Erectile Dysfunction - A Nightmare For Every Male

Introduction:

Men in every culture and society are too concerned about their sexual strength. Performance in the bed is one of the main essential criteria to determine sexual courage. In the olden era as well, males were judged based on their sexuality. This is a natural selection running from humanity's origin to determine one male's dominance over the other, hence claiming the right to procreate.

What Is Erectile Dysfunction?

Erectile dysfunction is one of the most prevalent sexual health-related problems faced by men. A whole multibillion industry is thriving on this problem, marketing various products claiming to improve the performance. Erectile dysfunction (ED) is defined as difficulty obtaining and maintaining an erection during sexual activity and has noticed a marked decrease in erectile rigidity in all or almost all (75–100%) sexual encounters. The prevalence estimates of ED had ranged from 10-45%. With age, the incidence of ED also increases such that, in men, less than 40 years of age, 1-10% develop ED, whereas in men more than 70 years of age, about 50% complain of having ED.

Comorbid conditions which can occur along with ED are:

• Poor general health.

• Substance use.

• Medical conditions such as cardiac disturbances, hypertension, diabetes, hyperlipidemia, etc.

• Psychological features such as depression and anxiety.

• Other sexual troubles like premature ejaculation, male hypoactive sexual desire disorder.

What are the Symptoms of Erectile Dysfunction?

The symptoms of Erectile dysfunction may include trouble sustaining an erection where the symptoms are persistent and may include:

• Trouble obtaining and maintaining an erection.

• Decreased sexual activity or desire.

What Causes Erectile Dysfunction?

1. Genetic Basis:

Involvement of ACE (angiotensin converting enzyme) gene and Nitric Oxide Synthase (NOS) gene.

2. Neurobiological Basis:

• Disease or events that cause disturbances in vascularity such as acute myocardial infarction, cerebrovascular accidents, and hypertension can cause ED.

• Neuropathic conditions like multiple sclerosis, epilepsy, encephalitis, Parkinson's disease, brain trauma, etc., also can lead to ED.

• Endocrinological disturbances such as hyperthyroidism, hypogonadism, hyperprolactinemia are also known to cause ED.

3. Psychological Factors:

• Performance anxiety, antecedent life changes (for example - divorce or loss of employment), and developmental vulnerabilities are the three common psychological factors associated with ED.

• Performance anxiety has been referred to as a specific cause of ED. It is characterized by a focus on negative thoughts relating to erectile failure that interfere with sexual stimulation and anxiety and worry about the consequences of failure.

• Negative attitudes and emotions about sex have also been linked to ED.

4. Social and Environmental Factors:

Status and dominance issues, intimacy and trust, loss of sexual attraction, low socioeconomic status, lower education are the common factors associated with ED.

5.Side Effects Due to Medicines:

ED can be a side effect of several common medicines, like:

• Blood pressure medicines.

• Antiandrogens, the medications that are used for prostate cancer therapy.

• Antidepressants.

• Tranquilizers or prescription sedatives are medicines that make you calmer or sleepy.

• Appetite suppressants or medicines that make you less hungry.

• Ulcer medicines.

What Are the Risk Factors For ED?

Risk factors for ED include having medical conditions such as:

• Cardiovascular disease or diabetes.

• Psychological disorders such as anxiety or depression.

• Overweight, particularly obese.

• Bearing an injury to or any surgery on your pelvic area.

• Using certain medications, such as antidepressants or blood pressure medications.

• Undergoing particular medical treatment, such as radiation therapy for cancer.

• Using tobacco products, alcohol, or drugs.

How To Diagnose Erectile Dysfunction?

Diagnosis of ED includes self-reporting of difficulties in erection during masturbation, morning erections, and partnered sex, complete medical evaluation and blood work (fasting blood glucose, lipid profile, cholesterol, prolactin, total testosterone, thyroid profile, prostate-specific antigen), manual inspection of penis and testicles, and nerve conduction studies to rule out any organic cause of ED. The other tests include:

• Hormone test: A blood test to estimate the levels of male hormones.

• Complete blood count (CBC): To check for diabetes, heart disease, or an infection causing the symptom.

• Urine test: To check for diabetes or any diseases.

• Digital rectal examination: Inserting a gloved finger into the rectum to monitor changes in the prostate gland.

• Ultrasound: Using sound waves to get images of the penis.

• Nocturnal penile tumescence: Using a battery-powered device to evaluate the nature of erections during sleep.

• Psychological examination: To evaluate for psychological disorders.

What Are the Treatment Options for Erectile Dysfunction?

Treatment of ED includes both somatic measures as well as psychological measures.

1. Somatic Measures:

• Intracavernosal injections (injection into the base of the penis).

• Penile self-injections like Papaverine and Alprostadil.

• Penile prosthesis.

• Vacuum pump devices.

• Hormonal replacement.

• Shock wave therapy.

• Herbal supplements.

• Phosphodiesterase 5 inhibitors like Sildenafil, Vardenafil, and Tadalafil can be used.

Mechanism of action of somatic measures is to increase the vascularity in the penis, resulting in engorgement of blood vessels via relaxation of smooth muscles, hence resulting in increased tumescence and rigidity.

2. Psychological Measures:

• Brief psychoeducation focused on therapy regarding the physiological mechanism of erection and age-related expectation of erection to be explained.

• Couple therapy, focusing on increasing the communication between couples and resolving relational conflicts.

• Sensate focus, relaxation training, and cognitive restructuring can also be used effectively.

Besides this, weight loss and regular physical exercise also show reasonable responses in mild to moderate cases. Avoid smoking and alcohol consumption, as they also contribute to the development of ED. The best modality of treatment is the combination of somatic and psychological measures to treat comorbid conditions for complete recovery of premorbid sexual performance. Last but not least, ED is just as treatable as other mental and physical ailments. Certain exercises can help with ED, like kegel's exercise, aerobic exercise, and yoga.

The following foods have been observed to help manage erectile dysfunction:

• Dark chocolates.

• Walnut.

• Green leafy vegetables such as kale.

• Watermelon.

• Cooked oysters.

• Coffee.

• Grape or pomegranate juice.

• Fish like salmon.

• Olive oil.

• Limiting the consumption of full-fat dairy, red meats, and processed sugars.

• Drink alcohol in moderation.

What Are the Complications of Erectile Dysfunction?

Complications usually result from poor sexual life:

• Stress.

• Problems in a relationship.

• Low self-esteem.

How To Prevent Erectile Dysfunction?

To prevent ED:

• Keep medical conditions such as diabetes and heart diseases under control.

• Do regular exercise.

• Maintain a healthy weight.

• Focus on eating a healthy diet.

• Find methods to reduce or manage stress.

• Seek advice if you are experiencing anxiety or depression.

• Quit smoking.

• Only use alcohol in moderation.

• Avoid using drugs that your doctor has not prescribed.