Erectile dysfunction (ED) is the inability of a man to maintain a firm hardon long enough to have sex. Although erectile dysfunction is more common in older men, this common problem can occur at any age. Having trouble maintaining an erection from time to time isn't necessarily a cause for concern. But if the problem is ongoing, it can cause stress and relationship problems and affect self-esteem.

Formerly called impotence, erectile dysfunction was once a taboo subject. It was considered a psychological issue or a natural consequence of growing older. These attitudes have changed in recent years. It's now known that erectile dysfunction is more often caused by physical problems than by psychological ones, and that many men have normal erections into their 80s.

Although it can be embarrassing to talk with your doctor about sexual issues, seeking help for erectile dysfunction can be worth the effort. Erectile dysfunction treatments ranging from medications to surgery can help restore sexual function for most men. Sometimes erectile dysfunction is caused by an underlying condition such as heart disease. So it's important to take erectile trouble seriously because it can be a sign of a more serious health problem.

Causes

Male sexual arousal is a complex process involving the brain, hormones, emotions, nerves, muscles and blood vessels. If something affects any of these systems — or the delicate balance among them — erectile dysfunction can result.

Anatomy of an Erection

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Physical Causes of Erectile Dysfunction

At one time, doctors thought erectile dysfunction was primarily caused by psychological issues. But this isn't true. While thoughts and emotions always play a role in getting an erection, erectile dysfunction is usually caused by something physical, such as a chronic health problem or the side effects of a medication. Sometimes a combination of things causes erectile dysfunction.

Common causes of erectile dysfunction include:

• Heart disease
• Clogged blood vessels (atherosclerosis)
• High blood pressure
• Diabetes
• Obesity
• Metabolic syndrome

Other causes of erectile dysfunction include:

• Certain prescription medications
• Tobacco use
• Alcoholism and other forms of drug abuse
• Treatments for prostate cancer
• Parkinson's disease
• Multiple sclerosis
• Hormonal disorders such as low testosterone (hypogonadism)
• Peyronie's disease
• Surgeries or injuries that affect the pelvic area or spinal cord

In some cases, erectile dysfunction is one of the first signs of an underlying medical problem.

Psychological Causes Of Erectile Dysfunction

The brain plays a key role in triggering the series of physical events that cause an erection, beginning with feelings of sexual excitement. A number of things can interfere with sexual feelings and lead to — or worsen — erectile dysfunction. These can include:

• Depression
• Anxiety
• Stress
• Fatigue
• Poor communication or conflict with your partner
• Wearing a condom

The physical and psychological causes of erectile dysfunction interact. For instance, a minor physical problem that slows sexual response may cause anxiety about maintaining an erection. The resulting anxiety can worsen erectile dysfunction.

Condoms and Hard-ons

A lot of us know how it feels to lose our hard-on when we try to put a condom on. And it’s a waste of time trying to put a condom on a dick that’s not fully hard. But it’s important to remember that erections come and go during sex and few of us stay rock hard from start to finish, with or without condoms.

Here are some tips if putting on a condom gives you erection problems.

Larger condoms

If a condom is too small it will be harder to get over the cock and feel uncomfortably tight to wear. Condoms come in larger sizes, either wider or longer (or both). These can be up to 1.5cm wider and 4cm longer than regular size rubbers. Examples include Durex Comfort XL and Mates Large. Bigger brands often have ‘XL’ or ‘XXL’ in their names. The measurements are usually stated on the packet.

The ‘sock’ method

If putting a condom on kills your hard-on some men find this helps: instead of putting the condom on the tip of their dick and rolling it down, they put it on like putting a sock on a foot. With thumbs holding the mouth of the condom open wide, it’s pulled over the head of the dick. Once on it can then be rolled down the dick as usual. Although handling and stretching the condom this way might possibly weaken the rubber, for some men this is a real help in getting a condom on.

Cock rings

Anything that keeps blood in a cock once it starts to get hard will help it stay erect. Gripping the base of a dick can do this for a while, e.g. while the condom goes on. But a cock ring has the same effect for a longer time. They can be metal rings or adjustable straps made of leather (these are better than metal rings as they can be adjusted to fit and can be taken off more easily, even when a cock is still hard).

A helping hand

Concentrating on the fiddly business of putting on a condom can cause a man to go soft. So it can help if he gets the other guy to put the condom on for him, especially if that guy’s stimulating a part of his body that gets him hard.

Other worries

Some men find a few quick tips can’t fix their anxieties around using condoms. Sometimes it can be hard getting the other man to agree to use them. Talking anonymously to someone on a helpline like Mensline (9322 8401 / 1800 671 130) or to a counsellor or a sex therapist can really help. You can ask for help from a sexual health advisor at a sexual health clinic or contact Project X Team on 9482 0000 – they’ll know where you can talk to a professional about this problem.

When To Seek Medical Advice

If erectile dysfunction is more than a temporary, short-term problem, see your doctor. Your own doctor, or a doctor specializing in erectile dysfunction, can help you determine the underlying cause or causes of erectile dysfunction and then help you find the right type of treatment.

