Erectile
dysfunction (ED) means that you cannot get a proper erection. Most cases are
due to narrowing of the arteries that take blood to the penis. This is due to a
build-up of fatty deposits (atheroma) in these arteries in the same way that
heart arteries are affected in people with heart disease. ED is usually
treatable, most commonly by a tablet taken before sex. You may also receive
lifestyle advice and treatments to minimise your risk of heart disease.
What is erectile dysfunction?
Erectile
dysfunction (ED) means that you cannot get and/or maintain an erection. In some
cases the penis becomes partly erect but not hard enough to have sex properly.
In some cases, there is no swelling or fullness of the penis at all. ED is
sometimes called impotence.
Physical causes
About 8
in 10 cases of ED are due to a physical cause. Causes include:
·
Reduced
blood flow to the penis. This
is, by far, the most common cause of ED in men over the age of 40. Like in
other parts of the body, the arteries which take blood to the penis can become
narrowed. The blood flow may then not be enough to cause an erection. Risk
factors can increase your chance of narrowing of the arteries. These include getting older; high smoking.
·
Diseases which affect the
nerves going to the penis. For example parkinson disease etc.
·
This is one of the most common causes of ED. Diabetes
can affect blood vessels and nerves.
·
Hormonal
causes. For example, a lack of a hormone
called testosterone which is made in the testes. This is uncommon. However, one
cause of a lack of testosterone that is worth highlighting is a previous head
injury. A head injury can sometimes affect the function of the pituitary gland
in the brain. The pituitary gland makes a hormone that stimulates the testis to
make testosterone. So, although it may not at first seem connected, a previous
head injury can in fact lead to ED. Other symptoms of a low testosterone level
include a reduced sex drive (libido) and changes in mood.
·
Injury
to the nerves going to the penis. For
example, spinal injury, following surgery to nearby structures, fractured
pelvis, radiotherapy to the genital area, etc.
·
Side-effect
of certain medicines. The most common
are some antidepressants; beta-blockers such as propranolol, atenolol, etc; some
'water tablets' (diuretics); cimetidine. Many other less commonly used tablets
sometimes cause ED.
·
Excessive
outflow of blood from the penis through the veins (venous leak). This is rare but can be
caused by various conditions of the penis.
In most
cases due to physical causes (apart from injury or after surgery), the ED tends
to develop slowly. So, you may have intermittent or partial ED for a while,
which may gradually get worse. If the ED is due to a physical cause, you are
likely still to have a normal sex drive apart from if the cause is due to a
hormone problem. In some cases, ED causes poor self-esteem, anxiety, and even
depression. These reactions to ED can make the problem worse.
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