Causes and risk factors
Erection is a result of various psychological and physiological processes. Penis receives nerve signals, stimulation from brain as result blood enters and retains in the penis which causes erection.Various contributing causes of ED include cardiovascular like hyperlipidemia, hypertension; diabetes, obesity, neurological disorders like parkinson’s disease, multiple sclerosis; post surgery trauma, psychological causes such as performance anxiety, stress, mental disorder; hormonal changes, Other Psychological causes include overexposure to pornography, gender identity, childhood sexual abuse. Risk factors for ED include ageing, smoking especially tobacco, drugs, alcoholism, prolonged cycling.
Clinical presentation
A doctor comes to the diagnosis of ED when the person complains of difficulty in developing erection of penis and difficulty in maintaining an erection during sexual intercourse.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. Routine blood Investigations to find the underlying cause may be done. Other investigations are done like Penile ultrasound, penile nervous function, nocturnal penile tumescence, MRA.
Treatment
Treatment depends upon the underlying cause. In most cases counselling by a sex therapist, psychologist or psychiatrist plays an important role. Stress in relationships and mental trauma can be overcome by psychotherapy. Some Oral and topical medicines help in treating ED. Newer medicines like sildenafil citrate have given promising results taken under medical supervision. Testosterone replacement therapy in case of hormonal cause of ED. Surgical intervention as a last option include use of penis pumps and prosthetic penile implant.
Other Modes of treatment
The other modes of treatment can also be effective in treating erectile dysfunction. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine is also found to be effective in treating erectile dysfunction. Herbal treatment with Yohimbinum bark has proved beneficial for ED.
Facts and figures
About 5% of 40 year old males and between 15 and 25 % of 65 year old male experience ED.
