Erectile dysfunction, or impotence (from the Latin “impotens” – “impotent”) is an integral part of the problem of sexual dysfunction. It’s the continuing inability to achieve and maintain erection at the necessary level to ensure a full sexual act.
What causes erectile dysfunction
There are the reasons why ED occurs:
- Psychogenic causes. The basis of psychogenic erectile dysfunction is stress, overwork, depression, some phobias, deviations and psychological traumas. Under the influence of psychological factors, the cerebral cortex negatively affects the mechanism of erection. In particular, it can have a direct inhibitory effect, which reduces erection. In addition, the level of adrenaline and noradrenaline increases under the influence of stress factors, which also adversely affects erection.
- Artery diseases. Arteriogenic erectile dysfunction occurs due to vascular lesions. They include atherosclerosis, some injuries of the penis, congenital anomalies of the penis vessels, diabetes mellitus, hypertension, smoking (due to which the vessels deteriorate) and other pathologies. As a rule, in such situations dystrophic changes occur in the cavernous tissues. Irreversible processes develop in the cavernous tissues in the absence of timely treatment.
- Disorders of venous origin. In this case, erectile dysfunction in a man develops due to a violation of the veno-occlusive mechanism.
- Cavernous tissue diseases. Impotence happens because of cavernous insufficiency. Changes of innervation and blood supply of cavernous bodies are possible, which leads to the deterioration of potency.
- Nervous system disorders. It is one of the main reasons that cause erectile dysfunction. In this case, erectile dysfunction happens on the background of various diseases of the brain and spinal cord. Peripheral nerve damage is also one of the causes. For example, this can occur during injuries or surgery when the nerve endings that serve the penis are affected.
- Anatomical disorders. This pathology is related to a violation of the anatomical structure of the penis For example, impotence can begin because of an evident curvature of the penis. Erectile dysfunction is also caused by fibrosis of the cavernous bodies, which is most often related to injuries and surgical interventions.
- Hormonal causes. The dilation of the penis vessels occurs due to a specific enzyme that is responsible for the synthesis of nitric oxide. This enzyme is dependent on the male sex hormones. The less testosterone, the less activity of this enzyme, which, accordingly, leads to deterioration of erection. In addition, low content of testosterone leads to increased storage of fat, particularly in the cavernous bodies. It also leads to the dystrophy of smooth muscle cells, which results in violation of venoocclusive mechanism. The libido also depends on the level of testosterone in a man’s blood, which undoubtedly affects the quality of erection.
- Age-related changes. With aging, the organism experinces natural changes: the elasticity of blood vessels deteriorates, the level of testosterone and the sensitivity of the nervous system decrease. However, it is worthwhile to clearly separate the natural age-related changes and the effects of chronic diseases that often affect the elderly. So, if a man does not suffer from serious chronic diseases, then even at 80 he can live a normal sex life.
- ED can be caused by medications. Some drugs inhibit the production of male sex hormones. Among these medicines are some narcotic drugs, as well as drugs that reduce the function of the cerebral cortex.
Erectile dysfunction: which age is dangerous?
An independent risk factor for erectile dysfunction is aging. The leading causes of erectile dysfunction during aging are age-dependent decrease in testosterone levels, vascular pathologies and chronic infectious diseases of the urogenital sphere. Sexual disorders progress with aging: in the age group of men 50–60 years of age, the number of patients with ED is 10%, and after 80 years it is already 80%.
When does erectile dysfunction start?
According to impotence statistics, approximately 20% of young people under the age of 30 suffer from impotence. What causes ED in 30 years of age? The main cause of sexual dysfunction in this age group is psychological problems. The first sexual experience affects the quality of potency, and it may be unsuccessful. After such sex, fear of failure in the future takes place, and the guy at a young age tries in every way to avoid the sexual intercourse
Psychological assistance at a young age is the basis of erectile dysfunction therapy. Guys are advised to consult a professional psychologist or psychotherapist.
Drug therapy may also be used. If the cause of impotence in a man of 20 years was a psychological trauma, drug treatment based on the placebo effect should be prescribed.
Statistics show that approximately 48% of patients under the age of 45 have erectile dysfunction. Bad habits are one of the main causes of impotence. Tobacco smoke components and alcohol do a lot of harm to the vessels. As a result, the blood supply to the penis suffers, and the penis cannot come to an erect state.
Sedentary lifestyle leads to stagnation of blood in the pelvic organs. As a result, the blood supply to the penis is decreased, the vessels lose their elasticity, and the valve apparatus becomes unusable. Therefore, the erection does not occur.
In order to get your male power back, you should eliminate stress, bad habits and sedentary lifestyle. It is recommended to relax regularly and try to get as many positive emotions as possible. If necessary, visit a psychologist.
More than half of men over the age of 50 suffer from ED. It’s caused by wearing out the male body and appearing of various diseases. There are several stages in the treatment:
- comprehensive diagnosis of the whole organism;
- taking hormonal drugs that will lead to the normalization of the balance of hormones in the body;
- prescribing antibiotics if necessary;
- treatment of accompanying diseases.
How is ED diagnosed?
What are erectile dysfunction symptoms?
