Understanding Erectile Dysfunction

ED or Erectile Dysfunction is characterized as a lack of ability to build up or maintain penis erection during sexual intimacy. The erection of the penile is a hydraulic effect of the blood entering the penis and being maintained inside the spongy bodies present in the penis.

Penis erection is controlled by two varying mechanisms.

  • Reflex erection – This is attained by a direct touch to the penile shaft. It employs the peripheral nerves along with the lower section of spinal cord.
  • Psychogenic erection – This can be triggered by emotional or erotic stimulation. It makes use of the brains limbic system.

In both cases, the nervous system must be intact for acquiring a complete erection. As the penile shaft gets kindled by the nervous system, there is secretion of NO (Nitric Oxide). NO relaxes the soft muscles of the foremost erectile tissue in the penis called corpora cavernosa.

With release of NO blood circulation also increases in the body and the genital areas. Consequently, the penile tissues are allowed to load with blood thus creating an erection.

For healthy development of erectile system there must be an intact pituitary gland and sufficient level of testosterone generated by the testes.

Ed can be caused due to biological and psychological conditions. A simple and helpful way to determine psychological and physical conditions of impotence is to find out if the sufferer ‘ever or still' has an erection. If the answer is ‘never' then the issue is probably physiological. If it is ‘sometime', which is rare then it could be both physical and psychological.

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Causes of ED

  • Neurogenic problems like brain and spinal cord injuries.
  • Nerve disorders like Parkinson's disease, Stroke and Alzheimer's disease.
  • Kidney failure.
  • Cavernosal turmoil such as Peyronie's disease.
  • Diseases including multiple sclerosis and diabetes.
  • Anti-depressant drugs that involve nicotine and SSRI's are the most common.
  • Ageing factor is higher in males in their 60's.
  • Smoking is the major cause of ED. Smoke from cigarettes increases the narrowing of arteries and causes impotence.
  • Surgery of colon, bladder cancer and prostate cancer can cause damage to the blood vessels and nerves that are involved in erection. The cancerous tumor has to be removed by surgery, so there is a need to eradicate the nerves and tissues that enclose the tumor, which elevates the jeopardy of impotence.
  • Psychological causes include stress, performance anxiety and negative feelings. In addition mental disorders involve schizophrenia, clinical depression, panic turmoil, substance abuse, personality chaos and generalized anxiety disorder.

The diagnosis of penis erectile dysfunction is made in many ways

  • Duplex Ultrasound for evaluating the blood flow, scarring of erectile tissues or venous leakage.
  • Bulbocavernousus reflex test to decide, if there is adequate nerve sense in the penis.
  • Nocturnal penile tumescence, where changes in penis rigidity and its circumference is measured during nocturnal erection.
  • Penile biothesiometry to measure sensitivity and nerve functions of penis glans and shaft.
  • Dynamic infusion cavernosometry acknowledges the vascular pressure at the time of erection.
  • Magnetic resonance angiography provides the detailed images and information regarding blood circulation and vascular abnormalities.

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