Causes of Erectile Dysfunction (ED)

Every man sometimes cannot reach an erection, it is normal. Erectile dysfunction occurs when problems are frequent or continuous.

Erectile dysfunction can be mild to severe. A man with mild erectile dysfunction can sometimes achieve full erection, but more often gets an erection that is not enough for penetration or no erection at all. A man with severe erectile dysfunction can rarely achieve an erection. Erectile dysfunction is more common with age but not part of the normal aging process. About half of men aged 65 years and three quarters of 80-year-old men experience erectile dysfunction.


To achieve an erection, the penis requires adequate inflow of blood, the circulation of blood is slowed down and the proper function of the nerve that regulates to and from the penis.

Disorders that narrow the arteries and reduce blood entry (such as atherosclerosis, diabetes, high blood pressure, and high blood cholesterol levels) or surgery that affects blood vessels can cause erectile dysfunction. Also, abnormalities in the vessels in the penis can sometimes return blood to the body quickly so that the erection cannot be maintained even though the blood flow is sufficient.

Nerve damage to or from the penis can produce erectile dysfunction. Similar damage can be caused from the pelvis or abdominal surgery (generally prostate surgery), radiation therapy, spinal disease, diabetes, multiple sclerosis, or neurological disorders.

Other risk factors include stroke, smoking, alcohol, and drugs. Medications generally cause erectile dysfunction (generally in older men) including antihypertensive, anti-depressant. Some are sedative, cimetidine, some diuretics, antipsychotics, and drugs illicit. Occasionally, hormonal disorders (such as low levels of testosterone) cause erectile dysfunction. Likewise, factors that reduce a man’s energy level (such as pain, fatigue, and stress) can make it difficult to achieve an erection. <

Psychological problems that can cause sexual dysfunction can affect the ability to achieve an erection. Psychological causes are more common in younger men. Every new stressful situation, such as changing sexual partners or problems with relationships or at work, can also contribute.


Sexual passion (libido) often decreases in men with erectile dysfunction, although some men maintain normal libido. Regardless of changes in libido, men with erectile dysfunction have difficulty having sex which is caused by an erect penis not hard enough, long or increasing to penetrate or because an erection cannot form. Some men stop having an erection when they sleep or wake up. Others can reach strong erections sometimes but cannot reach or maintain an erection at a later time.

When the level of testosterone is low, the result is more likely to decrease libido than erectile dysfunction. In addition, low testosterone levels can cause bone loss, loss of energy, and loss of muscle density.


To diagnose the cause of erectile dysfunction, doctors ask about diseases and conditions that can participate in erectile dysfunction and the drugs used. General physical examination, including examination of genital and prostate organs, is performed. Doctors can measure nerve function that supplies sex. Measuring blood pressure on your feet and counting your beats on your feet and hands can reveal problems with arteries.

Blood samples can be taken to measure testosterone levels. Some blood tests can help identify diseases that might cause temporary or permanent erectile dysfunction, such as diabetes or infection.

If the problem with the arteries or vessels is suspected, special tests can be performed. For example, a device can be used at home to measure erections during sleep (at the time of normal occurrence). If an erection is present during sleep, the cause may be very psychological, whereas if the erection is not present during sleep, the cause may be very physical. Ultrasonography can also be used to measure blood flow to the penis.


Actions that can help prevent or control the contribution of erectile dysfunction, such as high blood pressure, atherosclerosis, and diabetes, can also help correct erectile dysfunction, although the effect is unlikely. For example, losing weight, exercise, and quitting smoking can help. Some men and their partners can choose to take all treatments for erectile dysfunction. Physical contact without erection can satisfy their needs for intimacy and fulfillment.

Sometimes, stopping using certain drugs can increase erection. Some traditional medicines for erectile dysfunction are available, but their efficacy has not been proven. For men who choose to take treatment, there are many choices.

Treatment with drugs: many drugs are used to treat erectile dysfunction. Most drugs given to treat erectile dysfunction increase blood flow to the penis. Most of these drugs are given by mouth, but some medicines can be applied — by injection or inserted into the penis.

