Erectile Dysfunction

Erectile dysfunction is also known as impotence, although this connotes a decreasing of power or masculinity instead of a physical or physiological condition. Because of the stigma of ED, which is fortunately lessening, it is doubly important to understand the mechanics of an erection and how the process can be disrupted.

An erection is a physiological process beginning with mental and/or sensory stimulation. Brain and nerve impulses act like switches which when “turned on” send a signal to the penis. Inside the shaft of the penis there is a special matrix of fine, mesh like muscles name the “corpora cavernosa The signal from the nerves causes the spongy muscle tissue to relax , and the signal causes the arteries to increase their blood flow into this spongy tissue. As the blood flow increases, the penis expands and lengthens. Veins that normally allow the blood to drain back out of the penis, close off during an erection to trap the blood into the penis. The lining of the penis that surrounds the spongy tissue is incredibly strong and once it fills to its maximal size it will hold its size and shape as more and more blood flows in creating pressure much like the way a bicycle tire will initially fill out then get harder and harder as it is pumped with air. If any of these steps are interrupted or disrupted, an erection can be difficult to achieve and/or maintain. The brain, spinal column, and pelvic nerves have to switch on to send the signal. The penile arteries must be open and clean to pump blood into the penis, The penile spongy tissue or corpora cavernosum, has to be healthy and supple to expand and fill with blood. The tough outer lining has to be strong and smooth to maintain a straight erection, and the veins have to close off effectively to maintain the erection otherwise it “deflates.” A preexisting medical and/or psychological condition can interfere with one or more of these coordinated processes and prevent a normal erection from happening and lasting.

Damage or illness to the vascular or neurological systems, or to the nerves, arteries, muscles, and/or tissues may result in ED. Those with certain illnesses have a higher incidence of ED, including:

  • Diabetes
  • Kidney disease
  • Multiple sclerosis
  • Atherosclerosis
  • Vascular disease
  • Neurological disease
  • Hormonal imbalances
  • Chronic alcoholism
  • Medications for blood pressure, allergies, depression, anxiety, appetite suppression, and ulcers can also cause erectile dysfunction. Some 200 prescription drugs are linked to ED.

Precursors to heart disease, including smoking, elevated cholesterol, being overweight, or not exercising, may also cause ED. Erectile Dysfunction can be the first sign of more serious conditions such as heart disease or risk of stroke. The blood vessels of the penis are much smaller than the blood vessels of the heart or the brain, and they will narrow and clog sooner than the others. The penis is often the first to go, then sometimes comes heart attack or stroke if no one is paying attention.

Surgery of the penis, prostate, spinal cord, bladder, or pelvismay damage nerves, muscles, arteries, or spongy blood filled tissue in the corpora cavernosa( the chambers that expand in the penis).

There is much more to sexual activity than physical responses: mental or emotional responses can also play a role in ED. Psychological factors are believed to be the cause of 10 to 20 percent of erectile dysfunction cases. Those that can interfere with erection include:

  • Anxiety
  • Depression
  • Guilt
  • Low self-esteem
  • Fear of sexual failure or inadequacy

Many men with erectile dysfunction find that moderate lifestyle changes may be enough to reverse the condition. Healthy eating and healthy habits including exercise and stress reduction can reverse ED over time. With this approach, whats good for the penis is also good for the heart and helps reduce the risk of stroke as well. Dr. Spitz progresses from the least invasive treatments to more intensive treatments, depending on your individual needs and causes of ED. If lifestyle changes are not enough, medicines and other nonsurgical techniques or penile implant may be pursued. There is no reason to endure ED any longer, and every reason to take steps to help yourself improve your sexual health.