Erectile dysfunction

Erectile dysfunction

What is erectile dysfunction?

Erectile dysfunction, also referred to as ‘impotence’, is characterised by an inability to produce an erection and maintain it long enough to achieve mutual satisfaction for both parties during intercourse. Erectile dysfunction may be accompanied by poor self-esteem, stress and a feeling of inadequacy, which will only worsen the condition.

All men may experience periods with erectile dysfunction, but there is rarely any cause for concern if it is merely an occasional occurrence. Frequency increases with age, and it is estimated that 5 % of all 40-year-olds, and 20-25 % of all men over 65, suffer from erectile dysfunction.  

Thus, the condition is a very common problem that can cause significant issues in an otherwise well-functioning relationship. The underlying cause is usually harmless and reversible but may in some instances be serious. Therefore, it is recommended to consult your physician if you often or constantly experience erectile dysfunction during intercourse. Fortunately, there are many effective treatment methods against the condition.


What are the symptoms?

  • Difficulty with erections – penis does not become stiff, or not stiff enough

  • Difficulty keeping erections – penis becomes soft too quickly


What are the causes?

When a man gets an erection, it is due to a complex interaction between the man’s psyche, nervous system, vascular system and hormonal balance. The erection chambers within the penis contain blood vessels, and when a man is sexually aroused, these blood vessels become relaxed, expanded and filled with blood, causing the penis to swell. When the blood vessels are filled with blood, the pressure within the penis rises. This results in compression of the veins in the penis, preventing the blood from flowing back, thus maintaining the erection. The erection stops when the blood-filled blood vessels contract again, causing the pressure to drop so the blood can leave the penis. So, the erection is a complicated physiological process that requires interaction between different factors. However, this means that there are also many factors which can result in erectile dysfunction, and these factors are divided into:


  • Vascular causes:

Vascular diseases are a part of the causes as erections require functional blood vessels, which means that diseases influencing these vessels may cause erectile dysfunction. Among these diseases are: arteriosclerosis (hardening of the arteries), peripheral vascular disease, heart failure and high blood pressure. Arteriosclerosis is caused by overweight, smoking and diabetes. In addition, smoking is associated with poor blood circulation and reduced blood supply to the penis, causing smokers to experience erectile dysfunction more often than non-smokers.


  • Psychological causes:

Stress factors such as relationship problems, performance anxiety, or traumatic experiences related with sex can produce feelings of anxiety or anger which can cause erectile dysfunction.


  • Neurological causes:

Damage to nerves and blood vessels within the penis can cause the blood vessels to be unable to expand, thereby inhibiting the sequence of reactions leading to an erection. Nerve damage may be due to trauma, operations or chronic diseases, such as Parkinson’s disease and/or diabetes.


  • Hormonal causes:

Testosterone play an important part of the erection, and reduced production may be caused by diabetes, depression or chemotherapy.


  • Medical reasons:

Different medical preparations may lead to decreased libido (sexual urge) and erectile dysfunction. These medicaments include: Antidepressant drugs and drugs against hypertension (increased blood pressure). In addition, chemical substances such as tobacco, alcohol, narcotics and anabolic steroids may cause erectile dysfunction.   


  • Which factors increase the risk of erectile dysfunction?

Factors that may lead to the development of the condition include: Diabetes, smoking, overweight and poor fitness.


What are the treatments?

First and foremost, it is recommended that you have a BMI within the normal range, that you do not smoke, that you keep your alcohol intake to a minimum or moderate level, that you stay physically active, and that you try to deal with stress and anxiety to the best of your ability. Apart from these lifestyle recommendations that may relieve or prevent the condition, there are different medications for erectile dysfunction. The most well-known drug is Viagra, which should be taken about 1 hour prior to intercourse, but it is only effective if there is a desire for sex.

Apart from this, so-called ‘penis rings/penis pumps’ exist, and they help either maintain the stiffness of the penis, or reach sufficient stiffness. It is possible to use both so that you initially use the penis pump to achieve an erection and then use the penis ring to maintain the stiffness until the intercourse is finished.

People with a lengthy history of erectile dysfunction should be referred to a physician specialising in urology. The same is recommended to treat psychological causes, where the urologist can refer the patient to a psychologist specialising in erectile dysfunction. In certain rare instances, it may be necessary with an operation. For example, an abnormal bend of the penis can be corrected through surgery. It is also possible to implant a penile implant.

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