Sildenafil, vardenafil and tadalafil are known as phosphodiesterase inhibitors. These are drugs that are often used to treat erectile dysfunction. Effective in men with erectile dysfunction of around 60 to 75%. These drugs are used by mouth about 1 day before sexual activity. Tadalafil is effective for about one day, longer than sildenafil. Some trademarks named Viagra and vardenafil, which are effective for around 4 to 6 hours. These drugs are effective only when a man arises from his sexual desire. Side effects of the phosphodiesterase barrier include headaches, red face, stiff nose, twisted stomach, visual disturbances.

More serious side effects, including dangerous low blood pressure, can occur when a phosphodiesterase barrier is given with certain drugs (such as nitroglycerin or amyl nitrite). Because of this risk. Men should not use the phosphodiesterase barrier if they use nitroglycerin. Rarely, male users of these drugs experience blindness, although blindness may have nothing to do with drug use. Phosphodiesterase inhibitors can cause pain, long erections, but are very rare.

Other oral medicines that have been used to treat erectile dysfunction are phentolamine, yohimbine and testosterone. They have limited usefulness and can cause significant side effects.

Injection drugs or inserted into the penis widen the arteries and increase blood flow to the penis. Men who cannot use drugs by mouth can sometimes be treated with this drug. An example is alprostadil, in the form of a caplet (suppository), which can be inserted into the penis through the urethra. This can cause light headedness, burning sensation in the penis, or, occasionally, painful erections for a long time (priapism). Because these serious side effects sometimes occur, a man usually uses the first dose under the supervision of a doctor in the doctor’s room.

A man can also provoke erections by injecting drugs (such as alprostadil itself or a combination of alprostadil, papaverine, and phentolamine) into the shaft of his penis. Injections are one of the most effective ways to achieve an erection, producing erections of 80 to 90% of men with erectile dysfunction. Even so, many men are reluctant to inject his penis. After all, these injections are sometimes painful and sometimes cause priapism, and repeated injections can produce tissue injury.

Testosterone replacement therapy can help men who suffer from erectile dysfunction caused by abnormal testosterone levels. Unlike other drugs, the way it works increases blood flow to the penis, testosterone works to improve hormone deficiency. Testosterone can be used in various forms, including patches, topical creams, and injections. Side effects can include liver dysfunction, increased red blood cell count, and increased risk of stroke. Substitute testosterone alone is rarely enough to overcome erectile dysfunction. Whether testosterone increases the risk of prostate cancer is unclear, but men who use testosterone should be closely monitored.

Emphasis (binding) and vacuum devices: erectile dysfunction can often be controlled using a pressure device with or without a vacuum device. These tools enable a man to avoid the side effects caused by drug therapy. The suppressing tool between other erectile dysfunction treatments is at least not expensive. This tool (such as a ribbon and ring made of metal, rubber or leather) is installed at the base of the penis to slow blood flow. These medical devices can be purchased with a prescription at a pharmacy, but cheap versions (often called cock rings) can be purchased in stores that sell sex supplies.

A vacuum device (consisting of a tight hollow space for suction sources) is placed beyond the penis, making a seal. Mechanical suction is installed into the blood pulling chamber into the penis, producing an erection. Some vacuum devices that have a pressure device that is directed to the tip of the penis. If not, the pressure device can be used separately. Surgery: when erectile dysfunction does not react to other treatments, a device that stimulates erection (prosthesis) can be implanted through surgery on the penis.

Various prostheses can be found. One type consists of a pair of sturdy stalks, which are inserted into each corpus cavernosa to permanently make hard zakar. Another type of prosthesis is an enlarged balloon that is inserted into the penis. Before intercourse, men inflate the balloon with a small internal pump. Penile prosthetic implant surgery requires a short hospital stay and healing for 6 weeks before intercourse.

Psychological therapy: several types of psychological therapy (including behavioral modification techniques, such as the technique of focusing on sensations) can enhance the mental and emotional factors that contribute to erectile dysfunction. Psychological therapy can even help when erectile dysfunction experiences physical causes, because psychological factors are often a problem.

Special therapy is chosen based on certain psychological conditions that cause erectile dysfunction in men. For example, if men suffer from depression, psychotherapy can help erectile dysfunction. Antidepressants can help erectile dysfunction by eliminating depression, but antidepressants themselves can reduce sex drive and cause erectile dysfunction, so the effect is difficult to predict. Sometimes psychotherapy can reduce sexual attraction in men with erectile dysfunction due to various causes. The development takes a long time, and requires several sessions. A man, and his partner, must have high motivation so that the psychotherapist works.

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