Understanding erectile dysfunction and treating it effectively

An erection is an amazing phenomenon, which in ancient times was attributed to almost a magical origin. The ability to have a strong erection in all nations and at all times was considered an indispensable characteristic of the “tough guy”. And impotence was considered (in many parts of the world to this day) as the result of witchcraft or black magic.

Today, when not only the erection mechanism is well studied, but also there is a wide arsenal of drugs for treating sexual dysfunction, many men still are tormented by an almost primitive fear of impotence.

“Impotence leaves its mark on the whole personality of a man. He loses his sense of self-esteem, his characteristic vigor, all the joy of manifestations of creative activity. He is convinced that he is not a man”(Stekel, 1927).

In the second half of the last century, lively discussions were held about whether the term “impotence” itself was acceptable, since it was often used not only in a direct, but also in a figurative, derogatory sense. In 1993, the medical community adopted the term "erectile dysfunction" (ED) to mean problems with erection, which means "the inability to develop and (or) sustain an erection sufficient to satisfy sexual activity."

Short information about erectile dysfunction

Erection (from Latin erigo, erectum - straighten, lift) is a complex phenomenon, which is based on a complex mechanism, the main role of which belongs to the vessels that bring blood to the cavernous and spongy bodies. As a result of enhanced blood inflow (and at the same time temporarily stopping the outflow) during sexual arousal, the penis increases in volume and becomes elastic.

What are the reasons for ED occurrence?

Previously, various psychological problems were considered the main cause of ED, but now this opinion has changed - it has been proved that ED in almost 80% of cases arises as a complication of various, primarily vascular diseases. The psychological causes of ED, for instance, fear of being incapable of sexual intercourse, prevail in young patients aged 40 or fewer years. Most patients with erectile dysfunction are men older than 45 years.
ED is often related to chronic diseases such as arterial hypertension, diabetes mellitus, and atherosclerosis.

- With atherosclerosis, the walls of the vessels lose their elasticity and taper off due to atherosclerotic plaques covering them, which leads to the development of heart attacks and strokes. Atherosclerotic lesion of the vessels of the penis prevents sufficient flow of blood into the body and causes ED. Approximately 40% of cases of ED in men over the age of 50 are associated with this disease. Often, various manifestations of atherosclerosis, such as coronary heart disease and ED, develop in parallel.
- High blood pressure can cause problems with erections, regardless of whether a person suffers from atherosclerosis or not. If hypertension is not treated for a long time, the walls of the vessels, constantly exposed to high arterial tension, become dense and inelastic, and the vessels are unable to supply the organs with the necessary amount of blood.
- Raised blood sugar in diabetes damages both the walls of blood vessels and nerve fibers, making the penis less sensitive.
- Smoking is one of the main risk factors for the development of atherosclerosis and in combination with other diseases significantly increases the likelihood of erectile dysfunction.
- Alcohol abuse is another cause of erectile dysfunction, because ethanol, which is essentially a toxic substance, practically kills the nerve endings of the penis. In addition, in drinking men, testosterone, a hormone that determines male strength, is rapidly declining.

Thus, today the myths about potency, as well as methods of treating erectile dysfunction are destroyed. If you have problems, start by changing your lifestyle. It is sometimes difficult, but without it, none, even magic tablets, will help.

How to know if your problems with erection are caused by psychogenic or organic causes?

The easiest way to detect whether you suffer from psychological or organic ED is to look at your age – if you are younger than 40, most likely it is induced by psychological causes. However, to exclude pathologies that can be even life-threatening, it is still advised to undergo a general health checkup, do a blood test, x-ray or CT at your doctor’s discretion to be sure that there is no tumor, vessel disease or other pathology.

Besides, you can compare your symptoms to the symptoms of organic and psychological ED listed below.

Psychogenic ED:

- You have morning erection;
- You can develop an erection when masturbating;
- Once you develop an erection, it doesn’t disappear before ejaculation;
- Troubles with erection occur from time to time spontaneously;
- You notice that you have trouble developing an erection when you are stressed, tired, nervous, and so on.

Organic ED:

- You don’t have morning erection;
- You cannot develop erection when masturbating;
- An erection can wane during intercourse prior to ejaculation;
- You notice that troubles with an erection achievement and maintenance developed gradually and not spontaneously;
- Troubles with an erection are stable;
- You don’t observe any correlation with problems developing an erection with stress, intense emotions, nervousness, and so on.

How can you cure erectile dysfunction?

Although it is generally believed that ED cannot be cured, in fact, it can. The thing is that it is rather a symptom of negative processes in the body than a separate ailment. Thus, for the curing of ED, it is important to focus your attention and strivings on eliminating the underlying disease.

In the case of psychogenic ED, it is important to work with a psychologist or psychiatrist to find out the reason that prevents you from having a healthy sexual life and work on its elimination.

In the case of organic ED, you need to undergo a comprehensive health checkup and then, based on the results, receive treatment. Make sure to follow all your doctor’s recommendations including lifestyle changes such as quitting smoking, limiting alcohol consumption, starting doing physical exercises.

In the case of the treatment of an underlying condition and changes in a lifestyle, curing of erectile dysfunction is possible. However, it may take some time, especially, if you had been neglecting your health for many years. In this case, if sexual activity is not contraindicated to you, you can use erection-enhancing drugs such as Viagra Gold. This medication is a PDE5 inhibitor, i.e. it inhibits a certain enzyme in the body that doesn’t allow smooth muscles in the penis to relax. Once it is suppressed, the muscles relax which improves blood inflow into the penis and natural erection occurs. You can use the pills for as long as needed as there is no time limit for their use. However, make sure to observe guidelines and consult your doctor first, especially, if you have severe heart disease.

Post by: Jacob Hansen, General healthcare practitioner, National health centre, Stavanger, Norway