Erection
When the penile is stimulated either directly or erotically nitric oxide is released. The secretion of nitric oxide makes the smooth muscle of the erectile tissue relax. The stimulation is possible in two ways. Reflex erection, the first one, implies that the penis is stimulated directly by touching and peripheral nerves are involved. The second one psychogenic erection means that the penis is stimulated erotically. Healthy nervous system, the proper amount of testosterone in the blood and intact pituitary gland are the necessary compounds of the erectile system.
Impotence or Erectile Dysfunction
The term “impotence” is now used less frequently than the term “erectile dysfunction”. They both identify the impossibility to achieve erection needed to provide a successful sexual intercourse.
Erectile dysfunction can develop due to many causes. Most typical are those that directly affect the tissues and systems involved in the process of erection. Thus hormonal deficiency, impaired nervous system, inadequate blood supply to the penis is the most apparent causes of impotence. But much more disorders that are not evident at first glance can contribute to the development of the erectile dysfunction.
Insufficient blood flow can be a direct result of the damaged endothelium. Coronary diseases, prolonged exposures to bright light and noises can complicate the disorder.
Iatrogenic causes are also to be blamed. These include cases that arise as a result of complications after diseases, surgeries and as a side effect of various medications. For example antihypertensives and antidepressants can impair the erectile function.
During surgeries nerves or important tissues may be damaged. Changes in the nervous system, blood supply and surrounding tissues may lead to erectile dysfunction. Controversial data on the effect of circumcision on the erection do not allow to state with confidence whether it increases or decreases erection.
People addicted to alcohol have a great risk to develop what they call “brewer’s droop”. Shakespeare described such a phenomenon in his play Macbeth.
Recent research have investigated that bicycling can also alter the functioning of the erectile system. The pressure that is exerted to the penis by the saddle for a long time makes harm to the penis and redound to the erectile dysfunction.
Many cases of impotence go untreated as men tend to feel confused about the problem. They often try to ascribe the inability to achieve erection to other factors such as “It’s occasional”, “I’m too tired today”, “I can’t suffer from impotence as I’m too young and healthy”, “I am not satisfied with our relationships” and hundreds of others.
But if the impotence is paid a proper attention at early stages it can be treated successfully. Consulting a doctor on the erectile dysfunction can also help to identify other diseases that where the cause of the impotence (diabetes, arteriosclerosis, coronary heart diseases, impaired nervous or blood systems).
The Mechanism of Erection
Biologically the starting point of the erection is the secretion of nitric oxide that is necessary to activate the enzyme guanylate cyclase. The level of cyclic guanosine monophosphate then rapidly increases and smooth muscle of the corpus cavernosum relaxes and additional blood flows to the penis.
The general scheme of the erection process can be described as follows:
- Sexual excitement
- Smooth muscles relaxation
- Enlargement of blood vessels that provides blood inflow
- Expansion of the erectile tissue
- Increased pressure narrows the veins and the blood can’t flow back from the penis
- Accumulated blood leads to elongation and thickening of the penis
- Penis uprises due to the erector muscle activity
Causes of Impotence
80% of all the erectile dysfunctions are caused by physical impairments. And only one to five cases can be attributed to psychological problems. Nevertheless psychological disorders need as much attention as physical do because psychological disorders are often combined with physical ones and go unnoticed.
Physical Factors
- Vascular Diseases
- Metabolic disorders
- Nerve Disease
- Cancer treatment
- Hormonal Problems
- Side Effects of Medications
- Alcohol: Long-term
- Smoking
- Sedentary Lifestyle
Psychological Factors
- Anxiety
- Stress
- Depression
- Relationship Problems
Impotence diagnosis
Diagnosis of erectile dysfunction implies undergoing several tests as well as careful examination of the lifestyle, medical history of the patient and emotional stated. There’s no a test that can identify completely the cause of the impotence and its severity. Thereby several tests are taken to explore different body systems and determine the cause.
Blood test is necessary to measure the level of male hormone in the blood. Different physical tests examine how sensitive the penis is. By means of ultrasonography blood circulation can be checked. The data on changes in penile rigidity during nocturnal erections and vascular pressure measurements are receive after passing through nocturnal penile tumescence and cavernosometry correspondingly.
Afterwards all the information is collected in order to make a diagnosis and right out prescriptions.
Treatment and Care
Oral medication
Sildenafil (Vagra), vardenafil (Levitra) and tadalafil (Ciallis) are prescription drugs that block the action of PDE5 and therefore called PDE5 inhibitors. They regain the ability of penis to attract additional blood flow in the process of erection.
Oral medication (herbal remedies)
The basic difference between herbal remedies and prescription drugs is that the former are a combination of herbs, vitamins and minerals and do not have side effects. An example of herbal remedies is ProCalisX. Herbal remedies are taken just before the sexual activity.
Vacuum pump
Vacuum pump is used externally to draw blood to the penis and induce erection. A penis ring then supports the penis and maintains the erection. But the ring can be used only for 30 minutes. The effectiveness of the vacuum pump is quite controversial. Less rigid erection leaves many partners dissatisfied and in that case oral medications and injections are preferable. But many males resort to vacuum pump as other remedies do not work. Pay a special attention to the quality of the pump. High priced devices are usually very effective while cheap pumps can produce no effect at all.
Sex Counseling
A lot of males feel embarrassed to speak about sexual intercourse with the doctor. But sex counselors who are specially trained may help to solve the problems that arise during sexual activities. Psychologies can help to identify problems that interfere with sexual relationships.
Penile Injections
Injections into the penis are available and contain substances that stimulate blood circulation in the penis.
Intraurethral pellets
Special pellets can be inserted into urethra and thereby blood flow in the penis is activated.
Penile Implant Surgery
A male who suffers from erectile dysfunction can undergo a surgery and have a device that is used when in the sexual intercourse implanted into the penis.
Controversial treatments
Bremelanotide
Bremelanotide is a drug but it actions differently. Traditional drugs affect the vascular system of the body while bremelanotide stimulated sexual drive and desire in both partners. It is applied as a nasal spray. Bremelanotide is currently undergoing tests and is ranked as an experimental drug.
hMaxi-K
hMaxi-K is a gene therapy. To reduce impotence investigations into the encoding of hMaxi-K channel are taking place. The therapy is not approved yet and is passing through necessary trials.
Herbals and Alternative medications.
Tests have shown that these treatments are only effective when the person expect a result. Thus it has a psychological effect and does not influence the erection physiologically. Such an effect is called placedo. Alternative medications can be combined with drugs to produce a better effect.
It’s better to prevent the impotence than cure it
Before undergoing a medical treatment and resorting to drugs and other medications it’s essential to reconsider one’s lifestyle and make several changes that can improve erection ability and prevent the development of the disease.
Simple changes including daily exercises, healthy diet, coping with stress, reduction of the amount of alcohol, quitting smoking will not only contribute to your health but ensure satisfactory sexual relationships.
