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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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