Impotence

The inability to achieve or sustain an erection long enough for sexual activity is known as erectile dysfunction (ED). There are numerous potential causes, including as disorders of the blood vessels, neurological disorders, mental health issues, and traumas. Erectile dysfunction can be diagnosed and treated by a medical professional.

An erection that is not strong enough for sexual activity is known as erectile dysfunction, or impotence.

Periodically experiencing difficulties achieving an erection is not always a reason for alarm. However, if erectile dysfunction persists, it may lead to stress, undermine your confidence, and exacerbate interpersonal issues. In addition to being a risk factor for heart disease, difficulties achieving or maintaining an erection may also indicate an underlying medical issue that needs to be treated.

Even if you’re embarrassed to discuss erectile dysfunction with your doctor, do so. Reversing erectile dysfunction can occasionally be achieved by treating an underlying problem. Medication or other direct therapies may be required in other situations.

Men most frequently report erectile dysfunction, or ED, to their doctors as a sexual health issue. As many as thirty million males may be impacted.
Problems achieving or maintaining an erection strong enough for sexual activity are known as ED.
While occasional erection difficulties are common in men, progressive ED or recurrent episodes during sexual activity are abnormal and require medical attention.

ED may occur:

• Usually when there is restricted blood supply to the penis or when nerves are damaged

• due to emotional or stressful factors

• as a precursor to a more serious condition, such as heart disease, high blood pressure, diabetes, atherosclerosis (hardening or blockage of the arteries), or hyperglycemia

The Mechanism of Erections

Chemicals released by nerves during sexual stimulation enhance blood flow to the penis. Two erection chambers in the penis, composed of spongy muscle tissue (the corpus cavernosum), receive blood flow. The chambers of the corpus cavernosum are not hollow.
The spongy tissues relax and hold blood during an erection. An erection is brought on by the blood pressure in the chambers firming the penis. A second set of nerve signals enters the penis during an orgasm, causing the muscle tissues there to contract, releasing blood back into the circulation and causing the erection to collapse.

Erectile dysfunction: what is it?

Penile disorders include erectile dysfunction (ED). It interferes with your ability to achieve and sustain an erection strong enough for engaging in sexual activity.
The ability to achieve and sustain an erection is greatly influenced by your emotions. It is vital to feel at ease, self-assured, and stimulated. On the other hand, occasional erection problems are common. Problems with erection may arise if you experience nervousness, anxiety, frustration, or fatigue. Alcohol consumption and/or drug use can also have an impact. It may also be a side effect of specific drugs or cancer therapies, or it may be the outcome of other illnesses.
Making an appointment with a healthcare professional is a smart option if you’re experiencing problems achieving or sustaining an erection.

ED frequently appears as the initial sign of another underlying issue, such as heart disease. It’s crucial to consult a healthcare professional if you experience difficulties achieving and sustaining an erection.

There are other terms for erectile dysfunction:

• Impotence.
• Impotency.

Erectile dysfunction affects your body’s ability to fill erectile tissue with blood.

What are the types of erectile dysfunction?

Healthcare professionals classify ED patients into multiple groups:

erectile dysfunction vascular. Affected blood veins that supply blood to the tissues in your penis that enable you to achieve and sustain an erection, as well as the penis’s natural blood-holding valves, are among the causes of vascular ED. ED that is vascular is the most prevalent kind.
erectile dysfunction caused by neurons. Nerve issues that obstruct the transmission of information from your brain to your penis to produce an erection are the cause of neurogenic ED. Trauma, pelvic surgery, radiation therapy, or neurological diseases such as multiple sclerosis (MS), spinal stenosis, and stroke can all cause this.
erectile dysfunction caused by hormones. The term “hormonal ED” describes ED caused by a lack of testosterone or, in certain situations, by thyroid problems.
dysfunction erectile brainwashed. Conditions that impact your ideas, feelings, or behavior are known as psychogenic ED, and they can lead to ED.

How prevalent is male erection?

Men and those classified as male at birth (AMAB) most frequently report erectile dysfunction to medical professionals, especially as they get older and have other health problems.

