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How Erectile Dysfunction / Impotency Occurs
Now that we understand how erections happen we can look into the causes of impotence/erectile dysfunction.
Psychological causes
It is important to realize that impotence/erectile dysfunction is mainly caused by physical factors. Psychological factors are the cause in around 15% of cases. However depression, guilt, stress and anxiety; all of these and many more can contribute to loss of libido and impotence/erectile dysfunction. If a man fails to achieve an erection if often becomes a source of worry. This can lead to performance anxiety. Once in this vicious cycle it is hard to break the chain and reestablish a pattern of normal erections.
Qualified therapists or counselors who specialize in the treatment of sexual problems can often help diagnose and sort through these problems. Understanding the cause of the problem can be the key to solving the problem. Accepting that what happened is natural can alleviate the stress and lead to reestablishing a healthy pattern of erections. Not understanding is often the cause of worry and anxiety which is itself the cause of the problem.
As men get older impotence becomes are real concern. Men need to accept that this is part of the ageing process. It is not however the beginning of the end nor is it untreatable!
Relationship woes can interfere with potency and so can job stress, depression or financial worries. Impotence may also be the result of deep-seated emotional trauma, such as having been sexually abused as a child. Qualified psychotherapists can diagnose such problems and help men understand and overcome them.
However there is a complex relationship between the physical and psychological aspects of sexual function. Physical health problems can cause psychological distress. This distress can cause impotence/erectile dysfunction.
Physical causes
Physical causes are at the root of around 85% of impotence/erectile dysfunction cases. Some of the physical conditions that might be a factor in causing impotence/erectile dysfunction include:
High blood pressure
Diabetes
High cholesterol
Vascular disease
Multiple sclerosis
Spinal cord injury
Prostate problems
Kidney problems
Thyroid problems
There are other factors that could be a cause of impotence/erectile dysfunction. Some of these are listed below:
Medication – some medication has side effects that can lead to impotence/erectile dysfunction
Excessive drinking
Smoking
Advancing age
Trauma
What Are the Physical Causes of Impotence?
Physical Health
As we have discussed how the penis works we are aware that there is a sequence of events that have to take place in order to achieve and erection. There are several conditions that will prevent sufficient blood getting into the penis to enable an erection. These include diabetes and vascular disease. Once you have an erection there is also the issue of maintaining it. There are also conditions that will prevent this. This is called veno-occlusive disease.
The nervous system is vital to the erection process. Therefore any condition that may disturb or damage the nervous system can be a cause of impotence/erectile dysfunction. This occurs in conditions including multiple sclerosis, spinal cord injury and Parkinson's disease. Surgery to the pelvic area, such as removal of the prostate can lead to nerve damage that may affect the function of the nervous system.
In a small number of cases problems with hormone levels can also cause impotence.
The good news is that most causes of impotence can be treated and a normal sex life restored.
Here are some of the top causes of impotence:
Diabetes
Diabetes is one of the most common causes of impotence/erectile dysfunction
Diabetes can damage both the nerve and blood supply to the penis
Impotence/erectile dysfunction may be the first sign of diabetes or it can develop years after diagnosis
More than half of men with diabetes develop impotence/erectile dysfunction within 10 years of diagnosis
Most men with impotence/erectile dysfunction resulting from diabetes will respond to one of various treatments
A diabetic is between two and five times more likely to develop impotence than a man who does not have diabetes.
The good news is that as it is so common, medical science has been busy developing treatments for diabetic impotence. Most cases of diabetic impotence can be treated.
Diabetes Mellitus
Chronic high levels of blood sugar associated with diabetes mellitus often damage small blood vessels and nerves throughout the body. This can impair nerve impulses and the blood flow necessary to achieve an erection.
Vascular Disease
Arteriosclerosis is the hardening and narrowing of the arteries causing a reduction in blood flow throughout the body. It is normally associated with age and is the cause in over half of all cases in men over sixty. It can affect the artery leading to the penis so that it cannot dilate enough to deliver all the blood necessary for an erection.
There are three main areas of risk that can lead to Arteriosclerosis: diabetes mellitus, high blood pressure and high cholesterol. Smoking is the most significant risk factor for impotence related to arteriosclerosis.
Disease of the Nervous System
Nervous conditions like multiple sclerosis, Parkinson's disease and spinal cord injuries can affect or cause impotence.
Neurologic Conditions
Spinal Cord and brain injuries can interupt signals from the brain.
Pelvic Trauma, Surgery, Radiation Therapy
Trauma to the pelvic region or spinal cord can damage veins and nerves needed for erection. Surgery of the colon, prostate, bladder, or rectum may damage the nerves and blood vessels involved in erection. Prostate and bladder cancer surgery, prostatectomy and radical cystectomy respectively, often require removing tissue and nerves surrounding a tumor, which increases the risk of impotence. These nerves are crucial in the erection process but have no effect upon the sensations experienced through the penis. Radiation therapy for prostate or bladder cancer can permanently damage these nerves.
There are new surgical techniques that are being tried that aim to lower the risk of nerve and tissue damage that may cause impotence. Short-lived postoperative impotence is often associated with this surgery. It has been known to take up to two years for fully normal erections to return.
Medication
There are over two hundred prescribed drugs that are known to cause or contribute to impotence/erectile dysfunction. These include drugs for high blood pressure, heart problems, antidepressants, tranquilizers and sedatives. A number of over-the-counter medications also can lead to impotence. If it is determined that this is the case your doctor may be able to change your dosage to minimize or eliminate these side effects.
Long-term use of alcohol and illicit drugs may affect the vascular and nervous systems and are associated with erectile dysfunction.
Smoking
Statistically smokers are no more prone to impotence/erectile dysfunction that non smokers. However there are certain conditions where smoking makes the likelihood of impotence much higher. In tests 56%of smokers with heart disease were completely impotent compared with only 21% of non-smokers with the disease.
Alcoholism
Alcohol is not a good aid to achieving or maintaining an erection. Excessive drinking can affect hormone levels and lead to nerve damage. Impotence caused by excessive drinking can be permanent if the nerves are severely damaged. There is some evidence based upon studies conducted that suggests that about 25% of all alcoholics become impotent even if they stop drinking.
Hormone Imbalance
An hormonal imbalance can cause impotence. An endocrinologist will look at testosterone levels should it be suspected that this may be the cause. Testosterone deficiency can result in a loss of libido and the ability to achieve an erection. An excess of the hormone prolactin reduces levels of testosterone. Illnesses like kidney failure and liver disease can cause hormonal imbalance. Hormone disorders are responsible for fewer than 5% of all cases of impotence/erectile dysfunction. Hormone imbalances can also result from kidney or liver disease.
Peyronie's Disease
Peyronie's disease is a rare inflammatory condition that causes scarring of erectile tissue. Scarring produces curvature of the penis that can interfere with sexual function and cause painful erections.
Venous Leak
For Further Information
Diagnosis
Causes
Treatment
How an erection Occurs
FAQ's
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