Dr. I-Net

If a man can't get an erection or can't keep erection long enough for sexual intercourse, is called erectile dysfunction or impotence. Erectile dysfunction can occur at any age, but it is more common in men older than 60.erectile dysfunction is just a part of aging

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.

Signs and symptoms: Erectile dysfunction is the inability to maintain an erection sufficient for sexual intercourse at least 25 percent of the time. An occasional inability to maintain an erection happens to most men and is normal. But ongoing erection problems are a sign of erectile dysfunction and should be evaluated. In some cases, erectile dysfunction is the first sign of another underlying health condition that needs treatment.

Medical causes of erectile dysfunction: The following medical problems can also cause erectile dysfunction:

• Diabetes (high blood sugar) • Hypertension (high blood pressure) • Atherosclerosis (hardening of the arteries) If you can't keep your blood sugar or your blood pressure under control, you can get erectile dysfunction. It's important that you take your medicines for these problems just the way your doctor tells you.

Physical causes of erectile dysfunction: • Alcohol and tobacco use • Fatigue • Brain or spinal-cord injuries • Lower testosterone levels • Liver or kidney failure • Multiple sclerosis • Parkinson's disease • Radiation therapy to the testicles • Stroke • Bladder surgery

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

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.

Erectile dysfunction doesn't have to be a part of getting older. It's true that as you get older, you may need more stimulation (such as stroking and touching) to get an erection. You might also need more time between erections. But older men should still be able to get an erection and enjoy sex.

Sometimes the hormones get out of balance and this causes erectile dysfunction. Your doctor will decide if you need blood tests to check your hormones. Prescription medicines can cause erectile dysfunction. Drinking too much alcohol, smoking too much and abusing drugs can also cause erectile dysfunction.

Emotions that can lead to erectile dysfunction: Emotions nervous about sex, perhaps because of a bad experience or because of a previous episode of impotence • Emotions stressed, including stress from work or family situations • Being troubled by problems in your relationship with your sex partner •Feeling depressed • Feeling so self-conscious that you can't enjoy sex • Thinking that your partner is reacting negatively to you.

Diagnosis for erectile dysfunction: The physician will probably start by asking you some questions and doing a physical exam. Samples of your blood and urine may be tested for diseases and disorders. Other tests may also be needed. Your doctor will determine which tests are right for you.

How is erectile dysfunction treated: After your physician checks you for medical problems and medicines that might cause erectile dysfunction, he or she may have you try a medicine to help with erectile dysfunction. Some of these medicines are injected into your penis. Other medicines are taken by mouth. Not everyone can use these medicines. Your doctor will help you decide if you can try them. If the medicines aren't right for you, you could also try herbals or alternative medicine.

How to Cope 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 counselor with your partner. This can help you address concerns you both have about erectile dysfunction and can be an effective treatment.

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 available to treat ED include: 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.

• 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.

• Hormone replacement therapy For the small number of men who have testosterone deficiency, testosterone replacement therapy may be an option.

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.

Vascular surgery This treatment is usually reserved for men whose blood flow has been blocked by an injury to the penis or pelvic area. Surgery may also be used to correct erectile dysfunction caused by vascular blockages..

Penile implants This treatment involves surgically placing a device into the two sides of the penis, allowing erection to occur as often and for as long as desired. These implants consist of either an inflatable device or semirigid rods made from silicone or polyurethane.

Psychological counseling 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 counselor with experience in treating sexual problems (sex therapist).

Prevention: Although most men experience episodes of erectile dysfunction from time to time, you can take these steps to decrease the likelihood of occurrences: • Work with your doctor to manage conditions that can lead to erectile dysfunction, such as diabetes and heart disease. • Limit or avoid the use of alcohol. • Avoid illegal drugs such as marijuana. • Stop smoking. • Exercise regularly. • Reduce stress. • Get enough sleep. • Get help for anxiety or depression. • See your doctor for regular checkups and medical screening tests.