A Short Article To Understand Erectile Dysfunction

Called erectile dysfunction or male impotence, this is an affecting problem every day more frequent between men. According to statistics, these male erection problems are more common to appear after the 40 years of age, but, in certain circumstances, it can also appear in men of 20 years of age. A worldwide prevalence of 13% of male population is estimated.

Erectile dysfunction is the inability of having and/or maintaining the erection satisfactorily, while having a normal sexual desire. The causes of this problem can have multiple origins. They can be physical, emotional or a combination of both. Besides this, male impotence does not only has a negative effect on the sexual life of the male, affecting the relationship with his partner, but it can also be a contributory factor of low self-esteem, depression and mental stress, exasperating the medical situation and the quality of life in general.

Short review of the physiology of the male erection.

As we know, through the penis, male reproductive organ, the man expels his semen inside the woman´s uterus. This happens during the sexual coitus and it is necessary for the man to have a penile erection. This erection is a complex physiological response, which depends of various physical (structural, both vascular and muscular, hormonal or neurological) and emotional mechanisms, and reflects directly on the level of the male sexual excitement.

The penile erection is obtained thanks to the blood flow that goes into the arteries inside of the penis´ cavernous bodies, obtaining the elevation, increase in turgidity and the dimensions of the male organ. If this blood flow is not enough or is inferior to the cavernous bodies’ capacities, the physiological phenomena explained before will not happen, and if these do happen, they will be limited, originating the erectile dysfunction.

What are the causes of erectile dysfunction?

  • Penile trauma that causes pain at the moment of the erection or some level of structural incapacity.
  • Cardiovascular diseases that can diminish the blood flow inside the penis (atherosclerosis, cardiopathies, arterial hypertension, etc.).
  • Neurological pathologies such as Parkinson´s disease, multiple sclerosis, stroke and trauma to the spinal cord.
  • Hormonal pathologies such as hypogonadism, hyper/hypothyroidism and Cushing´s syndrome.
  • Diabetes mellitus.
  • Overweight and obesity.
  • Peyronie´s disease, which is characterized by an abnormal fibrosis localized in the cavernous bodies.
  • Medicines that can cause erectile dysfunction: diuretics, antihypertensives, fibrates, corticosteroids, antihistamines, anti-H2, anti-androgens, antipsychotics, antidepressants, anticonvulsants, cytotoxic.
  • Prostatic surgery and radiotherapy.
  • Psychiatric pathologies such as depression, anxiety, emotional trauma.
  • Excessive fatigue.
  • Alcohol and/or drug abuse.
  • Nicotine addiction.

How is erectile dysfunction diagnosed?

First of all, is necessary to realize a complete clinical history and an objective exam. The specialist will focus in knowing the patient´s risk factors, comorbidity, symptomatological characteristics and sexual life. After this, a complete physical exam will be done with special attention to some diagnostic maneuvers done to the penis and testicles to evaluate their cutaneous sensibility and anatomic structure.

Other diagnostic tests that can help the physician discover the cause of this pathology are:

  • General blood tests.
  • Urine tests.
  • Monitoring of the spontaneous erection during sleep using some ring-shaped detectors situated at the base and tip of the penis.
  • Measurement of sacral evoked potentials: this is a neurological exam that studies the electric stimuli of the pudendal nerve and the sacral cord.
  • Penile echocolordoppler: penis echography that studies blood flow.
  • Selective dynamic arteriography of the penis arteries: the specialist realizes this exam after discovering some vascular anomaly with the penile echocolordoppler.
  • Digital rectal exploration to control the status of the prostate.
  • Psychiatric evaluation.

How to prevent erectile dysfunction?

  • Practice regular physical activity.
  • Do not smoke or consume any drug.
  • Do not exceed alcohol consumption.
  • Keep an adequate diet and control body weight.
  • Control glycemia (sugar levels in blood).
Diminish and control mental stress.
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