Erectile dysfunction (impotence) is an insufficiency of tension and volume of the penis, in which it is impossible to perform penetration or finish penetrating sexual intercourse. A decrease in potency is a symptom that hides disorders in other organs and systems of the body: cardiovascular, hormonal, nervous. The reasons may also be psychogenic in nature, when a man is physically healthy, and impotence occurs due to the consequences of psychological trauma and incorrect beliefs. Thanks to the development of modern medicine, erectile dysfunction is eliminated in 90% of cases. The main thing is not to avoid the problem, but to find its root as soon as possible and start treatment.
Symptoms of erectile dysfunction
Erection is a delicate mechanism, and can fail when overworked, due to stress, strong excitement, after prolonged abstinence.
Therefore, if a decrease in potency occurs sporadically, especially after unpleasant events, do not sound the alarm. This happens to everyone, even if this “everyone” is not recognized.
There are a number of symptoms, the constant presence of which indicates a violation of erection:
- Spontaneous erections decrease or disappear.
- The degree of penis swelling decreases, penetration becomes difficult.
- Periodically, the opportunity to bring sexual intercourse to the end disappears. The number of unfinished sexual acts increases over time.
- There is a need for additional stimulation to achieve persistent arousal.
- The duration of sexual acts is reduced.
- The possibility of repeated coitus disappears during the day.
If the symptoms persist for 2-3 months, it is necessary to consult a doctor.
First of all, you need to contact a urologist or an andrologist. You may need the help of other narrow specialists: a cardiologist, a phlebologist, a neurologist, an endocrinologist, a psychotherapist or a sex therapist.
Erectile dysfunction – causes
The mechanism of erection
The erectile tissue of the male penis consists of cavernous bodies. The very name “cavernous” suggests that they have a hollow structure. When the cavernous bodies are filled with blood, the penis increases in size and becomes hard.
The flow of blood into the cavernous bodies occurs due to the expansion of the vessels of the genital organ. The command for the vessels to expand is given by impulses of nerve cells originating from the brain and spinal cord. Hormones – testosterone and serotonin – conduct the process.
The chain through which sexual arousal passes looks like this:
Any of its links can fail, and sometimes several at once. In this case, erectile dysfunction occurs.
Violation of potency, as a rule, is of a physical or psychological nature. There is also a reason to have a mixed type when there is both a physical illness and a psychogenic factor.
Violations of such systems lead to impotence:
- Cardiovascular. These are hypertension, atherosclerosis, venous insufficiency, coronary heart disease, vascular smooth muscle spasm. Diseases prevent the full filling of the vessels of the penis with blood and the retention of an erection.
- Hormonal. A drop in testosterone and serotonin levels, an increase in the level of female hormones, diabetes mellitus.
- Nervous. Violation of the patency of nerve impulses to the receptors of the penis. It occurs due to neuropathies, multiple sclerosis, spinal injuries, stroke and intervertebral hernias.
- Genitourinary. Inflammatory processes, injuries, tumors of the genitourinary sphere.
In addition, there may be a violation of libido due to medication. These can be anti-ulcer, cardiac, hormonal drugs. In this case, they need to find analogues.
Erectile dysfunction in men is closely related to psychoemotional disorders. This connection is especially evident in people who are educated and prone to doubts.
Psychological factors that lead to erectile dysfunction:
- Neurosis of expectation of failure. A man who has survived a fiasco blocks his own potency with the fear of a new failure. Which once again leads to an erection problem. There is a vicious circle.
- Relationship with a partner. Cooling in relationships, scandals, distrust, resentment.
- Self-doubt. Fear of non-compliance with the “high sexual standards” imposed by the porn industry.
- A bad experience of a past relationship. Criticism from a woman, humiliation, resentment, can lead to the fear of repetition of painful situations and the formation of distrust of women.
- Psychological trauma. Injuries can be caused by inadequate upbringing or sexual abuse experienced in childhood.
