Erectile dysfunction (ED) is the inability of a man to maintain a firm erection long enough to have sex. Although erectile dysfunction is more common in older men, this common problem can occur at any age. Having trouble maintaining an erection from time to time isn’t necessarily a cause for concern but if the problem is persistent, it can cause stress and relationship problems and affect self-esteem. Formerly called impotence, erectile dysfunction was once a taboo subject. It was considered a psychological issue or a natural consequence of growing older. These attitudes have changed in recent years. It’s now known that erectile dysfunction is more often caused by physical problems than by psychological ones, and that many men have normal erections into their 80s. Although it can be embarrassing to talk with your doctor about sexual issues, seeking help for erectile dysfunction can be worth the effort. Erectile dysfunction treatments ranging from medications to surgery can help restore sexual function for most men.
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Physical causes of erectile dysfunction:
At one time, doctors thought erectile dysfunction was primarily caused by psychological issues but this isn’t true. While thoughts and emotions always play a role in getting an erection, erectile dysfunction is can be caused by something physical, such as a chronic health problem or the side effects of a medication. Sometimes a combination of things causes erectile dysfunction.
Common causes of erectile dysfunction include:
- Heart disease
- Clogged blood vessels (atherosclerosis)
- High blood pressure
- Metabolic Syndrome
Common causes of erectile dysfunction include:
- Certain prescription medications
- Alcoholism and other forms of drug abuse
- Treatments for prostate cancer
- Parkinson’s disease
- Multiple sclerosis
- Hormonal disorders such as low testosterone (hypogonadism)
- Peyronie’s disease
- Surgeries or injuries that affect the pelvic area or spinal cord
In some cases, erectile dysfunction is one of the first signs of an underlying medical problem.
Psychological causes of erectile dysfunction:
The brain plays a key role in triggering the series of physical events that cause an erection, beginning with feelings of sexual excitement. A number of things can interfere with sexual feelings and lead to or worsen erectile dysfunction. These can include:
- Poor communication or conflict with your partner
The physical and psychological causes of erectile dysfunction interact. For instance, a minor physical problem that slows sexual response may cause anxiety about maintaining an erection. The resulting anxiety can worsen erectile dysfunction.
A variety of factors can contribute to erectile dysfunction.
Getting older: As many as 80 percent of men 75 and older have erectile dysfunction. Many men begin to notice changes in sexual function as they get older. Erections may take longer to develop, may not be as rigid or may take more direct touch to the penis to occur. But erectile dysfunction isn’t an inevitable consequence of normal aging. Erectile dysfunction often occurs in older men mainly because they’re more likely to have underlying health conditions or take medications that interfere with erectile function.
Having a chronic health condition: Diseases of the lungs, liver, kidneys, heart, nerves, arteries or veins can lead to erectile dysfunction, so can endocrine system (define as pop up) disorders, particularly diabetes. The accumulation of deposits (plaques) in your arteries (atherosclerosis) also can prevent adequate blood from entering your penis. And in some men, erectile dysfunction may be caused by low levels of testosterone (male hypogonadism).
Taking certain medications: A wide range of drugs including antidepressants, antihistamines and medications to treat high blood pressure, pain and prostate cancer can cause erectile dysfunction by interfering with nerve impulses or blood flow to the penis. Tranquilizers and sleeping aids also can pose a problem.
Certain surgeries or injuries: Damage to the nerves that control erections can cause erectile dysfunction. This damage can occur if you injure your pelvic area or spinal cord. Surgery to treat bladder, rectal or prostate cancer can increase your risk of erectile dysfunction.
Substance abuse: Chronic use of alcohol, marijuana or other drugs often causes erectile dysfunction and decreased sexual drive.
Stress, anxiety or depression: Other psychological conditions also contribute to some cases of erectile dysfunction.
Smoking: Smoking can cause erectile dysfunction because it restricts blood flow to veins and arteries. Men who smoke cigarettes are much more likely to develop erectile dysfunction.
Obesity: Men who are obese are much more likely to have erectile dysfunction than are men at a normal weight.
Metabolic syndrome: This syndrome is characterized by belly fat, unhealthy cholesterol and triglyceride levels, high blood pressure, and insulin resistance.
Prolonged bicycling: Over an extended period, pressure from a bicycle seat has been shown to compress nerves and blood flow to the penis, leading to temporary erectile dysfunction and penile numbness.
Porn-induced Erectile Dysfunction (PIED)
In the late 90’s older men rejoiced when Viagra hit pharmacy shelves. But today younger men are also seeking out drugs that correct erectile dysfunction (Global News). Yet, their problem isn’t physical, it’s mental and it’s caused by the overviewing of pornography. Many of the internet generation today have had access to porn 24 hours a day since middle school. Yet, when they come into contact with a real sexual partner they have a difficult time achieving and maintaining an erection.
The name for this new form of impotence is Porn-induced Erectile Dysfunction (PIED). When the problem is in the head and not the pants, however, oftentimes ED medications won’t work. Forums online team with thousands of young men who are suffering from PIED. Urologist and Director of Men’s Health Boston, Dr. Abraham Morgentaler, is worried about the affect instant access to a deluge of online pornography is having on us as sexual beings. “I see young men coming in who are really confused about what normal is because all they know about sex is what they’ve seen on porn,” Dr. Morgentaler said in a recent interview. In the Victorian age, Dr. Morgentaler points out, men swooned over seeing an ankle. In the 60’s it was the mini-skirt. But today there are no surprises. And we all have access to any kind of porn we want at any time.