What is the usual age for erectile dysfunction?

Providers and medical researchers estimate that erectile dysfunction affects over 50% of people who identify as male between the ages of 40 and 70. And those numbers may be higher — many don’t seek help for the condition due to embarrassment or shame. How common is erectile dysfunction? Erectile dysfunction is the most common sex-related condition that men and people assigned male at birth (AMAB) report to healthcare providers, especially as they age and develop other health issues.

Symptoms

Erectile dysfunction symptoms might include persistent:

• Trouble getting an erection

• Trouble keeping an erection

• Reduced sexual desire

When to visit a physician

When you have erectile dysfunction, a smart place to start is with your family physician. Consult a physician if:

 

• You’re having trouble getting an erection or you’re having other sexual issues like early or delayed ejaculation.

• You suffer from diabetes, heart disease, or any other recognized medical problem that may be connected to impotence.

• You have erectile dysfunction in addition to other symptoms.

Reasons

 

 

A complex process involving the brain, hormones, emotions, nerves, muscles, and blood vessels is male sexual arousal. Any of these issues may lead to erectile dysfunction. Similarly, erectile dysfunction can be brought on by or made worse by stress and mental health issues.
Sometimes erectile dysfunction is brought on by a confluence of mental and physical problems. For example, anxiety over sustaining an erection could be brought on by a minor physical problem that slows down your sexual reaction. Anxiety that follows may cause erectile dysfunction or make it worse.

Causes of erectile dysfunction that are physical

Physical factors are frequently the root cause of erectile dysfunction. Typical reasons include:

• Heart conditions

• blocked arteries in the blood (atherosclerosis)

• elevated cholesterol

• elevated blood pressure

• Diabetes

• Being overweight

• elevated blood pressure, and other symptoms is known as metabolic syndrome.

• elevated insulin, waist-diameter body fat, and elevated cholesterol

• Parkinson’s illness

• Multiple sclerosis

• Some prescription drugs

• Use of tobacco

• Development of scar tissue inside the penis is a symptom of Peyronie’s disease.

• Alcoholism and other substance misuse disorders

• problems of sleep

• therapies for enlarged prostates or prostate cancer

• traumas or surgeries involving the spinal cord or pelvis

• low levels of testosterone

reasons of erectile dysfunction that are psychological

An erection is the result of a sequence of physiological events, the first of which is emotions of sexual excitation, which are largely initiated by the brain. Numerous factors can impede one’s ability to feel sexually and either cause or exacerbate erectile dysfunction. Among them are:

• Anxiety, depression, or other mental illnesses

  Emphasize

• Relationship issues brought on by tension, inadequate communication, or other issues

Factors at risk

Erections may not be as solid or may take longer to occur as you age. To achieve and maintain an erection, you may require more direct contact with your penis.

Several risk factors, such as the following, can lead to erectile dysfunction:

• Health issues, especially those related to diabetes or heart problems

• Over time, tobacco smoking can result in chronic health concerns that can lead to erectile dysfunction because it restricts blood flow to veins and arteries.

• being obese or overweight in particular

• Some medical procedures, like radiation therapy for cancer or prostate surgery

• Accidents, especially if they harm the arteries or nerves that regulate erections

• prescription drugs, such as antidepressants, antihistamines, and ones for diseases relating to the prostate, high blood pressure, or discomfort

• psychological disorders including sadness, anxiety, or stress

• Use of drugs and alcohol, particularly if you’ve been using drugs or drinking a lot

 

Difficulties

The following are possible complications from erectile dysfunction:

• An inadequate sexual life

• Anxiety or stress

• Feelings of shame or low self-worth

• Relationship issues

• Not being able to conceive with your partner

Signs and Origins

What signs of erectile dysfunction are present?

Having an erection strong enough for sexual activity is difficult when one has erectile dysfunction (ED). Your primary care physician or a urologist can assist if ED starts to become a regular and painful issue.
If blockages are developing in a man’s vascular system, ED may be a serious warning symptom of cardiovascular disease. Men with ED are far more likely to experience a heart attack, stroke, or circulation issues in their legs, according to certain research. Moreover, ED leads to:

• Low regard for oneself

• Depression

• Anguish for the man and his companion

It is important to address ED if it is interfering with a man’s relationships or overall well-being. The goals of treatment are to improve or restore erectile function, support cardiovascular health, and improve a man’s quality of life.

