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Erectile dysfunction (impotence)

Failures in men’s sexual life often called impotence. Although, this is not exactly true. Doctors consider impotence as a condition, where a man is unable to perform sexual act under any circumstances. Fortunately, this doesn’t happen very often. Those erection problems that occur occasionally or periodically have to be called erectile dysfunction.

Mechanisms of erection

Before start speaking on the problem of erectile dysfunction, it seems necessary to refresh the memory about structure of the penis, as well as current understanding of how it functions.

Penis consists of two cavernous and one spongy body. Cavernous bodies resemble the shape of a spindle and they are located next to each other, the spongy body, which passes into the head of penis, is situated underneath them. The bodies of the penis are not connected to each other with blood vessels. Each body has its own artery, through which blood is supplied, and own veins for blood outflow.

The bodies of penis resemble a sponge by their structure. They contain many small lacunas (or caverns, as they called in Latin). This particular feature makes the phenomenon of erection possible. You can find more information about the structure of male genitals in the specific article.

When the man is sexually aroused, the following process occurs in penis: the arteries that deliver blood to the cavernous and spongy bodies widen and the veins, responsible for blood outflow, rapidly narrow. As a result, significant amounts of blood get accumulated in penis bodies (in their caverns) caverns strain, resulting in erection. Such vessel condition remains throughout the erection. At the same time, all the penis tissues, excluding the skin, don’t get the blood supply and they reside in a state of ischemia. With a very long time of sexual intercourses, with time, this can lead to particular problems, which we'll speak about further.

Forms and causes of erectile dysfunction

Erectile dysfunction can be provoked by several kinds of reasons - endocrine, medicational, local, neurologic, and vascular. All this refers to the erectile dysfunction of the organic nature, which is caused by some changes or disorders in the body. Psychological form of erectile dysfunction, where a normal sexual life interferes exceptionally with man’s neuropsychiatric characteristics, is much more common. In addition to that, almost always erectile dysfunction problems, that have organic nature, are complemented by a psychological component, which may come out on top after eliminating the original causes.

Endocrine causes of erectile dysfunction

Endocrine reasons of erectile dysfunction include predominantly hypogonadism – an insufficiency of gonadal function and low production of the male hormone testosterone. Aside from the erection problems, man notices the increase of voice frequency, deceleration of facial and body hair growth, fat deposition in the breasts, thighs, buttocks. Typically, these changes occur due to severe disorders of the human body hormonal system, and in these cases help of the endocrinologist is always required. Fortunately, such conditions are relatively rare.

Other endocrinological reason for erectile problems may be a hypophysis tumor. Hypophysis is located in the brain and it is one of the most important glands in the human body. If the tumor secretes a hormone, called prolactin, no other changes in the body, except for persistent erectile dysfunction, will draw the attention. In this case, diagnosis should not only determine the man’s hormonal status, but also include a CT brain scan.

Medication causes of erectile dysfunction

There are several types of medications that may have an adverse effect on the male’s erectile function. Hormonal drugs that block the action of male sex hormones (the so-called anti-androgens) and female sex hormone medications that cause serious problems with sustaining an erection, because the hormonal mechanism of erection occurrence gets distorted. Such preparations are usually prescribed only in case of severe illness; the most common one is the prostate cancer. In this situation doctors go by the principle "first things first" and do everything to extend and ease the patient’s life as much as possible.

Nevertheless, I, personally, know of cases, in which the powerful antiandrogens (otherwise known as castration meds) where prescribed by one "good" doctor to patients with benign prostatic hyperplasia (more known as an adenoma). Needless to say, drugs helped infallibly, but all the men in horror realized that they don’t feel as such. Fortunately, erectile function was restored quickly after canceling the medications.

All the substances with inhibitory action on the cerebral cortex are the other drugs that influence erection. This mainly refers to alcohol and narcotics. In addition to effects on the brain, they cause total body depletion, which does not contribute to erectile function in particular or reproduction in general. In such cases restoration of normal erection requires not only the complete refusal from the drug, but also properly held reconvalescence period.

Moreover, there are some medications, which have the ability to block peripheral nerves, responsible for erection. According to pharmacological classification they can be included in various groups. For instance, does anyone know that antihistamines, the most widely known representative of which is diphenhydramine, should not be taken more than 10 days for this reason? If you care about the normal erection, then during the prescription of any medication ask your doctor, whether it causes similar conditions. A small selection of various substances and preparations, which may have an effect on erectile function, is presented in the table.