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Male Erectile Dysfunction

male erectile dysfunction

What's to know about erectile dysfunction?

A man is considered to have erectile dysfunction if he regularly finds it difficult getting or keeping a firm enough erection to be able to have sex, or if it interferes with other sexual activity.

Most men have occasionally experienced some difficulty with their penis becoming hard or staying firm. However, erectile dysfunction (ED) is only considered a concern if satisfactory sexual performance has been impossible on a number of occasions for some time.

Since the discovery that the drug sildenafil, or Viagra, affected penile erections, most people have become aware that ED is a treatable medical condition.

Men who have a problem with their sexual performance may be reluctant to talk with their doctor, seeing it can be an embarrassing issue.

However, ED is now well understood, and there are various treatments available.

What are the symptoms of ED?

You may have erectile dysfunction if you regularly have:

  • trouble getting an erection
  • difficulty maintaining an erection during sexual activities
  • reduced interest in sex

Other sexual disorders related to ED include:

  • premature ejaculation
  • delayed ejaculation
  • anorgasmia, which is the inability to achieve orgasm after ample stimulation

You should talk to your doctor if you have any of these symptoms, especially if they’ve lasted for two or more months. Your doctor can determine if your sexual disorder is caused by an underlying condition that requires treatment.

What causes ED?

There are many possible causes for ED, and they can include both emotional and physical disorders. Some common causes are:

  • cardiovascular disease
  • diabetes
  • hypertension
  • hyperlipidemia
  • damage from cancer or surgery
  • injuries
  • obesity or being overweight
  • increased age
  • stress
  • anxiety
  • relationship problems
  • drug use

How Diabetes Causes ED

Human sexual response requires several different body functions to work properly and together: nerves, blood vessels, hormones, and psyche. Unfortunately, diabetes—and even the treatment for diabetes—can affect many of these functions.

Nerves: One of the most common complications of diabetes is neuropathy, or nerve damage. Erection is a function of the parasympathetic nervous system, but orgasm and ejaculation are controlled by the sympathetic system. Neuropathy to either system can cause ED.

Blood Vessels: Diabetes damages blood vessels, especially the smallest blood vessels such as those in the penis. Diabetes can also cause heart disease and other circulatory problems. Proper blood flow is absolutely crucial to achieving erection. “Erection is a hydraulic phenomenon that occurs involuntarily,” says Arturo Rolla, MD, of Harvard University School of Medicine. “Nobody can will an erection!” Anything that limits or impairs blood flow can interfere with the ability to achieve an erection, no matter how strong one’s sexual desire.

Hormones: Diabetes often causes kidney disease, and kidney disease, in turn, can cause chemical changes in the type and amount of hormones one’s body secretes, including the hormones involved in sexual response.

Medications:

Oral medicines: The best known ED medications are the Big Three: Viagra (sildenafil citrate, made by Pfizer, Inc.), Levitra (vardenafil HCl, made by Bayer and GlaxoSmithKline), and Cialis (tadalafil, made by Eli Lilly). The three are chemically very similar, and all have proven very effective. Because they are effective, convenient, and relatively inexpensive (about nine dollars per pill), these medicines have become the treatment of choice for most men experiencing ED.

Topical medicines: When the problem is insufficient blood flow, vasodilators (such as nitroglycerine ointment) can be applied to the penis to increase penile blood flow and improve erections. The main side effect of nitroglycerine ointment is that it may give the partner headaches. To prevent this, the man should use a condom.

Penile Injection Medication: This is just what it sounds like. Injected at home directly into the penis, the medication alprostadil produces erection by relaxing certain muscles, increasing blood flow into the penis and restricting outflow. Although some sources report an 80 percent success rate, the therapy has disadvantages, such as risks of infection, pain, and scarring—fibrosis—in the penis, and it may also cause priapism. A popular version of this medication is Upjohn Corporation’s Caverject. The MUSE System, by VIVUS, involves the same medicine (a pellet of alprostadil) applied with an eye-dropper-like applicator, directly into the urethra.

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