Thursday, 15 November 2018

ERECTILE DYSFUNCTION AND INFERTILITY

When a man cannot attain or maintain an erection suitably for sexual intercourse, it is usually an inconvenience, particularly if he and his partner are trying to conceive. Erectile Dysfunction (ED), also known as impotence, is a form of sexual dysfunction that is present in about 20-25 percent of infertile couples.

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Erectile Dysfunction is an inability to get an erection that is good enough to achieve intercourse. The severity of erectile dysfunction can vary from complete lack of erection, to a partial erection that is not enough for penetration or is lost soon after penetration. Although ED is typically more common among older men, it can occur at any age.

Sexual impotence has psychological roots with anxiety, depression and stress playing a role. Sexual arousal depends on an intricate interplay of psychological, neural, vascular, and endocrine factors. Hormonal imbalance can also lead to ED. The inability to achieve pregnancy could be due to below par sperm production or due to poor sperm motility. Both impotence and infertility have a negative impact on intimate relationships, quality of life and self-esteem.

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Erectile Dysfunction can be treated at any age however, the occurrence is increasingly common with ageing, but should not be considered a natural part of aging. In older men, there may be physical or medical conditions that contribute to ED, including a variety of diseases, physical injury or side effects from prescription medications. Psychological factors and certain life choices such as smoking, obesity, stress, anxiety, guilt and fear of poor sexual performance can all contribute to ED.

When ED is physical, there tend to be weak erections during masturbation or decreased frequency of morning erections. Men may be at higher risk for cardiac issues if their ED medication gradually stops working or if the ED has been a problem for a number of years. Presence of other cardiac risk factors such as diabetes, obesity or high cholesterol is helpful for diagnosis.

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While the risk factors are typically associated with older men, ED is often the only cardiac risk factor in a younger man and can be devastating to men regardless of their age and so should always be taken seriously. It helps to understand how an erection works. Sexual stimulation delivers extra blood to the penis through the arteries, causing an erection.

For an erection to occur, a specific sequence of event needs to take place, allowing blood to enter the penis while restricting the outflow of blood. The pressure created by this “trapped” blood is what maintains an erection.

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If there is a consistent breakdown in any steps in the sequence, ED is the result. Adequate sexual function is not essential for success of fertility treatments, but more importantly, any form of sexual dysfunction such as ED can be a source of stress and conflict within a couple’s relationship. The problem of ED can be worsened by performance anxiety and other concerns related to the need to achieve conception.

Many people believe that being impotent means they are infertile. However, impotence and infertility mean different things. While impotence is not a cause for infertility, it can make conception extremely difficult.

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There is connection between infertility and sexual intercourse, however, there is no scientific evidence supporting a claim that some sexual positions are more likely to increase sexual ability and lead to conception. Some positions, such as missionary, may deliver the sperm closest to the cervix, but whether this increases chances of getting pregnant is not proven. Timing intercourse properly during ovulation is more important than the position when trying to get pregnant.

Basically, when it comes to getting pregnant, having intercourse more often is not necessarily going to increase chances of conceiving. Women are fertile only five to ten days during their monthly cycle – just before and during ovulation. Having intercourse on other times during the monthly cycle will not lead to pregnancy.

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In addition, having sex several times per week can actually lower sperm count and decrease chances of getting pregnant. To increase chances of getting pregnant, a couple should have sex few days before ovulation and then on the day of ovulation, and limit sexual activity other times during this fertile time period. Thankfully there are a number of things that can be done to resolve this problem.

As men age, testosterone (male sex hormone) levels drop off to very low levels. In fact, about 25-30 percent of men in their 50s may have low levels. If fertility is a concern, addition of testosterone can further lower a sperm count which may already be lower than normal. ED is linked to cardiovascular disease and men with ED demonstrate increased calcium in the blood vessels of the heart at a younger age.

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Diagnosis includes evaluating medical and psychological history, performing a physical evaluation and conducting a series of laboratory tests. These tests include blood counts, lipid profiles and testosterone measurements. A psychosocial evaluation is used to examine possible psychological factors.

About half of all infertile couples suffer from one or more compromised factors in the male partner including ED. For this reason, during the initial evaluation the male partner will be tested for sperm production and health, including sperm count, motility and morphology; semen volume and viscosity, and white blood cell count; Physical abnormalities are also looked for.

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Erectile dysfunction can be treated with medication, psychological therapy, or vacuum devices. Surgical implantation of an inflatable prosthesis is also an option. During this procedure a device that simulates erection is used in pumping fluid from a reservoir into inflatable tubes in the penis.

No matter what type of ED men suffer, the first step is going to the doctor and the earlier, the better. Erectile dysfunction can have a profound effect on relationships because the men must admit to their partner that they have a problem and have to seek help. If a man is unhealthy and has not exerted himself, sexual activity can be a risky exertion.

There are many ways to treat impotence. The first line of therapy consists of lifestyle changes. Sometimes the cause may be a prescription drug, so a new medication may be necessary.



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