WHAT IS ERECTILE DYSFUNCTION?
Erectile dysfunction is a medical disorder which is marked by the disability to attain and maintain an erection of the penis during sexual activity. The causes, most of the time are medical but psychological factors could also be responsible for it. Usually erectile dysfunction occurs because of any underlying medical condition affecting the blood flow to the penis which may include diabetes, cardiovascular disease, hormonal deficiencies, neurological problems and side effect of medicines. Other factors may include unhealthy habits such as alcohol and smoking.
Penile erection occurs due to the effect of blood rush and the persistence of the same in a sponge like bodies within the penis and most of the times this is the result of sexual arousal.
FACTS AND FIGURES ABOUT ERECTILE DYSFUNCTION
As many as 30 million men in the U.S are affected by erectile dysfunction.
According to the national institute of health, 70% cases of erectile dysfunction in America are caused due to underlying conditions such as kidney problems.
A man’s chances of developing erectile dysfunction increases by 50% if he is a smoker.
According to the National Institute of Health, 43% of American men with erectile dysfunction also suffers from diabetes.
Around 25% of men in the U.S above 60 experience ED.
In the United States, 16 million men take Viagra.
15% of the ED cases are a result of psychological conditions such as anxiety, guilt or stress.
Around 40% men over 40 have ED, according to the national institute of health.
Almost 200 prescribed drugs are known to contribute or cause ED.
ERECTILE DYSFUNCTION SYMPTOMS
The most common erectile dysfunction symptoms are as follows:
Trouble in getting an erection
Trouble in maintaining an erection
Reduced sexual desire
ERECTILE DYSFUNCTION RISK FACTORS
Risk factor No. 1- AGE
According to the available data around 4% of men in their 50s experience complete inability to stay put; this percentage of men in their 60s are 17% and 47% for men over 75 years of age. But the question that often arises is that if erectile dysfunction is an unavoidable part of ageing? The answer to this question is no. although it is more common in older men, but it is not a consequence of ageing. Instead, it’s directly related to diseases that may occur during ageing.
Risk factor No. 2- RACE
Erectile dysfunction is more common in some minority groups when compared to others. According to a study, Hispanic and black men are more likely to develop ED than white men. However the reasons are attributed to socioeconomic status rather than to race.
Risk factor No. 3- HEALTH STATUS
According to The National Institute of Diabetes and Digestive and Kidney Diseases, 70% of the erectile dysfunction cases occurs due to some underlying disease. Kidney disease, diabetes, alcoholism, atherosclerosis, vascular diseases, multiple sclerosis and neurological diseases could be the reason.
Risk factor No. 4- MENTAL ISSUES
In most cases of erectile dysfunction there is some physical problem to blame. But in 20 to 10 % of cases the underlying issue may be related to psychological problems. Anxiety, stress, guilt and depression may lead to erectile dysfunction and it may also be in performance related anxiety and other sex related issues.
Risk factor No. 5- WEIGHT
According to a study published in the journal of sexual medicine when obese men with type 2 diabetes were kept on a low calorie diet for eight weeks, not only the weight of a number of men decreased but their sexual desire and erectile function also improved.
Risk factors No. 6- LIFESTYLE
Many of your daily lifestyle habits such as drinking, smoking and drugs can adversely affect the penile function. The biggest cause of erectile dysfunction in men under the age of 40 is smoking. The reason behind it is for maintaining erection healthy blood flow is a must and the nicotine from the cigarette causes blood vessels to contract thus restricting the blood flow.
Risk factor No. 7- MEDICINE
A lot of prescribed medicines are also known to cause erectile dysfunction. Drugs such as antihistamines, antidepressants, diuretics, appetite suppressants, anticonvulsives and antipsychotics may lead to erectile dysfunction as one of their side effects. In the United States 25% of the total ED cases are a result of a side effect from a drug.
ERECTILE DYSFUNCTION CAUSES
There are various causes both physical and psychological which may lead to erectile dysfunction. The main erectile dysfunction causes are as follows:
Atherosclerosis can be one of the potent causes for erectile dysfunction. In this condition, the wall of the arteries starts to thicken up thus narrowing them and making them lose their elasticity and restricting blood flow. The first ones to get affected by atherosclerosis are the smaller arteries of the penis. As even the slightest contraction in these arteries can affect the blood circulation.
In the early stages of atherosclerosis the arteries taking blood to the penis stop dilating properly, thus preventing the blood from filling up the penis and letting it become hard.