You should pay attention to this problem when the following symptoms occur:
- insufficient strength of morning erections or lack thereof;
- the inability to perform the penetration due to insufficient tension of the penis;
- premature ejaculation is the onset of ED;
- increased interval between sexual stimulation and erection;
- weak erection or the complete absence of erection during stimulation;
- inability to achieve and maintain erection before ejaculation;
- decrease in ejaculate volume;
- increased recovery period between erections.
Why do erectile dysfunction symptoms occurs?
It’s better to analyze their etiology.
Psychogenic erectile dysfunction
Psychogenic erectile dysfunction begins suddenly. It’s characterized by problems in the relationship, the presence of nighttime spontaneous erections. As a rule, such erection problems are episodic. After eliminating an external problem, a normal erection is usually restored.
Organic impotence is systematic erectile dysfunction. This form of the disease begins gradually and is rarely accompanied by spontaneous night erections.
As a rule, the diagnosis can be established already on the basis of the patient's complaints and his description of the onset and course of the disorder. In order to diagnose and determine the severity of this disorder, special questionnaires are used. They allow to save doctor’s time, but the main thing is that they help to avoid feelings of awkwardness.
In addition, to finalize the diagnosis and identify possible causes of the disease, the following examinations are performed:
- Physical examination of the urologist-andrologist, during which the overall hormonal status is evaluated, including the degree of development of the mammary glands, assessment of the external testicular volume, degree of development of secondary sexual characteristics, the determination of the severity of sexual reflexes.
- Laboratory tests: general blood and urine tests, determination of glucose, creatinine, urea, cholesterol, lipoproteins in the blood.
- Ultrasound examination of the scrotum, bladder and prostate gland.
- Doppler sonography, which allows to determine the speed of blood flow in the vessels of the penis.
Early detection of male impotence is the main condition for successful treatment. Be attentive to your body.
Erectile dysfunction treatments
In more than 90% of cases, it’s possible to restore a full erection. The main thing is to consult a doctor and start treatment. How can erectile dysfunction be treated? The elimination of this pathology can be conservative and surgical.
Lifestyle change is the best treatment of erectile dysfunction. If there are bad habits, obesity or physical inactivity, the doctor will definitely advise the man to lead a healthy lifestyle. Often this is the key condition for the restoration of normal potency. It is necessary to refuse smoking, the excessive use of alcohol and harmful food. Mandatory make physical exercises, which will help eliminate blood stagnation in the pelvic organs, thereby improving the blood supply to the penis.
Conservative treatment of erectile dysfunction includes the prescription of certain drugs. Medicines for the ED treatment are selected only by the attending physician on the basis of the obtained diagnostic data. Contraindications for the use of phosphodiesterase type 5 inhibitors include taking nitrogen donators or nitrates.
Hormone replacement therapy
If erectile dysfunction is caused by hormonal disorders, then phosphodiesterase inhibitors will not help. Hormone replacement therapy is needed to restore normal hormonal levels. Currently, there are quite convenient forms of testosterone, for example, in the form of gel, with which you can adjust the level of male sex hormones in the blood. Such preparations are prescribed only by a doctor, determining the dosage for each patient individually.
Vacuum therapy is erectile dysfunction treatment that really works. This is a non-drug type of erectile dysfunction therapy, which aims to increase blood flow to the penis. A simple vacuum pump for penis is used for such therapy. The pump creates negative pressure that stimulates the filling of the penis with blood.
Treatment with a psychotherapist
Often the cause of erectile dysfunction lies in psychological field, and in this case, the help of a competent therapist is necessary. Often such a treatment with a psychotherapist takes place with a partner. At the sessions, any issues related to sexual life, as well as emotional experiences that may contribute to the development of erectile dysfunction, are discussed.
A man may be recommended surgical treatment in cases of serious problems of blood supply. Usually, surgical intervention is resorted when no other treatment method has a positive effect. Surgical treatment allows to restore full blood supply to the penis, achieve a normal stable erection.
Treatment of impotence with alternative methods
Treatment of impotence with alternative methods is a good and effective supplement to the doctor's medical prescriptions. In such a therapy different parts of medicinal herbs are used - ginseng root, St. John's wort leaves, and also some food products - ginger, celery, garlic, horseradish, etc. The benefits of alternative therapy include harmlessness to the body, lack of financial costs, effectiveness. Definitely, there is no universal way, so you need to focus on the reviews of patients and doctors.
If you have problems with erection you should enrich your diet by protein foods. The daily protein intake is 120 g. It is recommended to eat sour cream, cottage cheese, meat, fish (preferably boiled), eggs daily.
It is necessary to eat food enriched with selenium and zinc on order to maintain masculine strength — seafood, beef liver, pumpkin seeds, mushrooms, and legumes. The daily amount of selenium should be not less than 100 g. Cereals are also incredibly useful to all men. Preference should be given to buckwheat, oatmeal or pearl barley.
Insurance Coverage for ED Treatment
Most commercial insurances and Medicare cover the cost of the initial visit and a full assessment for ED, including penile ultrasound, blood tests and penile implant treatment.
The amount of insurance coverage depends on the company and is determined by medical necessity. An acceptable definition of medical need may vary in different insurance policies, but medical need letters can only be submitted in the form of documentation from your doctor. To be absolutely sure, contact your insurance company to find out whether products related to ED will be covered.
Impotence can be cured. The main thing – do not be afraid to talk about the problem, pay attention to the symptoms and consult a doctor. There are many ways to treat erectile dysfunction, so you can combat the disease.