Erectile Dysfunction - Symptoms, Causes, Images, Treatment

Erectile dysfunction which is sometimes also referred to as impotence is defined as a lack of ability to maintain an erection firm enough for sexual intercourse. Though it is  not uncommon for a man to experience erection troubles, erectile dysfunction that is progressing or occurs frequently with sex is not normal and should be treated. Most common in men above 75 years of age. 

Certain disease conditions are responsible for causing erectile dysfunction. It includes:

1. High blood sugar levels
2. High blood pressure
3. Atherosclerosis
4. Alcohol and tobacco consumption
5. Stress, depression and anxiety
6. Tiredness
7. Low levels of testosterone hormone
8. Prostate cancer
9. Parkinson's disease
10. Injury to the brain or spinal cord
11. Usage of medications like antidepressants, pain medication, high blood pressure medications, anti-androgens etc. may cause erectile dysfunction.
12. Substances or drugs responsible for erectile dysfunction- It includes the usage of nicotine, opiates, methadone, amphetamines, cocaine, alcohol, marijuana etc.

Psychological and Emotional factors also contribute to erectile dysfunction, including

1. Work or family-related stress
2. Nervousness about sex
3. Depression
4. Self-consciousness about performance during intercourse
5. Negative thinking

Physical causes of erectile dysfunctions include -

1. If there is an injury to the pelvic area penis fails to trap blood at the time of erection.
2. In some cases, nerve signals fail to reach the penis which leads to erectile dysfunction.
3. Cancer treatment or radiation near the pelvic area may also cause erectile dysfunction.

1. Prostate issues
2. Diabetes type 2
3. Hypogonadism is linked to a variety of endocrinologic disorders.
4. High blood pressure
5. Vascular surgery and vascular disease
6. High cholesterol levels in the blood
7. Obstructive sleep apnea, insomnia.
8. Drugs
9. Neurogenic illnesses
10. Distortion or curvature of the penis.
11. Inflammation of the penis.
12. Depression
13. Use of alcohol
14. Lack of sexual awareness
15. Ineffective sexual approaches
16. Lack interpersonal connections
17. Many chronic diseases, particularly renal failure and dialysis, are prevalent.
18. Smoking worsens the symptoms of other risk factors such as vascular disease or high blood pressure.

1. Difficulty obtaining and maintaining an erection
2. Decreased sexual desire
3. Low self-confidence
4. Depression
5. Stress between couples

It includes previous medical history, physical examination, laboratory investigations, questionnaires, and advanced erectile dysfunction tests.

1. Medical history- The doctor may ask questions about medications used in the past or present. Smoking or alcohol consumption, any stress in life, other medical conditions etc.
2. Physical examination- Generally, testicles and penis are examined to check for erectile dysfunction. In addition, depending upon the age and familial history, a rectal examination is performed to check the condition of the prostate.
3. Questionnaires- The doctor asks questions related to health and lifestyle to understand erectile dysfunction. 
4. Blood test to check testosterone levels, and X-rays of the pelvic region. Your healthcare professional can use a penile Doppler ultrasonography to evaluate how blood flows in the penis during and after an erection.
5. Urine test- Sometimes underlying conditions like diabetes may cause male erectile dysfunction to detect those urine tests and blood tests are performed.
6. Nocturnal penile tumescence- In this test erection rate of a man is tested while he is asleep. Generally, 6 to 8 erections occur but lack of erections during sleep could suggest an issue with nerve function or circulation to the penis.

Erectile dysfunction can be treated in the following ways:

1. Medications
2. Intraurethral medications 
3. Counselling 

Medications- Use of medication known as sildenafil, most commonly known as Viagra. Vardenafil and tadalafil can also be used. People on drugs like nitroglycerines must avoid using oral erectile dysfunction drugs as it may cause low blood pressure.

● Side effects of using medications include nasal congestion, headache, indigestion, and visual changes.

Vacuum devices and penile constriction rings- A cylinder placed over the penis is a vacuum device which pumps out the air present in the cylinder leading blood to be drawn into the penis, causing an erection. Next, medications like papaverine and phentolamine are directly injected into the erection chambers of the penis with the help of a tiny needle and syringe. This medication relaxes the blood vessels allowing blood to flow into the penis.

Hormone replacement therapy -Sometimes low testosterone levels are also responsible for erectile dysfunction; therefore, hormone replacement can be done using creams, gels, patches, and pellets.

Counselling - Anxiety, depression, and fear may impact erectile dysfunction Counselling may help address this problem. Sex therapy is also beneficial as it helps to accept and manage erectile dysfunction. However, if a psychological problem is a primary reason for erectile dysfunction, counselling is necessary before starting other treatments.

1. An unsatisfactory sexual life.  
2. Anxiety or stress.
3. Low self-confidence.
4. Relationship difficulties.
5. Difficulty in conceiving with your partner.