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Erectile dysfunctions (ED) are defined as the persistent inability to attain or maintain penile erection sufficient for intercourse. The 1992 National Institutes of Health Consensus Development Conference recommends use of the term “erectile dysfunctions” rather than “impotence” because it more accurately defines the problem and has fewer disparaging connotations. An estimated 10 to 20 million men have some degree of erectile dysfunctions. Increased understanding of the male erectile process and the development of several agents to improve erectile function have generated great public interest among men and their sexual partners. These advances are expanding the treatment options available to primary care physicians in the management of erectile dysfunctions.

Define the causes of erectile dysfunction?
Male Reproductive System:

Causes The penis contains two cylindrical, sponge-like structures that run along its length, parallel to the tube that carries semen and urine (urethra). When a man becomes sexually aroused, nerve impulses cause the blood flow to the cylinders to increase about seven times the normal amount. This sudden influx of blood expands the sponge-like structures and produces an erection by straightening and stiffening the penis. Continued sexual arousal or excitation maintains the higher rate of blood flow, keeping the erection firm. After ejaculation, or when the sexual excitation passes, the excess blood drains out of the spongy tissue, and the penis returns to its non-erect size and shape.

Specific steps take place to produce and sustain an erection


The first step is sexual arousal, which men obtain from the senses of sight, touch, hearing and smell, and from thoughts.

Nervous System Response:

The brain communicates the sexual excitation to the body’s nervous system, which activates increased blood flow to the penis.

Blood Vessel Response:

A relaxing action occurs in the blood vessels that supply the penis, allowing more blood to flow into the shafts that produce the erection. If something affects any of these factors or the delicate balance among them, erectile dysfunction can result.

Nonphysical Causes:

Nonphysical causes may account for impotence. They may include

Psychological Problems:

The most common nonphysical causes are stress, anxiety and fatigue. Impotence is also an occasional side effect of psychological problems such as depression.

Negative Feelings:

Feelings that you express toward your sexual partner — or that are expressed by your sexual partner such as resentment, hostility or lack of interest also can be a factor in erectile dysfunction.

Physical causes

Physical causes account for many cases of erectile dysfunction and may include:
●Nerve damage from longstanding diabetes (diabetic neuropathy)

●Cardiovascular disorders affecting the blood supply to the pelvis

●Certain prescription medications

●Operations for cancer of the prostate

●Fractures that injure the spinal cord

●Multiple sclerosis]

●Hormonal disorders

●Alcoholism and other forms of drug abuse

In fact, erectile dysfunction may be one of the first signs of an underlying medical problem. The physical and nonphysical causes of erectile dysfunction commonly interact. For instance, a minor physical problem that slows sexual response may cause anxiety about attaining an erection. Then the anxiety can worsen your erectile dysfunction

How can erectile dysfunction be detected?

There are certain symptoms that can help us to judge that weather a person is suffering from erectile dysfunction or not. Shortening of penis length and girth

Loss of sexual desire

Weak erection

Loss of self confidence

Weakness in body


Risk factors

A variety of risk factors can contribute to erectile dysfunction. They include:

Getting older:

 As many as 80 percent of men 75 and older have erectile dysfunction. Many men begin to notice changes in sexual function as they get older. Erections may take longer to develop, may not be as rigid or may take more direct touch to the penis to occur. But erectile dysfunction isn’t an inevitable consequence of normal aging. Erectile dysfunction often occurs in older men mainly because they’re more likely to have underlying health conditions or take medications that interfere with erectile function.

Having a chronic health condition: 

Diseases of the lungs, liver, kidneys, heart, nerves, arteries or veins can lead to erectile dysfunction. So can endocrine system disorders, particularly diabetes. The accumulation of deposits (plaques) in your arteries (atherosclerosis) also can prevent adequate blood from entering your penis. And in some men, erectile dysfunction may be caused by low levels of testosterone (male hypogonadism).

Taking certain medicationsL

 A wide range of drugs — including antidepressants, antihistamines and medications to treat high blood pressure, pain and prostate cancer — can cause erectile dysfunction by interfering with nerve impulses or blood flow to the penis. Tranquilizers and sleeping aids also can pose a problem.

