Erectile dysfunction is more commonly known as impotence. It is referred to as the inability to keep an erection sustained enough for intercourse. Impotence may also be used to describe other problems that interfere with the intercourse, including low libido, problems with ejaculation or orgasm. Erectile dysfunction is well described as a total inability to achieve erection, or a tendency to sustain brief erections. In males with greater age, this disorder occurs mainly due to injury that impairs the blood flow into the shaft or side effects of drugs. It is an inevitable part of aging. It is possible to treat this disorder effectively by providing proper medical attention.

Occurrence of Erection

The shaft contains 2 chambers, which run across the entire length of the shaft and filled with spongy tissues. They are called as corpora cavernosa. There is a membrane surrounding this chamber of corpora cavernosa. This membrane is called tunica albuginea. The shaft has a rich supply of fibrous tissues, spaces, veins and arteries. Urethra, runs along the underside of the corpora cavernosa and is surrounded by the corpora spongiosum. Erection process depends greatly on sensory or mental stimulation. The muscle of corpus cavernosa relaxes after getting an impulse from the brain, which in turn enhances the flow of blood in the shaft. This creates pressure in the torso, which makes it erect. Tunica albuginea helps in trapping the blood in corpus cavernosa, thereby sustaining the erection. The muscles of the shaft contracts to stop the inflow and open the outflow of the blood, which causes loss of erection.

Causes of Erectile Dysfunction

Erection is a state achieved through a sequence of events like nerve impulse, response in muscles, veins, arteries in corpus cavernosa. Erectile dysfunction can occur due to disruption of any of those events. Some of the main causes of this sexual disorder are listed below -

Physical factors - These include physical causes of erectile dysfunction like damage to nerves, arteries, smooth muscles, caused due to any physical ailment. Certain diseases like diabetes, kidney problems, multiple sclerosis, vascular ailments and neurological disorders accounts for about 70% of erectile dysfunction cases.

Addiction - Addiction to alcohol or smoking is responsible for various cases of erectile dysfunction. According to ancient medical belief, alcohol is responsible for destroying the vigor from body, which causes a loss of energy from the body, rendering it weak. As a result, the erection process is disrupted.

Fatigue - There are possibilities of weak erection, when an individual is physically tired, which also causes loss of libido. Certain other physiological factors like stress, anxiety, guilt, depression and fear is responsible for 20% of erectile dysfunction cases.

Brain injuries - Another important cause for erectile dysfunction is brain or CNS injury. Injury in the spinal cord or nervous system causes failure of stimulation in erectile tissues of the shaft, thereby causing loss of libido and erectile dysfunction.

Hormonal Imbalance - Constant fluxion in levels of male hormones like testosterone and gonadotropin results in malfunctioning of genital organs and also erectile dysfunction.

Obesity - Obesity causes loss in the body energy which results in body's inability to produce sperms and decrease in intimate activities. Besides this, the body of an obese person in unable to bear the physical stress which is required to complete the intercourse activities.

Therapeutics - Sexual vigor in males is considerably reduced due to intake of anti-depressant pills. These pills suppress the physical as well as emotional sensation of the body, thereby causing erectile dysfunction.

Diagnosis of Erectile Dysfunction

Patient History -The medical history of an individual can define the extent and type of erectile dysfunction. A detailed description about the sexual history of a patient can clearly define problems related to desires, erection, orgasm etc. Intake of certain drugs can account for 25% of erectile dysfunction.

Physical Examination - It provides hints about systemic ailments. For instance, if the shaft is insensitive to touch, then the problem is related to nervous system, abnormal secondary sexual characteristics are caused due to hormonal imbalance in the body and so on.

Laboratory Test - Certain lab tests are used for the diagnosis of this disorder. These tests include blood count, urinalysis, lipid analysis, and evolution of liver enzymes. The blood testosterone level can provide an indication of problems with the endocrine system.

Other Examinations - Monitoring involuntary erection during sleep can help in identifying the physical causes of erectile dysfunction. If nocturnal erection fails to occur, then the causes are likely to be physical, rather then psychological.

Treatment of Erectile Dysfunction

The treatment strategy for erectile dysfunction ranges from least to most invasive. Some of the methods are listed below -

Psychotherapy - The physiological based erectile dysfunction are treated by reducing the anxiety associated with lovemaking activity. This includes gradual development of intimacy level and stimulation. This helps in overcoming the anxiety associated with erectile dysfunction.

Drug Therapy - The drug treatment is either given orally, or injected directly into the shaft or inserted into the urethra at the tip of the penis. Drugs used include Viagra, Levitra and Cialis, which belong to the class of phosphodiesterase (PDE) inhibitor. Oral testosterone can reduce erectile dysfunction caused by low level of natural testosterone.

Vaccume Devices - Certain mechanical vaccume device can cause erection by forming partial vacuum, which increases the flow of blood into the penis, making it erect and expanded.

Surgery - Surgery can is done in order to achieve one of the three objectives. First to implant a device that causes erection of the shaft, second is to reconstruct the arteries to enhance the flow of blood into the torso, and third is to block the vein causing leakage of blood from penile tissues.

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