Erectile dysfunction (ED) is a condition wherein a man fails to keep an erection firm enough for sexual intercourse. A person with ED have a persistent inability to attain and maintain a sufficient erection so as to permit satisfactory sexual intercourse. Erection trouble at times is necessarily not a major cause of concern, however, if the dysfunction is continued for a longer period then it may cause relationship problem, stress or may affect self-confidence.
Both physical and psychosocial health of the person with ED is affected. This problem might impart significant impact on the quality of life (QoL) of the person concerned, his partners and families as well. Epidemiologic studies report that approximately 5–20% of men have moderate to severe erectile dysfunction. Variation in incidences reported is probably due to differences in the methodology and the socioeconomic status and age of the populations studied.
Continual difficulty in getting an erection
Difficulty in maintaining an erection
Reduced desire for sexual intercourse
Sexual arousal in men is a complex process that involves the hormones, brain, nerves, emotions, blood vessels and muscles. The brain plays a major part in setting off the series of physical outcomes that makes an erection, which starts with the onset of sexual excitement. Any problem related to the above stated organs or conditions may result in erectile dysfunction. Ed may occur due to certain physical or psychological issues at times. As, for example, a minor physical trouble that might slow the sexual response makes a man anxious about attaining and maintaining an erection.
A few of the physical causes associated with erectile dysfunction are listed below:
High blood pressure
Clogged blood vessels (atherosclerosis)
Another condition, metabolic syndrome, that involves increased blood pressure, body fat around the waist, high insulin levels and high cholesterol may cause erectile dysfunction.
Peyronie's disease, development of scar tissue inside the penis
Certain prescription medications
Pelvic area or spinal cord affected by operations or injuries
Use of Tobacco
Substance abuse like alcoholism
Erectile dysfunction often shares common risk factors associated with cardiovascular disease, that includes obesity, lack of exercise, hypercholesterolaemia, smoking. Adjustment of these factors and in particular carrying out suitable weight loss exercise regime may help in reducing ED. Another major risk factor associated with ED is (RP) in any form, i.e. laparoscopies, robotic or open that might cause injury to cavernosal nerve, vascular insufficiency and poor oxygenation of the corpora cavernosa. Postoperative ED is reported in nearly 25–75% of men undergoing. Patients considered for nerve-sparing radical prostatectomy, ideally, should be potent, and to ensure erectile function recovery after RP, the cavernosal nerves must be preserved.
With primary erectile disorder that are not caused by psychogenic disorder or organic disease
With a history of perineal or pelvic trauma who could be beneﬁtted from potentially curative vascular surgery
With Peyronie’s disease (penile deformities) that might require surgical correction
Having complex psychosexual or psychiatric disorders
With complex endocrine disorders
Having medicolegal reasons (e.g., Penile Prosthesis Implant, sexual abuse)
Erectile dysfunction (or impotence) is one of the most prevailing complaints in male sexual medicine. Proper diagnosis of the underlying cause of the disease may be enough to treat and reverse erectile dysfunction.
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