The disadvantage of atherosclerosis is that it reduces the ability to get an erection. But this does have a positive side to it as it can be an early sign of arterial disease.
Another cardiovascular risk factor that can cause erectile dysfunction is hypertension. According to the American heart association high blood pressure may lead to erectile dysfunction as the arteries throughout the vascular system gets damaged, thus impairing the flow of blood which is required for attaining and maintaining an erection.
PHYSICAL CAUSES OF ERECTIE DYSFUNCTION
If you are facing persistent problems in getting an erection it is always better to consult a doctor as soon as possible. Erectile dysfunction could occur due to several serious underlying problems.
The following is the list of most common organic/physical causes of erectile dysfunction:
Heart disease and thinning of blood vessels.
High blood pressure
Hormonal syndromes such as testosterone deficiency and thyroid
Alcoholism, smoking and substance abuse
Anatomical/structural disorder of the penis
Treatments for prostate disorder
Injuries in the spinal cord or the pelvic area
Radiation therapy to the pelvic area
Several prescribed medicines or drugs are also one of the biggest causes of erectile dysfunction. Some of such medications are mentioned below:
Medicine’s to control high blood pressure
Diuretics (some of them)
Medicines that affect the central nervous system, this includes amphetamines and some sleeping pills
Antidepressants, which includes monoamine oxidase inhibitors (MAOs), tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs)
Few cancer drugs, including chemotherapeutic agents
Peptic ulcer medicine, cimetidine
Treatments for prostate, which also includes treatments for cancer and also for enlarged prostate (benign prostatic hypertrophy). Anti-androgen drugs (drugs used to counteract the effect of androgens i.e. male hormones) may also lead to erectile dysfunction.
PYSCHOLOGICAL CAUSES OF ERECTILE DYSFUNCTION
Out of the total cases of erectile dysfunction 10-20% of the cases occur due to psychological factors. Often an underlying physical cause is responsible for it. The psychological factors may arise due to a sexual trauma or childhood abuse. The most common psychological factors that may cause erectile dysfunction are as follows:
Stress- Any type of stress whether money related or job related may lead to erectile dysfunction.
Guilt- Performance related guilt could be another potential psychological cause.
Anxiety- A man dealing with ED becomes overly conscious of himself. This can further lead to performance anxiety and also sexual failure.
Low self-esteem- This could happen due to the feeling of inadequacy due to prior failure or the effect of other concerns which are not related to sexual performance.
Indifference- This may be the outcome of increasing age, side effect of medications and loss of interest in sex or relationship dilemmas.
Depression- It is one of the most common causes of ED which affects a person both psychologically and physically. Antidepressants may also lead to erectile dysfunction.
CAN RIDING A BICYCLE CAUSE ERCTILE DYSFUNCTION?
According to some research men who regularly cycle for prolonged hours are at a higher risk of erectile dysfunction. Other health issues such as prostate cancer and infertility are also at a high risk.
But a recent study showed that there is no connection between cycling and developing erectile dysfunction. But it does suggest a link between long biking hours and prostate cancer.
The lead author, however, said that “men should not worry about the research because the overall benefits of cycling outweigh these unproven concerns.”
He also added that, “Men should cycle as much as they did before. The benefits for your heart, lungs, whole body, and mental health are much more important.”
PROSTATE DISEASE- A POTENTIAL CAUSE?
Prostate cancer treatment may lead to erectile dysfunction, though the cancer does not cause the problem. The procedure of removing cancer involves the risk of causing erectile dysfunction- even when the surgery is performed by the best surgeons and nerves are spared. Radiation therapy for prostate cancer may also lead to erectile dysfunction.
This happens because of the distress caused to the delicate blood vessels and nerves that are needed for an erection. As the blood vessels and nerves heal, the ability of having erections is returned.
Treatment of benign or non-cancerous prostate disease may also lead to erectile dysfunction.
TESTS AND DIAGNOSIS FOR ERECTILE DYSFUNCTION
Before considering a diagnosis of erectile dysfunction that requires treatment, a physician will look for symptoms that have hung on for at least three months. Once it is confirmed the doctor will move on to the next step of further examination. The postage stamp test is one very common test in order to check if the underlying cause of ED is medical or psychological. This test looks out for the occurrence of night time erections- men usually hold three to five a night- by checking if the stamps applied around the penile area are still intact or snapped off.
Men suffering from psychogenic ED generally have regular erections while sleeping. On the other hand, such erections do not occur if the underlying reason is organic. There are some other tests such as snap- gauge test and the potent test that can help the physician to determine the cause and help you with the further treatment accordingly.
