ED is one of the most common sexual problems in men, becoming more widespread with age. In fact, half of all men over 40 will experience erectile dysfunction or impotence at some point.
Causes of Erectile Dysfunction
Physical Causes – There can be several physical reasons why the blood and nerve supply to the penis should cause problems with impotence.
- Vascular disease – such as the effects of diabetes, chronic high blood pressure and high cholesterol cause narrowing or furring-up of the blood vessels going to the penis.
- Veno-occlusive disease, in which the blood needed to swell the penis quickly drains away, resulting in erections that deflate too soon.
- Conditions affecting the nervous system, such as multiple sclerosis, spinal cord injury, diabetes and Parkinson’s disease. These disrupt the transmission of signals from the brain to the blood vessels in the penis.
- Injury, or surgical damage to the nerves involved in sexual arousal, such as removal of the prostate.
- Testosterone and other hormone levels can also affect erection. Drinking too much alcohol in the short term affects sexual ability – in the longer term, it interferes with the production of testosterone (the male hormone), reducing libido and performance.
- Medication: some treatments for high blood pressure and depression can have unfortunate side effects. Medicines can also affect sexual desire (libido), ejaculation and orgasm.
- Smoking damages the circulation, and increases the risk of erection problems.
- Poor cardiovascular fitness due to lack of exercise may also lead to erectile dysfunction
Psychological Aspects of Erectile Dysfunction
Psychological problems can also influence the ability to get and maintain erections. These can be;
- anxiety, fear and guilt (particularly when connected to relationship experiences and issues)
- boredom with current sexual practices
- partner conflicts
- unresolved issues about sexual orientation
Even seemingly unrelated issues such as stress at work or depression can be to blame.
And although about two thirds of cases of impotence can be due to physical problems, such health problems can themselves cause psychological suffering that can have an additional effect.
Diagnosis of ED
Overcoming embarrassment and talking to a specialist in erectile dysfunction problems is a good start. A few questions about your symptoms, a physical examination and some simple tests should help us to help you by tackling the cause of the problem, whether this is physical or psychological.
Treatments for ED have considerably improved over the years, and in due course most men can achieve successful intercourse again. Other medication, such as Viagra, can raise an erection for around two-thirds of men, whilst vacuum pumps to draw blood into the penis and cause an erection are also successful in 92% of cases. Psychological treatments include cognitive behavioural therapy (CBT) and sex therapy.
One of the main causes of impotence, atherosclerosis – or the narrowing of the arteries – might be helped by losing weight, which may relieve symptoms and will help to ward off cardio-vascular problems. Cholesterol-lowering statins and blood pressure controlling drugs may also be given to treat atherosclerosis.