About Erectile Dysfunction

Erectile dysfunction (ED), as the name suggests, is a medical condition that causes an inability to achieve or maintain an erection for satisfactory sexual performance. The condition mainly affects men older than 40 years and the prevalence of ED increases with age. Some of the common causes of the condition include excessive medication, chronic illness, poor blood flow to the pelvic region, and unhealthy habits such as drinking too much alcohol or excessive smoking.

Most of the time, this condition is temporary and is triggered by stress, performance anxiety, or certain medications. Sometimes it can be due to underlying medical conditions like diabetes, heart problems, depression, and high cholesterol levels. In these cases, it requires intervention by a specialist. Since most men find it embarrassing to discuss the problem with their doctor, they resort to self-medication that can worsen the problem in the long run and harm their overall health.

Symptoms Of Erectile Dysfunction

The inability to sustain an erection is one of the main presentations of erectile dysfunction. 
However, based on the cause of the impotence (organic / non-organic or psychogenic) the other symptoms that a person can also experience include:

Symptoms of psychogenic ED

  • Sudden onset of errection issues
  • Intermittent dysfunction (variability and situational)
  • Loss of sustaining capability
  • Nocturnal erection
  • Excellent response to phosphodiesterase type 5 (PDE-5) inhibitors 

Symptoms of organic ED

  • Gradual onset
  • Often progressive
  • Consistently poor response to phosphodiesterase type 5 (PDE-5)inhibitors
  • Poor nocturnal erection
  • Symptoms improve on standing than lying down (in cases of venous leak)

Causes Of Erectile Dysfunction

In order to understand the causes of ED, you need to first know the mechanism of an erection. Here is what happens during an erection.

The penis remains in its flaccid state when the blood vessels in penis are not fully dilated. This allows only a small amount of arterial blood flow in penis that is basically required for nutritional purposes. When  you are sexually stimulated, there is a release of neurotransmitters namely nitric oxide (NO) from the nerve terminals in the penis. This causes relaxation of the smooth muscles of blood vessels  and results in increased blood flow into the cavernosa of the penile region. This causes the penis to become erect and rigid.

Erection ends when the ejaculation occurs and sexual arousal ends, that allows the accumulated cavernosa blood to flow out through the penile veins back into the circulation.

Sometimes a combination of various physical and psychological factors can cause a disturbance in the mechanism of erection. These factors are explained in detail in the next section.