It is best to talk to your doctor about any erection problems as it could be the earliest sign of atherosclerotic disease, i.e. thinning of the arteries which will eventually lead to heart diseases.
WHAT THE DOCTOR WILL EXAMINE?
After acknowledging the various causes of erectile dysfunction, the doctor will prescribe several blood tests to check for diabetes, heart problems and low testosterone, along with other things. He will also ask several questions with regard to the patient’s past history. The physician will also perform a physical examination, along with the genitals.
The questions will help the doctor to look out for any possible cause in patients past. This may include checking for alcohol and herbal products, smoking, prescription drugs, pelvic surgery and trauma.
The medical records of the patient are checked for high blood pressure or diabetes. The doctor would also like to dismiss atherosclerosis and the symptoms of neurological, vascular, hormonal and psychological disorders.
The patient is also checked for the symptoms and signs of depression. The consultation also involves extraction of personal information such as their relationship status, current emotional events and sexual intimacy with their partner.
ERECTILE DYSFUNCTION TREATMENT AND CURE
Now that you are aware of the causes of ED, let’s have a look at the erectile dysfunction treatment and cures available.
ERECTILE DYSFUNCTION DRUGS
Once the condition has been recognized as a tenacious problem rather than a short term or temporary one, the primary option available for erectile dysfunction cure is a group of drugs called PDE-5 (phosphodiesterase-5) inhibitors.
PDE- 5 inhibitors are not over the counter medicine and hence must be prescribed by a doctor, after checking for heart conditions and the use of other drugs. There is an array of possible serious side effects associated with PDE-5 inhibitors, which includes visual abnormalities, flushing, dyspepsia, hearing loss and headache.
Another less common erectile dysfunction drug is Prostaglandin E1 which when applied into the penis, helps with getting an erection. Though this drug is reserved for men who cannot take oral medication.
Men who are not eager or do not want to use drug treatments or if the treatments are not working for them, then vacuum erection devices can be useful. Vacuum erection device is a mechanical device to cure erectile dysfunction. These pumps create a vacuum which in turn draws blood to the penis making it erect and hard. These pumps come with a separate fitted compression ring to maintain the erection.
Some of the issues that are common with penile pumps are:
If the ring is left for too long it may cause tissue damage.
Bruising of penis.
Coldness and numbness of the tip of penis.
Implants- Men who did not have any luck with drugs and other treatments, for them this is one of the last options available. These mechanical implants are placed surgically in the penis and works. The implant is completely concealed within the body and looks very natural all the time and is activated by a discharge valve, which fills the implant with fluid.
Getting implants is a decision that you should take enough time to think about. As it may have side effects and risks associated with it.
The possibility of contracting an infection is always there.
If the mechanism of the device failed, another surgery is required to rectify it.
Also, there are chances of penile shortening.
When the device is removed afterwards, the effectiveness of other treatments may also reduce.
Vascular surgery is yet another surgical option available for getting the erectile disorder corrected. This surgery involves the correction of some blood vessels which are defected.
There is one more option, arterial reconstructive surgery, which is limited to only very few cases of ED. It is an option available only for men who have recently developed erectile dysfunction as a result of focal arterial occlusion and also when there are not enough evidence of any vascular disease.
ERECTILE DYSFUNCTION EXERCISES
Exercising works wonders for our body in general. But there are also exercises that are great to increase your sexual stamina. Furthermore, there are certain erectile dysfunction exercises that might be helpful in treating the disorder.
1. Kegel exercises-
This exercise involves your pelvic floor muscles. These muscles can be easily located by contracting your penis or vagina, the same way you do to stop the flow of urine when you have to. Firming up the pelvic floor muscles is very important for both men and women in order to overcome sexual issues.
To start with the exercise, contract your pelvic floor muscle, and hold it for 5 seconds, then relax. Repeat. Contract, hold and release. Contract, hold and release. Do this exercise for at least 20-25 times thrice a day.
2. Aerobic exercises-
To combat erectile dysfunction you need to work up your other muscles as well and not just the pelvic floor muscles. According to a study published in the American journal of cardiology aerobic exercises can help with the improvement of erectile dysfunction.
In the absence of aerobics exercises the other muscles of your body may become tired and it might affect your performance during the intimate act. These exercises will build up your lower back, chest, abs, legs, arms and butts.
The cause of erectile dysfunction often times are the restricted flow of blood. Diabetes, obesity, vascular disease and high cholesterol can affect the blood flow and may lead to erectile dysfunction. Adding these exercises to your daily routine may improve your complete health and visible improvement can be seen with respect to ED.
