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Erectile Dysfunction

Erectile Dysfunction (ED) is a medical condition where a man is consistently unable to achieve and maintain an erection that allows for satisfactory sexual function. ED is also referred to as impotence.

A recent study shows that 49% of Canadian men over 40 experience symptoms of erectile dysfunction.

Symptoms of Erectile Dysfunction

The common signs of erectile dysfunction are related to the inability to achieve erection:

  • Erections are less hard
  • Erections may take longer and require more stimulation
  • Erection cannot be maintained during sexual intercourse
  • Erection cannot be achieved at all.

For some men with ED, penetration may not be possible. For others, penetration can be initiated but not maintained until orgasm is reached.

Men with ED often lose confidence in their sexual ability and their overall sense of self-worth can be negatively affected. Erectile dysfunction can have an important psychological impact.

What is Impotence?

When a man becomes aroused, the brain releases a neurochemical to increase the size of blood vessels carrying blood to the penis and reduce the size of the vessels that carry it out. Twin compartments that run the length of the penis, called corpora cavernosa, become flush with blood that is trapped in the shaft. This causes the penis to stiffen and become erect.

If blood flow to the penis is inhibited or the blood vessels are clogged or constricted, erection cannot be achieved or maintained. This is one of the primary causes of erectile dysfunction.
ED is a treatable medical condition that is not related to masculinity or sexual prowess.

Diagnosis

Your doctor will review your symptoms and do an examination of the penis, prostrate, testicles and rectum. The following tests may also be performed in some cases:

  • Testosterone levels: blood test taken in early morning to look for testosterone deficiency.
  • Thyroid function: Blood test to determine thyroid hormone levels
  • Blood sugar levels: Glucose test to determine whether diabetes is present

The doctor may test for other conditions or indicators of poor circulation such as high cholesterol.

Extreme curvature of the penis may make achieving erection for penetration difficult or impossible.

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Causes of a Impotence

Erectile dysfunction occurs when blood flow to the penis is inhibited. Healthy arousal engorges the penis with blood causing it to stiffen and become erect. Without an influx of blood that is held in the penis until after ejaculation, erection will not occur.

The reasons for erectile dysfunction can be broken out into two groups: Psychological and Biological

Psychological: Men who suffer from clinical depression or chronic stress many become impotent. Some of the medications that treat depression can also contribute to the problem. The inability to perform sexually can cause further anxiety and depression, creating a downward spiral.

Biological: Health conditions that affect circulation, structural anomalies in the penis, certain neurological conditions can cause impotence.

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CirculationNervous  SystemStructuralSome medications for :
AtherosclerosisParkinson’s DiseasePeyronie’s DiseaseHigh blood pressure
DiabetesLow TestosteroneAnxiety
Multiple SclerosisPast issues w/ Priapism
Injury or Trauma

Risk Factors for ED

Erectile dysfunction is a common condition among older men. Aging is a key component in developing ED.

  • Men’s testosterone levels naturally decline at a rate of 1% a year, starting in a man’s thirties.
  • High cholesterol and the buildup of arterial plaque over time causes blood vessels to narrow, lessening the capability of your circulatory system.
  • Risk of heart disease and diabetes also increase with age

Lifestyle choices and health conditions can also contribute to impotence:

  • Smoking
  • Obesity
  • Sedentary life style
  • Chronic alcohol/substance abuse

Men with healthier lifestyles – no tobacco, less sitting, more exercise – typically have a lower risk of impotence than other men in the same age group.

Treatment for Erectile Dysfunction

ED is a treatable condition and most men are able to return to healthy sexual function.

  • Medication: The most common treatment is PDES inhibitors (i.e. Viagra or Cialis) that increase blood flow to the penis. Men with certain health conditions cannot take PDES inhibitors
  • Topical Medications: These medications stimulate blood flow.
    Creams, Suppositories, Self-managed injection
  • Penile Vacuum Device: This device fits over the penis and is pumped to achieve an erection. An elastic ring around the base of the shaft holds the blood in the penis, maintaining erection.
  • Penile Implants: Protheses implanted in the penis, either as bendable rods or inflatable cylinders that are pumped up to achieve erection
  • PRP Therapy: Using the patient’s blood, platelet rich plasma is separated and injected into the afflicted area, revitalizing muscles and tissues and improving circulatory function.
  • Erectile Dysfunction Shock Wave Therapy: The application of low-intensity shockwaves (similar to sound waves) to reopen veins and re-establish proper blood flow to the penis.

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