Increased understanding of the male erectile process and
the development of several agents to improve erectile
function have generated great public interest among men
and their sexual partners. These advances are expanding
the treatment options available to primary care
physicians in the management of erectile dysfunctions.
Define the causes of erectile dysfunction?
Male Reproductive System

Causes The penis contains two cylindrical, sponge-like
structures that run along its length, parallel to the
tube that carries semen and urine (urethra). When a man
becomes sexually aroused, nerve impulses cause the blood
flow to the cylinders to increase about seven times the
normal amount. This sudden influx of blood expands the
sponge-like structures and produces an erection by
straightening and stiffening the penis. Continued sexual
arousal or excitation maintains the higher rate of blood
flow, keeping the erection firm. After ejaculation, or
when the sexual excitation passes, the excess blood
drains out of the spongy tissue, and the penis returns
to its non-erect size and shape.

Specific steps take place to produce and sustain an
erection
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.
If something affects any of these factors or the
delicate balance among them, erectile dysfunction can
result.
Nonphysical causes
Nonphysical causes may account for impotence. They may
include
Psychological problems
The most common nonphysical causes are stress, anxiety
and fatigue. Impotence is also an occasional side effect
of psychological problems such as depression.
Negative feelings
Feelings that you express toward your sexual partner —
or that are expressed by your sexual partner such as
resentment, hostility or lack of interest also can be a
factor in erectile dysfunction.


Physical causes
-
Physical causes account for many cases of erectile
dysfunction and may include:
-
Nerve damage from longstanding diabetes (diabetic
neuropathy)
-
Cardiovascular disorders affecting the blood supply to
the pelvis
-
Certain prescription medications
-
Operations for cancer of the prostate
-
Fractures that injure the spinal cord
-
Multiple sclerosis]
-
Hormonal disorders
-
Alcoholism and other forms of drug abuse
In fact, erectile dysfunction may be one of the first
signs of an underlying medical problem. The physical and
nonphysical causes of erectile dysfunction commonly
interact. For instance, a minor physical problem that
slows sexual response may cause anxiety about attaining
an erection. Then the anxiety can worsen your erectile
dysfunction.
How can erectile dysfunction be detected?

There are certain symptoms that can help us to judge
that weather a person is suffering from erectile
dysfunction or not
Shortening of penis length and girth
-
Loss of sexual desire
-
Weak erection
-
Loss of self confidence
-
Weakness in body
-
Fatigue
Risk factors
A variety of risk factors can
contribute to erectile dysfunction. They include:
·
Getting
older. As many as 80
percent of men 75 and older have erectile
dysfunction. Many men begin to notice changes in
sexual function as they get older. Erections may
take longer to develop, may not be as rigid or may
take more direct touch to the penis to occur. But
erectile dysfunction isn't an inevitable consequence
of normal aging. Erectile dysfunction often occurs
in older men mainly because they're more likely to
have underlying health conditions or take
medications that interfere with erectile function.
·
Having
a chronic health condition.
Diseases of the lungs, liver, kidneys, heart,
nerves, arteries or veins can lead to erectile
dysfunction. So can endocrine system disorders,
particularly diabetes. The accumulation of deposits
(plaques) in your arteries (atherosclerosis) also
can prevent adequate blood from entering your penis.
And in some men, erectile dysfunction may be caused
by low levels of testosterone (male hypogonadism).
·
Taking
certain medications. A
wide range of drugs — including antidepressants,
antihistamines and medications to treat high blood
pressure, pain and prostate cancer — can cause
erectile dysfunction by interfering with nerve
impulses or blood flow to the penis. Tranquilizers
and sleeping aids also can pose a problem.
·
Certain
surgeries or injuries.
Damage to the nerves that control erections can
cause erectile dysfunction. This damage can occur if
you injure your pelvic area or spinal cord. Surgery
to treat bladder, rectal or prostate cancer can
increase your risk of erectile dysfunction.
·
Substance abuse. Chronic
use of alcohol, marijuana or other drugs often
causes erectile dysfunction and decreased sexual
drive.
·
Stress,
anxiety or depression.
Other psychological conditions also contribute to
some cases of erectile dysfunction.
·
Smoking. Smoking can cause
erectile dysfunction because it restricts blood flow
to veins and arteries. Men who smoke cigarettes are
much more likely to develop erectile dysfunction.
·
Obesity. Men who are obese
are much more likely to have erectile dysfunction
than are men at a normal weight.
·
Metabolic syndrome. This
syndrome is characterized by belly fat, unhealthy
cholesterol and triglyceride levels, high blood
pressure, and insulin resistance.
Prolonged bicycling.
Over an extended period, pressure from a bicycle
seat has been shown to compress nerves and blood
flow to the penis, leading to temporary erectile
dysfunction and penile numbness