Just by adding 30 minutes of brisk walking a day, thrice a week would be enough to improve your cardiovascular health and benefit your erectile dysfunction.
Pushups can also be a great addition to increase your abs, lower back, shoulders, chest, arms, legs and buttocks.
NATURAL REMEDIES FOR ERECTILE DYSFUNCTION
Apart from the medical procedures or drugs, there are some natural remedies that are proven to be helpful in treating ED. Such as:
Amino acid L- arginine occurs naturally in our food which enhances the body’s ability to produce nitric oxide, a compound that aids erection by expanding the blood vessels. The effectiveness of L- arginine for erectile dysfunction have generated mixed results from various studies. According to trial a published in the online journal BJU International in the year 1999, L- arginine when consumed in high doses can help with erectile dysfunction. But only those men can benefit from it who are dealing with abnormal nitric oxide metabolism, like the kind of associated with cardiovascular disease. According to another study which was published in 2003 in the Journal of sex and marital therapy, men who were suffering from ED saw major progress in their sexual activity after consuming L- arginine combined with pine extract.
Korean red ginseng is a plant that grows in Asia and has been utilized for several years by the natives to treat sex related issues, especially erectile dysfunction in men. It is known by various names such as Chinese ginseng, Asian ginseng or Panax ginseng. Although ginseng is little expensive as the plant needs to grow for at least five years before it can be utilized.
Various studies have been performed to know the benefits of ginseng to men suffering from erectile dysfunction. In one such study that took place 2002, 45 men with erectile dysfunction benefited from the use of the herb. Though experts are still not sure of how ginseng might help with erectile dysfunction.
Horny Goat Weed
For years, herbs like horny goat weed and the similar ones have been used for treating sexual dysfunction. The reason behind it is that it contains a Viagra like compound called icariin which in turn helps with erectile dysfunction.
Weird as it may sound, but watermelon can help with erectile dysfunction. The fruit contains high concentration of an amino acid, Citrulline which is found to be effective for improving the blood flow to the penis. According to a study performed in 2011, men who were suffering from mild ED, benefited from the supplement and their erectile functions were improved to a satisfactory level.
MYTHS ASSOCIATED WITH ERECTILE DYSFUNCTION
Like any other medical condition, there are several myths associated with erectile dysfunction as well.
Myth no. 1- ED occurs when you start losing interest in your partner
The majority of times for ED occurs due to psychological factors. But sometimes it may occur when you are not attracted to your spouse/partner or any disturbances in the relationship. “The trouble starts with a biological reason, which can lead to confidence issues, avoiding sex, fear of failure, and then avoiding your partner”, explains Alan W. Shindel, MD, clinical instructor and fellow Andrology at the University of California at San Francisco.
Myth no. 2- tight under wears can cause ED
There is no study or research to prove that tight underwear can cause erectile dysfunction. However, it may add to the risk of infertility, as keeping the testicles too close to the body may increase their temperature which leads to depletion in sperm production.
Myth no. 3- ED is an inevitable part of aging
It is not a normal part of the process of ageing but it is more common in older men. Diseases like arthritis and heart related increase in likelihood with age and so does erectile dysfunction. It can also be a warning for any underlying illness such as cardiovascular disease. The penis being a vascular organ gets affected, by any condition that restricts the flow of blood.
Myth no. 4- The best treatment for ED is oral medications
Oral medications do not work for everyone. And even before prescribing oral medications the doctors usually recommend several lifestyle changes such as losing weight and quitting smoking. Then the doctor will identify the potential medications that might be causing ED. The doctor may prescribe oral medications to increase the blood flow to the penis.
Myth no. 5- It affects only older men
Older men have higher chances of developing ED when compared to younger men. But such problems may occur in men of any age. Younger men with high blood pressure, diabetes or cardiovascular problems are at a relatively higher risk.
Myth no. 6- Cycling cannot cause erectile dysfunction
“When you ride a bike most of your body weight is on the crotch, which may cause damage by crushing endothelial cells”, says Irwin Goldstein, MD, clinical professor of surgery at the university of California.
Myth no. 7- It is only an emotional issue
Earlier people had a common notion that erectile dysfunction occurred solely because of psychological factors. But the scenario has changed today as doctors and experts consider psychological factors to be one of the root causes for ED but they also agree that underlying problems such as high blood pressure, diabetes and kidney disease could also be a potential cause. Side effects of certain medicines may also be the reason. These physical factors may also add to emotional factors.