Erectile DysfunctionMale erectile disorder (DSM-IV, 302.72), more commonly known as erectile dysfunction (ED) or impotence, is failure, difficulty getting, or inability to maintain an erection. Cases rate about 90% physical and 10% psychological. Because in so many cases, physical causes are behind ED, there are now several medical means of correcting with this problem (discussed below).Precipitating EventsMany things can precipitate erectile dysfunction. These include, fatigue, too much alcohol, preoccupation with getting an erection, jet lag, partner's criticism, not feeling appreciated or wanted by partner, boredom, ugly partner, guilt, anxiety, low desire.Physiological/Medical AspectsIn general, the medical condition that underlies ED is poor blood circulation to the penis caused by hardening of the arteries. Diabetes, which drains the body of critical proteins if not well managed, damages the circulatory system, and many diabetic men develop ED because of this. Hardening of the arteries is the leading cause of ED. Over weight, hypertension, smokers are all at risk. Heart diseases is also an underlying cause. Another cause is Peyronie's Disease-- scar tissue is deposited as the result, usually, of inflammation in the blood vessels of the penis. Excessive alcohol consumption can cause Peyronie's Disease.Finally, I will mention venogenic impotence. This is the failure of the veins that drain the penis to respond appropriately. The erectile tissue of the penis is the corpus cavernosa and corpus spongiosum. During an erection, these become engorged with blood. To do this, the outgoing veins of the penis must constrict to keep the blood in the penis. So if these veins remain open or leak, the corpus tissues will not fill, and no erection. Nitric OxideNitric oxide (NO) plays critical key roles in the regulation of blood pressure, memory, and many other body physiological function, including erections. It is a major signal molecule (see Gene Regulation) and neurotransmitter (see nervous system) of the body. Its excess is also the molecule that causes the most damage in stroke victims. To maintain or obtain an erection, the appropriate amount of NO must be available to the cells and blood vessels. NO is the focus of such prescription ED drugs as Cialis™, Viagra™, and others. These work by inhibiting an enzyme that breaks down a precursor of NO. Thus the concentration of NO can increase and do its magic.Drug TreatmentOral
SuppositoryMuse (alprostadil)--5-15 minutes to act, lasts 60 mins. Success rate is 45-65%.OthersInjections are also available. Talk to your physician about these.Mechanical TreatmentVacuum pumps and cock rings. The vacuum pump is put on the penis and pumped to draw blood into the penis. The cock ring is placed on the base of the penis to prevent blood from escaping. |
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