- Irrational beliefs related to sex and relationships.
- Depressive states. In this case, physiologically, an erection can be preserved, but libido decreases – that is, sexual desire.
As a rule, psychological causes of impotence prevail in young people, and older people are prone to physical diseases.
Diagnosis of erectile dysfunction
At the initial stage, information is collected about the frequency of sexual contacts, the quality of erection, the frequency of unsuccessful penetrations, the presence of sexual dysfunctions in the partner, the presence or absence of spontaneous erections, etc.
Therefore, the patient is asked to fill out a test, the questions of which it is important to give honest answers. The questionnaire helps to establish a preliminary diagnosis of “erectile dysfunction” or to question it.
Then instrumental and laboratory tests are performed. Depending on the situation, the following types of examinations may be assigned to the patient:
- tests for hormones of the reproductive and endocrine systems;
- biochemical blood test and lipidogram with determination of the indicator of “bad” cholesterol;
- vascular dopplerography;
- Ultrasound of the pelvic organs;
- cavernosography (X-ray examination of the cavernous bodies of the penis with the introduction of a contrast agent into them);
- vasoactive test;
- MRI of the brain and spine.
Erectile dysfunction of a psychogenic nature
- More often occurs suddenly;
- The number of nocturnal and spontaneous erections persists;
- Stable potency during masturbation;
- “Different” erection with different partners. There is a dependence of potency on circumstances.
Erectile dysfunction of a physical nature
- It has cumulative dynamics
- Spontaneous and nocturnal erections decrease or disappear altogether;
- The erection is unsatisfactory and during masturbation;
- Stable unstable erection, regardless of the partner and circumstances.
If the examination does not reveal deviations of an organic nature, it is necessary to consult a psychotherapist.
There are a number of signs that allow us to make an assumption about the probable nature of impotence.
If the cause of impotence is of a mixed nature, a team work of a doctor and a psychotherapist will be needed.
Such unfavorable factors lead to a decrease in potency:
- A sedentary lifestyle causes chronic stagnation in the small pelvis, and as a result – a decrease in potency.
- Fatty foods, overeating lead to atherosclerosis. Clogged vessels become unable to fully fill the penis with blood and keep an erection.
- Smoking. It leads to vasospasm and deterioration of the filling of the penis with blood.
- Alcohol. Abuse leads to vascular spasms, deterioration of nerve conduction (the signal from the brain “does not reach” the penis), premature ejaculation, a decrease in orgasmic sensuality, a drop in libido.
- Chronic fatigue, lack of sleep, stress. They lead to exhaustion of the nervous system, emotional burnout, and a decrease in testosterone levels. As a result, both libido and potency suffer.
- Fatness. This is fraught with diabetes, an increase in the level of female sex hormones and a decrease in testosterone.
As you can see, an unhealthy lifestyle can lead to serious health disorders and, ultimately, harm potency to a greater extent than the notorious prostatitis.
Also, middle–aged age is a risk factor – the level of sex hormones decreases, the intensity of blood circulation decreases, and chronic diseases accumulate.
Treatment of impotence
Therapy is always prescribed individually, depending on the causes of the disease, and is aimed at eliminating them.
With erectile dysfunction , such methods of treatment are often used:
- vasodilating tablet preparations;
- statins (normalize cholesterol levels in atherosclerosis);
- means that improve nerve conduction;
- intracavernous administration of vasoactive drugs;
- physiotherapy procedures.
In severe cases, surgical treatment may be prescribed.
Erectile disorders caused by psychological reasons are subject to correction in the office of a psychotherapist or a sex therapist.
The working methods and the duration of the process are determined on the spot – it all depends on the individual situation.
In lighter cases, several techniques may be sufficient. If the cause is deep, for example, the consequences of a traumatic experience, long-term psychotherapy may be required.
It is very important to get rid of bad habits, move more and eat right – otherwise the results of treatment will be short-term.