Although you might view erectile dysfunction as a personal or embarrassing problem, it's important to seek treatment. In most cases, erectile dysfunction can be successfully treated. Also, see your doctor if the therapy or medication prescribed to treat erectile dysfunction isn't working for you. Don't try to combine medications or therapies on your own or make changes from prescribed doses.

Treatment

A variety of options exist for treating erectile dysfunction. They range from medications and simple mechanical devices to surgery and psychological counseling. The cause and severity of your condition are important factors in determining the best treatment or combination of treatments for you.

Oral Medications

Oral medications available to treat ED include:

• Sildenafil (Viagra)
• Tadalafil (Cialis)
• Vardenafil (Levitra)

All three medications work in much the same way. Chemically known as phosphodiesterase inhibitors, these drugs enhance the effects of nitric oxide, a chemical that relaxes muscles in the penis. This increases the amount of blood flow and allows a natural sequence to occur — an erection in response to sexual stimulation.

These medications don't automatically produce an erection. Instead they allow an erection to occur after physical and psychological stimulation. Many men experience improvement in erectile function after taking these medications regardless of the cause of their impotence.

These medications share many similarities, but they have differences as well. They vary in dosage, duration of effectiveness and possible side effects. Other distinctions — for example, which drug is best for certain types of men — aren't yet known. No study has directly compared these three medications.

Not All Men Benefit

Although these medications can help many people, not all men can or should take them to treat erectile dysfunction. You should not take these medications if:

• You take nitrate drugs (commonly known as poppers or amyl)
• You take a blood-thinning (anticoagulant) medication
• You take certain types of alpha blockers for enlarged prostate (benign prostatic hyperplasia) or high blood pressure

Viagra, Levitra or Cialis may not be a good choice for you if:

• You have severe heart disease or heart failure
• You've had a stroke
• You have very low blood pressure (hypotension)
• You have uncontrolled high blood pressure (hypertension)
• You have uncontrolled diabetes
• Don't expect these medications to fix your erectile dysfunction immediately.

Work with your doctor to find the right treatment and dose for you. Dosages may need adjusting. Or you may need to alter when you take the medication.

Before taking any medication — including Viagra, Levitra or Cialis — make sure to discuss with your doctor:

• Potential benefits and side effects of the medication you are considering
• Any illnesses or serious health problems you have now or have had in the past
• Any prescription or over-the-counter medications you take (including herbal remedies)

Prostaglandin E (alprostadil)

Two treatments involve using a drug called alprostadil. Alprostadil is a synthetic version of the hormone prostaglandin E. The hormone helps relax muscle tissue in the penis, which enhances the blood flow needed for an erection.

There are two ways to use alprostadil:

Needle-injection therapy. With this method, you use a fine needle to inject alprostadil (Caverject, Edex) into the base or side of your penis. This generally produces an erection in five to 20 minutes that lasts about an hour. Because the injection goes directly into the spongy cylinders that fill with blood, alprostadil is an effective treatment for many men. And because the needle used is so fine, pain from the injection site is usually minor. Other side effects may include bleeding from the injection, prolonged erection and formation of fibrous tissue at the injection site. The cost per injection can be expensive. Injecting a mixture of alprostadil and other prescribed drugs may be a less expensive and more effective option. These other drugs may include papaverine and phentolamine.

Self-administered intraurethral therapy (Muse). This treatment involves using a disposable applicator to insert a tiny alprostadil suppository, about half the size of a grain of rice, into the tip of your penis. The suppository, placed about two inches into your urethra, is absorbed by erectile tissue in your penis, increasing the blood flow that causes an erection. Although needles aren't involved, you may still find this method painful or uncomfortable. Side effects may include pain, minor bleeding in the urethra, dizziness and formation of fibrous tissue.

Penis pumps

This treatment involves the use of a hollow tube with a hand-powered or battery-powered pump. The tube is placed over the penis, and then the pump is used to suck out the air. This creates a vacuum that pulls blood into the penis. Once you achieve an adequate erection, you slip a tension ring around the base of your penis to maintain the erection. You then remove the vacuum device. The erection typically lasts long enough for a couple to have sex. You remove the tension ring after intercourse.

Psychological counselling and sex therapy

If stress, anxiety or depression is the cause of your erectile dysfunction, your doctor may suggest that you, or you and your partner, visit a psychologist or counsellor with experience in treating sexual problems (sex therapist). Even if it is caused by something physical, erectile dysfunction can create stress and relationship tension. Counselling can help, especially when your partner participates.

Coping Skills

Whether the cause is physical factors or psychological factors or a combination of both, erectile dysfunction can become a source of mental and emotional stress for a man — and his partner. If you experience erectile dysfunction only on occasion, try not to assume that you have a permanent problem or to expect it to happen again during your next sexual encounter. Don't view one episode of erectile dysfunction as a lasting comment on your health, virility or masculinity.

In addition, if you experience occasional or persistent erectile dysfunction, remember your sexual partner. Your partner may see your inability to have an erection as a sign of diminished sexual desire. Your reassurance that this is not the case can help.

Try to communicate openly and honestly about your condition. Treatment is often more successful if couples work together as a team. You may even want to see a counsellor with your partner. This can help you address concerns you both have about erectile dysfunction and can be an effective treatment.

Reference

http://erectiledysfunction.morefocus.com/

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