How can erectile dysfunction be diagnosed?
The amount dysfunction may vary from an individual to an
individual. More over the time factor may also be a
consolidation factor. Erectile dysfunction may last from
few days to months and years. There are three main
diagnosing techniques that are applied for diagnosing
the impotence or erectile dysfunction.
Physical examination
– This is the most primary diagnostic method that is
also the preference. In this few methods are judged like
the sensitivity of the penis to the sexual arousal or
examining the factor that may be caused by any injury to
penis or erectile tissue.
History of patient
– It is also a very important factor to determine the
extent of ED (erectile dysfunction). In this the past
sexual behavior and other physical as well as well as
medical history is considered. It has been seen that
people might suffer from erectile dysfunction due to
some chronic ailments like diabetes etc.
Psychological examination
– This is also an important factor that is to be
considered while diagnosing the erectile dysfunction. In
this the psyche of a person is judged and a relation is
being established between is ailments and mental sate of
mind.
Tests and diagnosis


Your doctor will ask questions
about how and when your symptoms developed, what
medications you take and any other physical
conditions you might have. Your doctor will also
want to discuss recent physical or emotional
changes.
If your doctor suspects that
physical causes are involved, he or she will likely
want to take blood tests to check your level of male
hormones and for other potential medical problems,
such as diabetes. Your doctor may also want to try
eliminating or replacing certain prescription drugs
you're taking one at a time to see whether any are
responsible for erectile dysfunction.
More specialized tests
may include:

·
Ultrasound.
This test can check blood flow to your penis. It
involves using a wand-like device (transducer) held
over the blood vessels that supply the penis. The
transducer emits sound waves that pass through body
tissues and reflect back, producing an image to let
your doctor see if your blood flow is impaired. The
test often is done before and after injection of
medication into the side of the penis to see if
there's an improvement in blood flow.
·
Neurological evaluation.
Your doctor usually assesses possible nerve damage
by conducting a physical examination to test for
normal touch sensation in your genital area.
·
Dynamic infusion cavernosometry and
cavernosography (DICC).
This procedure involves injecting a dye into penile
blood vessels to permit your doctor to view any
possible abnormalities in blood pressure and flow
into and out of your penis. It's generally done with
local anesthesia by a urologist who specializes in
erectile dysfunction.
·
Nocturnal tumescence test.
If your doctor suspects that mainly nonphysical
causes are to blame, he or she may ask whether you
obtain erections during masturbation, with a partner
or while you sleep. Most men experience many
erections, without remembering them, during sleep. A
simple test that involves wrapping a special
perforated tape around your penis before going to
sleep can confirm whether you have erections while
you're sleeping. If the tape is separated in the
morning, your penis was erect at some time during
the night. Tests of this type confirm that there is
not a physical abnormality causing erectile
dysfunction, and that the cause is likely
psychological.


Are there any prevention erectile dysfunction?
-
Avoid unhealthy life style
-
Do not eat junk food
-
Avoid masturbation
-
Prevent daily sexual indulgence
-
Avoid over usage medicines
-
Avoid wearing tight underpants and under wears
What diet is recommended for person suffering from
erectile dysfunction?
-
Dairy products are recommended but should be taken in
limits
-
Reduce salt content in your diet
-
Avoid eating junk food
-
Eat fruits and vegetables
-
Avoid eating non-vegetarian food at night
-
Avoid fatty diet.
Is there any treatment for erectile dysfunction?
Yes, as per herbal treatment two types of treatments are
undertaken. One is psychotherapy and other is the
medication. Depending upon the cause of erectile
dysfunction, the treatment path of the patient is
planned and then it is applied on the patient.
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