What is Erectile Dysfunction (ED)?

Erectile dysfunction (ED) is the medical term for impotence, which is characterized by inability to reach and/or maintain an erection hard and long enough for the intercourse to be successful. One can talk about impotence, if in more than 70% cases of the coupling, there is no lasting erection, and such a condition persists for at least six months.

An erection is a very complex physiological process of hardening of the male’s penis, which is triggered by neurotransmitters in the brain. Without the sufficient stiffness of the penis, penetration is impossible.

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The doctors distinguish between:

Erectile dysfunction (Latin: impotentia coeundi), the inability to achieve an erection sufficient enough for penetration.

Infertility (Latin: impotentia gene randi), the inability for producing offspring.

Causes of erectile dysfunction

An erection is a complex interplay between the nervous system, blood vessels, hormones and the psyche. Any erection problem is caused by either psychological problems or organic (physiological) related problems.

Psychologically induced impotence problems

Previously, it was thought that ED was often caused by psychological problems. However, the recent studies overlooked this, having concluded that those were the organic disorders (especially, cardiovascular issues) which caused Erectile Dysfunction by most.

Now we know that only about 20% of the Erectile Dysfunction problems have exclusively psychological problems as a cause. Particularly, these could be stress, fatigue, pressure at work or in the private life, depression, etc. It is often the partner, who causes pressure (almost always unconsciously) by one’s high expectations in bed.

Organic impotence problems

About 80% of ED problems have organic, physiological causes.

Problems of the blood vessels are most frequently diagnosed as the cause of erectile dysfunction. A general weakness of cardiovascular system as well as blood vessel calcification (atherosclerosis), leading to Impotence problems, are often a result of obesity and diabetes.

Physiologically, impotence can be caused by:

Cardiovascular diseases in general. The hardening of the arteries (atherosclerosis), high blood pressure and high cholesterol are among the possible perpetrators of cardiovascular diseases.
Diabetes mellitus
Smoking and consequently too narrow, inflexible blood vessels and poor blood circulation
Overweight with high blood pressure and thus low perfusion
Lack of exercise
Chronic renal failure
Pelvic surgery (e.g. the prostate) or injury
Spinal disorders can interfere with impulse conduction in nerve
Hormonal disturbances
Diseases of the nervous system, e.g. Multiple sclerosis
Drug or alcohol abuse

Treatment of Erectile Dysfunction

The sooner Erectile Dysfunction is treated, the better are the chances for quicker recovery.

The treatment of an erection can roughly be divided into psychological therapy (sex therapist, psychotherapy) and a medical treatment.

The psychological treatment is based on addressing the underlying reasons. Depending on the problem, attention can be given to exercises (e.g., relaxation exercises and instructions for both, perception and excitation), the communication between the partners, the detection and possibly changing of negative thoughts and fears during sex. In addition, other aspects, such as tips for changing the perception and stimulation during sex itself play a great role in psychological treatment of ED.

The medical treatment, which is commonly based on prescribing such oral drugs (so-called PDE-5 inhibitors) as, Viagra (sildenafil), Levitra (vardenafil), Cialis (tadalafil), is now an essential way out of the problem.

These oral ED drugs may help both with physical and psychological causes. However, these drugs can only work if it also comes to sexual stimulation. So if there is no sexual excitement, it will not come to an erection.

In general, the tablets start to work after 30 minutes, and the effects may last up to 4, 5 and 36 hours in Viagra, Levitra and Cialis, respectively.

If the certain drug does not work or causes too many side effects, the treatment can be adjusted by lowering or increasing of the dosage or by changing the medication.