Symptoms of erectile dysfunction include:

• Being able to obtain an erection prior to sexual activity very occasionally.

• having the ability to achieve an erection prior to sexual activity but failing to sustain it during it.

• total unable to achieve an erection.

  needing a lot of provocation to keep an erection going.

What leads to a malfunctioning penis?

There are numerous potential reasons of ED, such as illnesses that impact your:

• system of circulation. The blood capillaries in your body that transport blood throughout it are part of your circulatory system. For your penis to get and stay erected, there must be sufficient blood flow. When it fills with blood, your penis also depends on a network of valves to seal; occasionally, these valves malfunction.

• nervous system. Your brain, spinal cord, and nerves are all part of your nervous system. Together, they send electrical impulses that facilitate movement and sensation throughout your body, including the penis.

• The endocrine system. The glands in your body that produce and release hormones are part of your endocrine system. Hormones aid in instructing your body how to carry out specific tasks. Vasodilation, or the opening up of blood vessels, is a possible effect of testosterone on penile blood flow.

Among the potential contributing elements are:

 

• certain ailments or diseases

• Diabetic neuropathy with diabetes.

• elevated blood pressure, or hypertension.

• Hyperlipidemia, or high cholesterol.

• illness of the vessels.

• renal illness that is persistent.

• Atherosclerosis.

• Peyronie’s illness.

• Low testosterone, or a lack of testosterone.

• a stroke.

• seizures.

• ED can also result from trauma or injuries to the penis and surrounding tissues. Among them are:

• fracture of the penile.

• damage to the spinal cord, bladder, prostate, and pelvic bones (hips, sacrum, and tailbone).

• Prostate, colon, or bladder cancer surgery is included under pelvic surgery.

• radiation treatment.

Some drugs

One typical negative effect of several pharmaceutical medications is erectile dysfunction. ED is frequently listed as a possible adverse effect of the following medications:

• drugs that fight depression.

• Anxiolytics are anti-anxiety drugs.

• blood pressure drugs.

• diuretics.

• antihistamines.

• medications used in chemotherapy.

• medications for Parkinson’s disease.

• medications for prostate cancer.

• counter-arrhythmics.

• sedatives.

  relaxants for muscles.

• seizures-preventing drugs.

These substances can affect and suppress your central nervous system. They can also cause severe damage to your blood vessels, which may lead to permanent erectile dysfunction.

Diagnoses and Examinations

How is a diagnosis of erectile dysfunction made?

A medical professional can identify the cause of ED and make a diagnosis. They will examine you physically and go over your medical history. Inquiries concerning your past sexual and personal interactions will also be made. These inquiries could cause you to feel awkward or ashamed. However, in order to identify the cause as soon as possible, it’s critical to be truthful with the provider. The inquiries could concern:

Do you currently use any medications? This includes prescription, over-the-counter, herbal, nutritional, and non-medical pharmaceuticals.

• Have you ever received a diagnosis of anxiety or depression from a medical professional?

• Do you experience stress on a regular basis?

• Do you have any issues in your relationships?

• What is the frequency of your erections?

• The strength of your erections?

• For what duration can you sustain an erection?

• Do you ejaculate earlier than you would like to, which causes you to lose your erection?

• When did you initially become aware that you have erectile dysfunction?

• When did you initially experience the symptoms of erectile dysfunction?

• Have you ever had an erection in the morning or at night?

• Which sexual postures do you frequently adopt?

• Also, the provider can ask to speak with your partner about sex.

Your spouse could have more knowledge about such causes.
To validate their diagnosis and identify the root cause of your ED, the clinician could prescribe testing.

What tests will be done to diagnose erectile dysfunction?

Depending on what your doctor believes is the root cause of your erectile dysfunction, that is. Your supplier could place an order for:

• blood examinations.

