Impotence, also called erectile dysfunction, is estimated to affect between 10 and 30 million men in the United States. Previously thought to be mainly a psychological problem or caused by the aging process, physicians now believe that more than 80 percent of cases stem from physical causes, including disease, injury (especially spinal cord injury), substance abuse, or the side effects of prescription medications. And while incidence increases with aging, it is not an inevitable result. Because the term impotence has developed a negative connotation, it is now rarely used in technical literature.
Among the most common causes are diseases that affect blood flow, such as heart disease, arteriosclerosis, and high blood pressure. Other common causes are diabetes, kidney disease, chronic alcoholism, liver failure, elevated cholesterol level, hormonal abnormalities, and neurological disorders, such as multiple sclerosis or spinal cord damage. Smoking also restricts blood flow. Drugs, such as cocaine, marijuana, anti-depressants, narcotics, blood pressure medications, antifungals, and beta-blockers may also cause impotence.
Psychological factors-such as stress, anxiety, guilt, depression, or low self-esteem-are estimated to cause between 10 and 20 percent of cases.
Signs and Symptoms
Inability in males to achieve or sustain an erection for sexual intercourse more than 25 percent of the time or a tendency to sustain only brief erections
Conventional Medical Treatment
Since achieving and sustaining an volves the man's mental state-as erection in-well as the nerves, muscles, and circulatory system-physicians often take a team approach to treatment. Your doctor generally begins by taking a medical and sexual history and giving you a complete physical examination. Typical tests ordered include a blood count, urinalysis, lipid profile, measurements of creatinine and liver enzymes, and a blood testosterone analysis. Since healthy men have involuntary erections during sleep, you may also be asked to monitor your erections during the night, to help evaluate the possibility of psychological problems.
Though today about 95 percent of cases of erectile dysfunction are treatable, only 5 to 10 percent of men seek treatment. Among the most successful and least invasive treatments is the prescription medicine sildenafil, sold as Viagra originally used to treat high blood pressure disorders. Viagra works by inhibiting a particular enzyme in the body, therefore allowing blood to flow into the penis. It is not recommended for men with certain types of heart disease, but is effective for about 65 to 70 percent of men, including those with physical and psychological problems.
Before Viagra became available, other medications recommended included testosterone and yohimbine hydrochloride, but both are controversial. Testosterone is effective in only a small percentage of men with hormonal imbalances. Yohimbine, which is derived from tree bark and has been used for centuries as an aphrodisiac, has not been proven effective in clinical trials.
Several mechanical devices also have been used with varying degrees of success. One of these, a vacuum constriction device, pulls blood into the penis by means of a vacuum created when the penis is inserted into a plastic tube and air is then pumped out of the tube. The result mimics an erection, which can be maintained for about a half an hour by placing an elastic band around the penis.
With penile injection therapy, medication is injected into the side of the penis to create an erection. The drawbacks, however, include the pain of the injection and the possibility of a prolonged erection of two hours or more. In the treatment known as intraurethral therapy, a soft pellet of medication, about the size of a grain of rice, is inserted into the urethra with an applicator. The medication is absorbed directly into the erection chambers of the penis, resulting in an erection in between 30 to 80 percent of men that can last 30 minutes to an hour.
In some cases, especially in young men with vascular injuries, physicians may recommend surgery. Surgery may be used to implant a prosthesis to cause the penis to be erect, reconstruct arteries to increase blood flow to the penis, or repair veins that may allow a too-rapid exit of blood from the penis. Two types of implants are used: one consists of two semi-rigid but malleable rods; the other is an inflatable implant that can be expanded with a pressurized saline fluid. Men and their partners using prosthesis report a 93 percent satisfaction rate.
Erectile dysfunction (ED) affects the lives of many middle-aged men and their partners. The term erectile dysfunction covers a range of disorders, but usually refers to the inability to obtain an adequate erection for satisfactory sexual activity.
