Erectile dysfunction, commonly referred to as ED, is the inability to achieve and sustain an erection suitable for sexual intercourse. This condition is not considered normal at any age and is different from other problems that interfere with sexual intercourse, such as lack of sexual desire and problems with ejaculation and orgasm.
According to the National Institutes of Health, approximately 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience ED on a long-term basis.
Failure to achieve an erection less than 20% of the time is not unusual and treatment is rarely needed. Failure to achieve an erection more than 50% of the time, however, generally indicates there is a problem requiring treatment.
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.
How does an Erection occur?
The penis contains two chambers called the corpora cavernosa, which run the length of the organ. A spongy tissue fills the chambers. The corpora cavernosa are surrounded by a membrane, called the tunica albuginea. The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora cavernosa and is surrounded by the corpus spongiosum.
An erection begins with sensory or mental stimulation, or both. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the spaces. The blood creates pressure in the corpora cavernosa, making the penis expand. The tunica albuginea helps trap the blood in the corpora cavernosa, thereby sustaining an erection. When muscles in the penis contract to stop the inflow of blood and open outflow channels, the erection is reversed.
What happens during Male Impotence?
Since an erection requires a precise sequence of events, male impotence can occur when any of the events is disrupted. The sequence includes nerve impulses in the brain, spinal column, and area around the penis, and response in muscles, fibrous tissues, veins, and arteries in and near the corpora cavernosa.
Most of the times, Male Impotence is caused by Physical Problems
Damage to nerves, arteries, smooth muscles, and fibrous tissues, often as a result of disease, is the most common cause of male impotence. Diseases—such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease—account for about 70 percent of ED cases. Between 35 and 50 percent of men with diabetes experience male impotence.
Lifestyle choices that contribute to heart disease and vascular problems also raise the risk of Erectile Dysfunction. Smoking, being overweight, and avoiding exercise are possible causes of male impotence.
In around three-quarters of cases there are physical problems affecting the blood supply. However, there is a complex relationship between the physical and psychological aspects of sexual function. For instance, you may have physical health problems that cause psychological distress and this may have an additional effect on erection problems.
Also, surgery (especially radical prostate and bladder surgery for cancer) can injure nerves and arteries near the penis, causing ED. Injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to ED by harming nerves, smooth muscles, arteries, and fibrous tissues of the corpora cavernosa.
In addition, many common medicines—blood pressure drugs, antihistamines, antidepressants, tranquillizers, appetite suppressants, and cimetidine (an ulcer drug)—can produce male impotence as a side effect.
Experts believe that psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause 10 to 20 percent of male impotence cases. Men with a physical cause for ED frequently experience the same sort of psychological reactions (stress, anxiety, guilt, depression). Other possible causes are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as not enough testosterone.
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