Erectile dysfunction (ED) is currently one of the most common sexual dysfunctions in men worldwide . This serious health problem has been the focus of public attention in recent times. It ranges from partial decrease in penile rigidity to a complete erectile failure .
It is one of the major social problems causing significant distress in men. Despite the increasing difficulty in management, knowledge, and understanding of factors responsible for its development are important for prevention and care.
WHAT CAUSES AN ERECTION?
ED can occur because of problems at any stage of the erection process. An erection is the result of increased blood flow into your penis. Blood flow is usually stimulated by either sexual thoughts or direct contact with your penis.
When a man is sexually excited, muscles in the penis relax. This allows for increased blood flow through the penile arteries, filling two chambers inside the penis. As the chambers fill with blood, the penis grows rigid.
An erection ends when the muscles contract and the accumulated blood can flow out through the penile veins.
WHAT IS ERECTILE DYSFUNCTION?
Erectile dysfunction is the inability of a man to achieve or sustain an erection for satisfactory sexual intercourse. ED tends to affect the psychological and emotional well-being of men. Some men who have this problem are often shy to complain because of loss of self-esteem associated with this condition thus resulting in late presentation that delays early treatment. Some men do prefer to seek remedy to this condition by patronizing local African traditional herbalists.
GLOBAL PREVALENCE OF ERECTILE DYSFUNCTION
The estimated global prevalence has been on the increase. It is projected that the number of men with this condition will rise to 322 million by the year 2025 . ED is usually underestimated in many developing countries including Nigeria . This is because it is not a life threatening condition and due to associated stigma, men with the problem rarely seek help. There is also the problem of early detection and management of factors responsible for the development of ED. The impact of ED could be devastating because evidence has shown that sexual function is one of the important indices of quality of life.
WHAT ARE THE SYMPTOMS OF ERECTILE DYSFUCTION?
Erectike dysfunction symptoms might include persistent:
- Difficulty getting an erection
- Difficulty sustaining an erection
- Reduction in desire for sex
- Reduction in libido(sexual urge).
WHAT ARE THE CAUSES OF ERECTILE DYSFUNCTION ?
Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.
Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen ED.
Also an underlying medical condition can predispose an individual to ED. ED is commonly seen among men with hypertension, diabetic mellitus and psychosis when it is often related to the disease as well as the medications. Other known causes of ED are sickle cell disease patients who develop priapism. It is common among married men and those with significant alcohol ingestion and cigarette smoking.
The causes of ED could also be divided into 3; physical causes, physiological causes and risk factors.
PHYSICAL CAUSES OF ED.
In many cases, erectile dysfunction is caused by something physical. Common causes include:
- Heart disease
- Clogged blood vessels (atherosclerosis)
- High cholesterol
- High blood pressure
- Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
- Parkinson’s disease
- Multiple sclerosis
- Tobacco use
- Peyronie’s disease — development of scar tissue inside the penis
- Alcoholism and other forms of substance abuse
- Sleep disorders
- Treatments for prostate cancer or enlarged prostate
- Surgeries or injuries that affect the pelvic area or spinal cord
- Low testosterone.
PSYCHOLOGICAL CAUSES OF ERECTILE DYSFUNCTION
The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:
- Depression, anxiety or other mental health conditions
- Relationship problems due to stress, poor communication or other concerns.
RISK FACTORS FOR ERECTILE DYSFUNCTION
As you get older, erections might take longer to develop and might not be as firm. You might need more direct touch to your penis to get and keep an erection.
Various risk factors can contribute to erectile dysfunction, including:
- Medical conditions, particularly diabetes or heart conditions
- Tobacco use, which restricts blood flow to veins and arteries, can — over time — cause chronic health conditions that lead to erectile dysfunction
- Being overweight, especially if you’re obese
- Certain medical treatments, such as prostate surgery or radiation treatment for cancer
- Injuries, particularly if they damage the nerves or arteries that control erections
- Chronic Use of Medications, including antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate conditions
- Psychological conditions, such as stress, anxiety or depression
- Drug and alcohol use, especially if you’re a long-term drug user or heavy drinker
COMPLICATIONS OF ED
A lot of complication could arise from ED. Complications resulting from erectile dysfunction can include:
- An unsatisfactory sex life
- Stress or anxiety
- Embarrassment or low self-esteem
- Relationship problems
- The inability to get your partner pregnant.
HOW CAN IT BE TREATED?
Patients suffering from erectile dysfunction should first be evaluated for any underlying physical and psychological conditions. If treatment of the underlying conditions doesn’t help, medication and assistive devices, such as pumps, may then be prescribed.
Oral medications: Vasodilators such as Sildenafil popularly known as Viagra, Tadalafil (Adcirca, Cialis),Vardenafil (levitra, staxyn) and Avanafil (stendra).
Physical exercise and Stop every underlying conditions that predispose you to ED.
NOTE: All four medications enhance the effects of nitric oxide; a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation.Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing normal penile function in some people.
Oral ED meds are not aphrodisiacs (substances that increase sexual desire), will not cause excitement and are not needed in people who get normal erections; for those abusing Viagra.
Also, you could do a Penis pump, Implants and Surgery.
This treatment involves surgically placing devices into both sides of the penis. These implants consist of either inflatable or malleable (bendable) rods. Inflatable devices allow you to control when and how long you have an erection. The malleable rods keep your penis firm but bendable.
Testosterone replacement therapy can also be done.
Testosterone replacement therapy
Some people have erectile dysfunction that might be complicated by low levels of the hormone testosterone. In this case, testosterone replacement therapy might be recommended as the first step or given in combination with other therapies.
PREVENTION OF ERECTILE DYSFUNCTION
The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health conditions. For example:
- Work with your doctor to manage diabetes, heart disease or other chronic health conditions.
- See your doctor for regular checkups and medical screening tests.
- Stop smoking, limit or avoid alcohol, and don’t use illegal drugs.
- Exercise regularly.
- Take steps to reduce stress.
- Get help for anxiety, depression or other mental health concerns.
- Some diets may help increase blood flow which may be beneficial in both preventing and treating ED. Such as eating whole grains, vegetables, and fruits. Limit your consumption of red meats, full-fat dairy, and processed sugars.
- Several specific foods, from cocoa to watermelon, may help with ED.
If you’re concerned about erectile dysfunction, talk to your doctor — even if you’re embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.