction in a middle aged man may be the first sign of vascular disease and should prompt a full cardiovascular work up. Erectile dysfunction as a result of damage to the nerve signal to the penis can occur secondary to pelvic surgery such as from colon cancer or prostate cancer. It can additionally be caused by external beam radiation to the pelvis or brachytherapy (prostate seeding). Diabetes can cause damage to the delicate nerves delivering the critical signal to the penis to initiate an erection.
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