• Complete blood count (CBC).

• Panel with lipids.

• testing for liver function.

• testing for renal function.

• thyroid examinations.

• Test for testosterone.

• Urinalysis (testing urine).

• Doppler ultrasound penile.

• Penile biothesiometry tests determine whether the nerves in your penis react to vibrations.

• medications that cause a transient erection in the penis (vasoactive injection).

• MRA stands for magnetic resonance imaging.

Your provider will go over the requirements and address any concerns you may have prior to the test. You are free to decide not to take the exam at any point if you are uncomfortable.

Management and Treatment

What is the best way to fix erectile dysfunction?

Finding the underlying cause of erectile dysfunction is the first step in treating it. A medical professional will assist in choosing the appropriate course of action for you. Possible course of treatment options include:

Exercise for the heart. Three times a week, at least forty-five minutes of intense aerobic exercise could help reverse some mild cases of ED. Exercises for the heart can include swimming, cycling, jumping rope, jogging, and brisk walking.
Giving up smoking. After several months, stopping smoking can improve things for men with mild ED.
conversing with a sex counselor.
Oral drugs such as vardenafil (Levitra®), tadalafil (Cialis®), avanafil (Stendra®), and sildenafil (Viagra®) can aid in boosting blood flow to your penis. Within an hour, oral drugs begin to function.
Low-intensity focused shockwave treatment for the penis (LiSWT). Through the use of sound waves, this noninvasive treatment increases blood flow. It can take two months to observe results.
pharmaceuticals that you inject straight into your penis to get an erection, such as phentolamine (Regitine®), papaverine (Papacon®), alprostadil (Caverject®), or a mix of many drugs. Medication administered by injection begins to act in ten minutes.
Penis pump is a vacuum constriction device. Penis pumps function nearly instantly.
hormone replacement treatment, which comes in the forms of pellets, gels, injections, and patches. Within four weeks, testosterone replacement therapy begins to show results.
Procedure for a penile implant. During a penile implant operation, a surgeon inserts a hardening device into the penis. The orgasm, urination, or feeling are unaffected by the device.

Other Frequently Asked Questions

What does it feel like to be unable to achieve an erection?

A variety of emotions can be brought on by erectile dysfunction. You could have feelings of guilt, embarrassment, embitteredness, rage, or “less than.” More severe, protracted feelings like anxiety and depression may result from this. However, you are not required to endure these emotions. ED is a common condition that doesn’t define you as a person. Medical professionals are here to assist.

What can I do if my partner has erectile dysfunction?

Many people find erectile dysfunction to be a delicate subject. If your companion suffers from erectile dysfunction, you can aid them by using the following advice:
Promote honest dialogue. Express your concern for your partner’s emotions and well-being. Choose moments when you can chat to your partner without putting them in a vulnerable position.
Tell your companion that you are here for them. ED is widespread, and it can be treated. Support groups and therapists can assist your partner in managing their emotions.

Promote wholesome behaviors. Pay attention to the advantages of eating well, exercising frequently, and reducing your intake of drugs that could lead to ED.
Learn the facts. If you are well-informed on the latest treatments available for erectile dysfunction, your spouse will feel encouraged.
Offer to accompany your partner to their scheduled activities. You can assist your spouse in gathering information for a diagnosis by asking them questions, taking notes, and referring them to a healthcare professional. Should they wish to see a provider alone, respect their right to privacy.
Use alternative methods to convey your emotions. There are other ways for lovers to become more intimate than through sexual activity. Physical gestures like holding hands or giving them a back rub, spending time together, kissing, writing messages, being patient, and paying attention are all ways to show your partner how much you care.
A message from Cleveland Clinic
It’s typical to have erectile dysfunction (ED), especially as you age. Embarrassment, low self-esteem, and other, more severe psychological disorders might result from it. However, having ED shouldn’t make you feel embarrassed or humiliated. It can be your body’s method of alerting you to a problem. It’s critical to discuss your symptoms and how they impact your quality of life in an open and honest discussion with your healthcare professional. They are qualified to diagnose ED, identify its underlying cause, and suggest the best course of action for you.