The good doctor went on to say, “I think that the concern is what porn has figured out is what really works for the brain of the guys. It’s the maximum stimulus.” The porn industry has gotten very good at delivering its product, perhaps too good. This ever-prevalent access has changed the psychology of some guys but also their biochemistry. Dopamine levels have changed drastically. The newest research just coming out of Cambridge University likens the brains of excessive porn watchers to alcoholics and those addicted to drugs. Those who are overstimulated by online porn then have trouble being aroused by real, offline sex. Symptoms of PIED include Irritability, anxiety, feelings of insecurity, depression, and physical problems such as lack of appetite and insomnia can also occur. In extreme instances sufferers may have suicidal thoughts thinking they’ll never have an erection again, or that they broke themselves. Some unscrupulous doctors will prescribe medication and tell their patients that it’s performance anxiety they’re suffering from.
The real cure is to cut out watching porn and cease masturbation for a time; what sufferers of PIED call “rebooting”. Instead, this is a time to stay physically active and feel good about yourself. Soon the overstimulation will subside and sexual functioning will return to normal. The trouble is, there are a lot of guys online who don’t know about this simple treatment. If you think you could be suffering from PIED and would like help, consider speaking with a medical professional.
Safeguarding Against ED
Many men experience erectile dysfunction (ED) as they grow older (WebMD). But there are ways you can safeguard against ED. One of the most important things you can do is to follow a heart healthy diet. What effects the heart effects erections. Studies have elucidated this relationship displaying that the same types of foods that lead to heart disease also constrict blood flow to the penis, making erections more difficult to achieve and maintain. Eat a diet rich in fruits, vegetables and nuts. Make it low fat with lean protein. Consuming fried or fatty foods, highly processed foods, and large amounts of salt and sugar can lead to poor heart health, diabetes, obesity and sexual issues. The latest research shows that men who consume a Mediterranean diet have extremely low levels of ED. This diet is replete with heart healthy fats, whole grains, fish, beans and legumes and lots of fruits and vegetables. This diet also suggests consuming a small amount of wine, particularly red wine, which is good for the heart. Director of sexual medicine at Alvarado Hospital in San Diego, Irwin Goldstein, MD, says that “The link between the Mediterranean diet and improved sexual function has been scientifically established.”
Make sure to keep your weight down. Carrying around an unhealthy amount of excess fat can lead to type 2 diabetes. This in turn can lead to nerve damage in different areas in the body including the penis. Reaching and sustaining a healthy body weight is also key in maintaining good sexual health. High cholesterol and high blood pressure lead to heart trouble and trouble downstairs, too. These can damage your blood vessels, leading to ED. When you have a checkup, see what your doctor says your cholesterol level and blood pressure are. If you want to you can also purchase a monitor at the pharmacy to check your blood pressure at home. Seek medical attention if either one is not where it should be.
Blood pressure medications can also affect your sexual ability and performance. But lots of times the medicines are blamed when the real problem is arterial damage from the high blood pressure to begin with. There has been lots of evidence linking ED to lack of exercise. Aerobic exercises such as swimming, running or bike riding will do the trick. Find one that you enjoy and stick with it. Avoid anything that can damage the perineum area, or excessive strain on this area. This is the place between the anus and the testicles. Blood flow to the penis passes through here. Damage to that area can cause ED.
Take care of any mental health issues, including managing stress in a healthy manner. Don’t smoke or try to quit if you’re already a smoker. Don’t use anabolic steroids and watch your testosterone level. Doing this will help keep you active and healthy both inside the bedroom and out.
How to Talk to your Doctor about ED
Erectile dysfunction (ED) can be mortifying. Who wants to talk about it? Some guys are so embarrassed they don’t even want to discuss it with their doctor (WebMD). But it will not only affect your sex life and overall quality of life if you ignore the issue, ED can be a sign of a deeper health issue, which if left untreated could lead to serious complications and even death. Two such issues are diabetes and heart disease. Certain medications could also be causing ED like heart medications or those for certain psychological conditions such as depression. But sometimes just a simple consultation with a doctor and a change in medication or certain lifestyle changes are all that is needed to correct the issue. However, if it is a deeper issue is at hand, asking about ED can save you from more serious health concerns.
So how do you talk to your doctor about ED?
- First, take heart. Realize that this is a common issue that many men face. Over half of men between the ages of forty and seventy encounter some sort of erectile issue according to a recent study out of Massachusetts. The chief complaint physicians deal with as men age is erection satisfaction.
- Next, think about your approach. How will you broach the subject with your doctor? When you call for an appointment, you don’t have to share why you are calling over the phone. You can just say it’s a sexual health concern, or better yet, a men’s health concern.
- When you get into the examining room with your doctor alone, don’t hold back. Be completely honest with your physician. Think about all the aspects of the situation in order to give the doctor all the information that may be useful. When did you first notice the issue? Was it during masturbation or while having sex with your partner?
- Bring up any other health problems you’ve been experiencing. Your doctor will probably ask you about alcohol, smoking and illicit drug use. Answer your physician honestly. It’s the only way to get to the root of the problem. How have you dealt with problems achieving an erection in the past? Have you felt anxious or depressed lately? What has your stress level been like?Think and see if there are any other things which may be contributing to the problem.
- In addition bring a list of questions to ask the doctor. Ask what is normal in terms of achieving an erection at your age. See if your doctor thinks a more serious condition may be causing the problem. Find out whether the problem is physical or psychological. Keep asking questions and find out as much as you can. Following these steps will bring you and your doctor closer to having the situation alleviated.