Erectile Dysfunction – Physical or Psychological?

Understanding the Basics of Erectile Dysfunction – ED.

If you are having difficulty in having an erection, or sustaining one once it is achieved, and this is taking a toll on you and your relationship, then this article is to help you understand what you are going through and how to effectively solve this dreaded problem most men past through in their lives. Be of good cheer because it is estimated that almost all men who have this problem can overcome it. Overcome psychological erectile dysfunction.

Normal male sexual function generally starts with sexual desire or libido involving the stimulation of the brain, nerves, blood vessels and hormones, and the erection of the penis by becoming firm, the release of semen (ejaculation) and ends finally with having an orgasm. An erection is achieved when the muscles of a set of spongy tissues in the penis, namely the corpora cavernosa, relaxes to allow the inflow of blood into the spongy tissues resulting in the expansion and firmness of the penis. To sustain this erection, another set of muscles blocks the outflow of blood once an erection is achieved and this is the same with all ED, including Depression Impotence

impotency

When there is a disruption or impairment of any or more of these processes involved in achieving an erection as a result of several psychological, neurological, hormonal or vascular causes, this will lead to the inability of the man to achieve or maintain an erection that is sufficient for satisfactory sexual activity. This situation is what is generally referred to as male Impotency or ED.

ED is relatively a common problem affecting up to 30 million men of all ages in the United States alone and over 150 million men worldwide. However, according to The Mayo Clinic, “an occasional episode of Erectile Dysfunction is normal” but then states that “When erectile dysfunction proves to be a pattern or a persistent problem, however, it can interfere with a man’s self-image as well as his sexual life. It may also be a sign of a physical or emotional problem that requires treatment.”

Therefore, failure to achieve an erection less than 20 percent of the time is not unusual, and may not require any treatment. It is the failure to achieve an erection more than 50 percent of the time, which should generally be indicative of a problem and therefore requiring treatment.

Causes of Erectile Dysfunction

For most men the causes of ED can be due to a psychological, neurogenic, vascular or drug-induced factor, or a combination of these factors.

Psychological Causes of ED

This accounts for about 15-20% of most reported cases of ED. Common causes of Psychological erectile dysfunction include performance anxiety, work stress, and strained personal relationships or reduced attraction for his partner (which may not be associated with a relationship problem). Also, past sexual trauma, misconceptions about normal sexual functions, childhood sex abuse, and suppressed feelings about sexuality are possible causes of psychogenic erectile dysfunction.

Neurogenic Erectile Dysfunction

If there is a possible physical problem with the nervous system, this can lead to the development of ED. The male erection system depends on an intact nervous system to function; therefore any injury to the nervous system involved in erections may cause erectile dysfunction.

Diseases such as Parkinson’s disease, Alzheimer’s disease, stroke, or head injury can lead to erectile dysfunction by affecting the libido, or by preventing the initiation of the nerve impulses responsible for erections. Also men with a history of pelvic trauma, pelvic surgery such as radical prostatectomy, cystectomy or colectomy may have injury to the cavernous nerves that control erection. Peripheral neuropathy due to, for example, diabetes or excessive alcohol consumption may also affect some nerves as well as causing erectile dysfunction. This cause of erectile dysfunction accounts for about 10% to 15% of cases.

Endocrinologic/Hormonal Causes of ED

Diseases and conditions which decreases the level of circulating testosterone in the body, such as castration or hormonal therapy used to treat prostate cancer, will decrease libido and impair erections. Androgen and prolactin levels are of particular concern here as a high level of circulating prolactin causes inhibition of gonadotrophin releasing hormone which lowers the level of testosterone.

Vascular Causes of ED

High blood pressure, diabetes mellitus, hypertension and hyperlipidaemia are underlying causative factors for vascular impairment. These conditions lead to the partial or complete loss of the ability to not only achieve but also maintain an erection long enough for it to be useful to its owner and his partner. Also, high triglyceride and cholesterol, pelvic irradiation treatment of prostate, bladder and rectal cancers may damage blood vessels to the penis over time.

Drugs and Erectile Dysfunction

The usage of street drugs such cannabis, cocaine, amphetamines, and heroin can lead to decreased erectile function. Also certain anti-depressants or anti-psychotics have been associated with erectile dysfunction, especially those drugs that regulate serotonin, noradrenaline and dopamine. Excess alcohol intake has also been acknowledged to affect ED.

With regard to the causes of erectile dysfunction listed above, The Mayo Clinic has this to say: “The physical and nonphysical causes of erectile dysfunction commonly interact. For instance, a minor physical problem that slows sexual response may cause anxiety about attaining an erection. Then the anxiety can worsen your erectile dysfunction.”

This is a two-part article concluding with the Treatment of Erectile Dysfunction.

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