Although erectile dysfunction, formerly called impotence, is more common in men older than 65, it can occur at any age. An occasional episode of erectile dysfunction happens to most men and is normal. As men age, it's also normal to experience changes in erectile function. Erections may take longer to develop, may not be as rigid or may require more direct stimulation to be achieved. Men may also notice that orgasms are less intense, the volume of ejaculate is reduced and recovery time increases between erections. Erectile dysfunction may also be a sign of a physical or emotional problem that requires treatment.
Erectile dysfunction was once a taboo subject, but more men are seeking help. Doctors are gaining a better understanding of what causes erectile dysfunction and are finding new and better treatments.
This Website discusses all about erectile dysfunction, physiology of the normal erection and the pathophysiology, and treatment of ED.
What is Erectile Dysfunction?
Erectile dysfunction or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. There are various underlying causes, such as diabetes, many of which are medically reversible.
The causes may be physiological or psychological. Psychological impotence can often be helped by almost anything that the patient believes in; there is a very strong placebo effect.
Due to its embarrassing nature and the shame felt by sufferers, the subject was taboo for a long time, and is the subject of many urban legends. Folk remedies have long been advocated, with some being advertised widely since the 1930s. The introduction of perhaps the first pharmacologically effective remedy for impotence, sildenafil (trade name Viagra), in the 1990s caused a wave of public attention, propelled in part by the news-worthiness of stories about it and heavy advertising.
The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina. It is now mostly replaced by more precise terms.
Signs and symptoms:
Erectile dysfunction is characterized by the inability to maintain erection. Normal erections during sleep and in the early morning suggest a psychogenic cause, while loss of these erections may signify underlying disease, often cardiovascular in origin. Other things leading to erectile dysfunction are diabetes mellitus (causing neuropathy) or hypogonadism (decreased testosterone levels due to disease affecting the testicles or the pituitary gland).
Here are some causes of Erectile Dysfunction:
* Arousal: The first step is sexual arousal, which men obtain from the senses of sight, touch, hearing and smell, and from thoughts.
* Nervous system response: The brain communicates the sexual excitation to the body's nervous system, which activates increased blood flow to the penis.
* Blood vessel response:. A relaxing action occurs in the blood vessels that supply the penis, allowing more blood to flow into the shafts that produce the erection.
Physiology of normal erections:
Penile erections involve an integration of complex physiologic processes involving the CNS, peripheral nervous system, and hormonal and vascular systems. Any abnormality involving these systems, whether from medication or disease, has a significant impact on the ability to develop and sustain an erection, ejaculate, and experience orgasm. Tumescence, the vascular filling of the cavernous bodies, relies on neural and hormonal mechanisms operating at various levels of the neural axis. This is unique among visceral functions because it requires central neurological input.
Andersson et al summarized some of the information related to the pathways involved in erectile function. The degree of contraction of corpus cavernosal smooth muscle determines the functional state of the penis. The balance between contraction and relaxation is controlled by central and peripheral factors that involve many transmitters and transmitter systems. At the cellular level, smooth muscle relaxation occurs following the release of acetylcholine from the parasympathetic nerves.
Pathophysiology of erectile dysfunction:
Erectile Dysfunction is essentially a vascular disease. It is often associated with other vascular diseases and conditions such as diabetes, hypertension, and coronary artery disease. Other conditions associated with Erectile Dysfunction include neurologic disorders, endocrinopathies, benign prostatic hyperplasia, and depression. Conditions associated with reduced nerve and endothelium function, such as aging, hypertension, smoking, hypercholesterolemia, and diabetes, alter the balance between contraction and relaxation factors. These conditions cause circulatory and structural changes in penile tissues, resulting in arterial insufficiency and defective smooth muscle relaxation. In some patients, sexual dysfunction may be the presenting symptom of these disorders.
Treatment:
Sildenafil Citrate is the way to treat Erectile Dysfunction. Generic Viagra contains sildenafil citrate and contains same ingredients like branded drug.
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