Definition
The definition of an erection problem is the inability to get or keep an erection that is strong enough for a man to have intercourse. Some may not be able to get an erection at all and some may loose the erection during intercourse before the man is ready. If the problem persists, the medical term is called erectile dysfunction.
Alternative Name
The other names for erectile dysfunction are impotence, Sexual dysfunction for the male species.
Considerations
Erection problems are very common for adult men. Actually most men that are experiencing occasional difficulty getting or keeping an erection. Some cases are temporary and will go away on their own with no necessary treatment. However there are cases that are continue and become an ongoing problem and can damage a man’s self esteem and even have an effect on the relationship with their partner. This will in turn require a form of treatment.
If you are have trouble keeping an erection for more than 25% of the time, you are going to be considered a risk for problems.
In earlier times, erection problems were made out to be ” all in the man’s way of thinking.” Men are often given helpful advice like ” don’t worry about it” or ” just relax and it will go away.” Today, many doctors think that when the problem is not temporary and does not go away on its own, there may be some type of physical factor to think about.
There is one way to determine if the problem is physical or psychological and that is to determine if you are having nighttime erections. Usually a man has three to five erections a night and each will continue for about a half hour. Your doctor will explain the test that will help to determine if you are having the normal number of nighttime erections.
In most men, an erection problem will not affect their sex drive.
Premature ejaculation is when an orgasm comes on too fast. This is not the same thing as impotence. If you are having this problem, you should seek counseling for this problem because it is usually due to psychological factors.
Male infertility is very different from impotence. A man who is not able to maintain an erection may be able to produce sperm that could fertilize an egg. An infertile man is usually able to keep an erection however may not be able to father a child due to problems with sperm count and other problems.
The common Causes
An erection will require the interaction of your brain, nerves, hormones, and blood vessels. If something interferes with the normal process, this can create a problem. Common causes can include:
* Disease and conditions like diabetes, high blood pressure, heart or thyroid conditions, poor circulation, low testosterone, depression, spinal cord injury, nerve damage from something like prostate surgery for example, or neurological disorders like multiple sclerosis, or Parkinson’s disease.
* There are certain medications such as blood pressure medication like beta-blockers, heart medication, like digoxin, some peptic ulcer medications, sleeping pills, and antidepressants.
* Nicotine, alcohol, or cocaine
* Stress, fear, anxiety, or anger
* Unrealistic sexual expectations, which make sex a task rather than a pleasure
* Bad communication with your partner
* A “vicious cycle” of doubt, failure, or negative communication that will reinforce the erection problems
All erection problems will tend to be more common as you get older, but it can affect a man at any age and at any time in their life. Physical causes are more common in older men while the psychological causes are more common in younger men.
Home care
For some men, changing their way of life can help:
* Cut down or quit smoking, using alcohol, and illegal drugs.
* Get enough rest and take the time to relax.
* Exercise and eat healthier to maintain a good amount of circulation.
* Use safe sex practices because this will reduce the fear of HIV and STDs.
* Talk openly to your partner about sex and your relationship. If you are not able to do this, you should get counseling to help.
Couples who cannot talk to each other are not likely to be able to make love to each other. Men who have trouble communicating their feelings may find it difficult to share with their partner any anxieties about their sexual performance. If you keep worries to yourself, you are more likely to lose erections. Men who cannot express and resolve feelings of anger or frustration towards their partner may hold back their erection as a weapon in the conflict. In these circumstances, counseling can be very helpful for both you and your partner.
If erection problems seem to be caused by a medication you are taking for an unrelated condition, consult your doctor. You may benefit from reducing the dose of the drug or changing to another drug that has the same result but not the same side effects. DO NOT adjust or discontinue medications without consulting your doctor first.
Talk to your health care provider if your erection problems are related to fear of recurring heart problems — sexual intercourse is usually safe in these circumstances.
Call your heath care provider
You should consult with your doctor if:
* Self-care measures do not resolve the problem and you continue to have difficulty with erections. There are effective treatments available.
* If you suspect that a medication that you are taking is causing the problem.
* If you have problems that begin with an injury or prostate surgery.
* If you have other symptoms like lower back pain, abdominal pain, or change in urination.
You may need to call your doctor immediately or go to the emergency room if your erection problems are giving you unwanted erections that last more than an hour. Permanent impotence or lasting damage to your penis may be the result from this condition.
What can you expect at your health car provider’s office.
Your doctor will perform a physical examination, and this will usually include checking your circulation, a rectal exam, a neurological exam, and an exam of your penis.
To help diagnose the cause of this problem, your doctor will ask medical history questions, such as:
o Have you been able to achieve keep erections in the past?
o Is it difficult to achieve an erection or maintain the erection?
o Do you have erections during sleep?
o How long have you had difficult with erections?
o What medications are you taking and this will include prescriptions medications, over the counter medications, recreational drugs?
o Do you smoke? How much each day?
o Have you recently had surgery?
o Have you had vascular surgery or other treatments for your blood vessels?
o Are you depressed?
o Are you afraid or worried about something?
o Have you experienced a lot of stress?
o Have your energy level decreased?
o Are you sleeping well every night?
o Are you afraid of sexual activity because of other physical problems?
o Have there been any recent changes in your life?
o What other symptoms do you have?
o Have you noticed changes in sensations in your penis?
o Do you have problems with urination?
Tests may include:
o Urine analysis
o Blood tests, including CBC, metabolic panel, hormone profile, PSA
o Penile ultrasound to evaluate for blood vessel or blood flow problems
o Nocturnal penile tumescence (NPT) to test if you are having problems with nighttime erections and rigidity monitoring (Rigiscan)
o Neurological testing
TREATMENT
The treatments will depend on the cause. For example, if the problem is caused by a hormonal imbalance, medication to treat the underlying endocrine disorder will be prescribed. Consult your health care provider for appropriate evaluation and management.
There are many treatments that are available today. These include medicines taken by the mouth, injections into the penis, vacuum devices, and surgery. In order to treat erectile dysfunction effectively, you must be aware of and be comfortable with the possible side effects and complications that might occur.
Sildenafil (Viagra), vardenafil (Levitra), and tadalafil are medications prescribed for mild to moderate erection difficulties that are caused by either physical or psychological problems. Although these medicines are very popular they are not cure alls and they do not enhance erections if you are not impotent. They also do not have side effects. These pills should not be used with other certain medications.
Any man that takes nitroglycerin for a hear conditions (as either tablets, spray, or patches) should NOT take these medications. When taking them with nitroglycerin, these drugs can significantly lower blood pressure. Some men have died from combining these drugs and nitroglycerin.
If some pills do not cure the problem, there are other options available. Testosterone may be prescribed by either skin patch or injection, especially if the problem is related to age. Alprostadil, injected at the penis or inserted as pellets, will improve blood flow to the penis. The technique is usually more effective than medications taken orally.
For some of the patients, a vacuum pump or penile prosthesis (implant) may also be a good choice or even required.
You should consult with your health care provider to see if one of these treatments is the right one for you.