Certain surgeries or injuries:

 Damage to the nerves that control erections can cause erectile dysfunction. This damage can occur if you injure your pelvic area or spinal cord. Surgery to treat bladder, rectal or prostate cancer can increase your risk of erectile dysfunction.

Substance abuse: 

Chronic use of alcohol, marijuana or other drugs often causes erectile dysfunction and decreased sexual drive.

Stress, anxiety or depression:

 Other psychological conditions also contribute to some cases of erectile dysfunction.


Smoking can cause erectile dysfunction because it restricts blood flow to veins and arteries. Men who smoke cigarettes are much more likely to develop erectile dysfunction.


Men who are obese are much more likely to have erectile dysfunction than are men at a normal weight.

Metabolic syndrome:

 This syndrome is characterized by belly fat, unhealthy cholesterol and triglyceride levels, high blood pressure, and insulin resistance.

Prolonged bicycling:

 Over an extended period, pressure from a bicycle seat has been shown to compress nerves and blood flow to the penis, leading to temporary erectile dysfunction and penile numbness

How can erectile dysfunction be diagnosed?

The amount dysfunction may vary from an individual to an individual. More over the time factor may also be a consolidation factor. Erectile dysfunction may last from few days to months and years. There are three main diagnosing techniques that are applied for diagnosing the impotence or erectile dysfunction.

Physical examination: 

This is the most primary diagnostic method that is also the preference. In this few methods are judged like the sensitivity of the penis to the sexual arousal or examining the factor that may be caused by any injury to penis or erectile tissue.

History of patient:

 It is also a very important factor to determine the extent of ED (erectile dysfunction). In this the past sexual behavior and other physical as well as well as medical history is considered. It has been seen that people might suffer from erectile dysfunction due to some chronic ailments like diabetes etc.

Psychological examination:

 This is also an important factor that is to be considered while diagnosing the erectile dysfunction. In this the psyche of a person is judged and a relation is being established between is ailments and mental sate of mind.

Tests and diagnosis

Your doctor will ask questions about how and when your symptoms developed, what medications you take and any other physical conditions you might have. Your doctor will also want to discuss recent physical or emotional changes. If your doctor suspects that physical causes are involved, he or she will likely want to take blood tests to check your level of male hormones and for other potential medical problems, such as diabetes. Your doctor may also want to try eliminating or replacing certain prescription drugs you’re taking one at a time to see whether any are responsible for erectile dysfunction.


This test can check blood flow to your penis. It involves using a wand-like device (transducer) held over the blood vessels that supply the penis. The transducer emits sound waves that pass through body tissues and reflect back, producing an image to let your doctor see if your blood flow is impaired. The test often is done before and after injection of medication into the side of the penis to see if there’s an improvement in blood flow.

Neurological evaluation: 

Your doctor usually assesses possible nerve damage by conducting a physical examination to test for normal touch sensation in your genital area.

Dynamic infusion cavernosometry and cavernosography (DICC):

 This procedure involves injecting a dye into penile blood vessels to permit your doctor to view any possible abnormalities in blood pressure and flow into and out of your penis. It’s generally done with local anesthesia by a urologist who specializes in erectile dysfunction.

Nocturnal tumescence test: 

If your doctor suspects that mainly nonphysical causes are to blame, he or she may ask whether you obtain erections during masturbation, with a partner or while you sleep. Most men experience many erections, without remembering them, during sleep. A simple test that involves wrapping a special perforated tape around your penis before going to sleep can confirm whether you have erections while you’re sleeping. If the tape is separated in the morning, your penis was erect at some time during the night. Tests of this type confirm that there is not a physical abnormality causing erectile dysfunction, and that the cause is likely psychological.

Are there any prevention erectile dysfunction?

Avoid unhealthy life style
Do not eat junk food
Avoid masturbation
Prevent daily sexual indulgence
Avoid over usage medicines
Avoid wearing tight underpants and under wears

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