An erection is one of the basic functions of the penis. The penis consists of erectile bodies of sponge-like structure. Erectile bodies also contain the urethra, vessels and muscular tissue. During a sexual excitation the small cavities of the erectile bodies fill with blood and therefore harden. The penis enlarges and erects. The hardening enables it’s insertion into the vagina. Dysfunctions of the erection are one of the commonest sexual diseases. 50% of men aged 40-70 years suffer from it. 17 % of men have a mild, 20 % a middle and 10 % a severe form of the disease. It is an unpleasant problem, which causes a loss of self-confidence, certainty and psychic well-being. Erectile dysfunction is, however, curable and many men regain their satisfactory sexual life and psychic well-being.
Nature of erectile dysfunction
Erectile dysfunction is defined as a permanent (lasting for at least 6 month) inability to achieve or maintain erection in order to achieve a long enough sexual intercourse. We distinguish between the organic or disease induced nature of the dysfunction and a psychogenic nature where no signs of a disease are found. The organic nature has the 80 % prevalence and the 20 % of cases are purely psychogenic. Certain psychogenic signs are always present, but usually result from the preexisting disease. Erectile dysfunction is most common in the 21-30 age group as a result of entering the sexual life. The age group 41-50 years is also at particular risk. Other risk factors in developing an erectile dysfunction are hypertension, diabetes, lipid metabolism diseases, obesity and smoking.
Causes of erectile dysfunction
A cause of the erectile dysfunction is not always possible to find. It is usually a sign of several related illnesses. They are usually vascular diseases, which result from a damage of the vessels by toxic substances. The neurologic diseases represent another important group. For example Parkinson’s disease, sclerosis multiplex, but also a nerve damage due to an inflammation, an injury or a surgery. Among the endocrine diseases diabetes mellitus is on the first place. It damages the nerves and the vessels important for erection. Anatomical aberrations such as deformities of the erectile bodies or posttraumatic changes can also be the blame. The second large group are the psychogenic causes. All cases of inability to maintain a satisfactory erection despite no organic disease found are classified in this group. Such causes are negative emotions, negative attitude towards the partner, sexual discrepancy of the partners, uncertainty, fear of failure, depression, anxiety.
Diagnosis of erectile dysfunction
During the diagnosis of the erectile dysfunction we need to focus on the anamnesis, which means the information about past diseases, diseases in the family, current problems and medication used. It is crucial to differentiate if the dysfunction is or is not a sign of a systemic disease. We are also interested in number of sexual partners, presence of desire, need of sexual activity, easiness of achieving an erection and ability to maintain it. We are also interested in a presence of risk factors such as hypertension, diabetes or smoking. Afterwards we move to a physical examination, which can show the possible cause of the erectile dysfunction, such as phimosis or narrowing of the prepuce, which cannot be easily retracted over the glans, plastic induration of the penis in which the penis bends more and more with increasing erection (sometimes up to 80°). Biochemical and laboratory tests are also conducted and sometimes a specialized examination is needed.
Treatment of erectile dysfunction
If there is an erectile dysfunction in more than one quarter of attempts to have a sexual intercourse, it is advised to seek a medical assistance. The first group of treatment comprises medication, vacuum erection devices and psychotherapy. The second group is represented by injection into the erectile bodies and treatment via the urethra. The third group is represented by penile prostheses. The penile prostheses are flexible or inflatable bodies, which give the penis the required hardness to accomplish the sexual intercourse. A pump is surgically implanted into the scrotum. By pressing the pump the prosthesis fills and the penis erects. Despite the progress in awareness in sexual health, it is estimated that only 10 % on men with erectile dysfunction seek the help of their doctors. On the other hand the doctors ask about their patients’ sexual health only in 10 % of cases. Do not be ashamed of this disease and seek the help of a specialist, who can help you.