Erectile Dysfunction Treatment

Erectile or sexual dysfunction is much more than impotence. Impotence comes from inability to unite and means the impossibility of "coming together". Erectile or sexual dysfunction is however a dysfunction not only of erection, but p. ex. also libido, ejaculation, orgasm.

Anatomical and physiological points of view

The erectile tissues in the penis are in a dorsal position on the left and right and are called cavernous corpus. The cavernous body around the urethra is called spongiosium corpus and forms an anatomical and functional entity with the penis of the penis. The arterial blood comes from the common iliac artery, which is divided in internal iliac artery and further in pudendal artery and finally cavernous artery.

Physiologically, an erection consists of vasodilatation of cavernous artery followed by sinus relaxation and finally an increase in venous resistance. This means that an erogenous stimulus sends a central signal via the spinal cord to the pelvic plexus, whereupon, after release of nitric oxide from the nerve ends, guanylate cyclase stimulation occurs which results in an increase in cyclic GMP and thereby decreased intracellular calcium in smooth muscle cells resulting in relaxation of smooth muscle cells. This relaxation means vasodilatation and erection.

It is often very difficult to determine a single cause of erectile dysfunction because there are usually three main causes:

-          A physical affection.

-          Psychological problems.

-          Taking certain medications.

Physical factors  

Some of the main physical factors that cause erectile dysfunction include:

-          Abnormalities involving blood vessels caused by high blood pressure (40% of erectile dysfunction), diabetes, high cholesterol levels and tobacco.

-          The atheroma plaques that deposit on the walls of the arteries irrigating the penis can cause narrowing of the arteries and then prevent the blood from circulating properly to achieve a real erection.

-          Overweight and obesity.

- Abnormalities related to the nervous system (and thus the proper functioning) of nerves such as:

Alcoholism, Parkinson's disease, multiple sclerosis, epilepsy, stroke or spinal cord injury

-  Kidney failure:

40% of men with kidney failure have erectile dysfunction.

-  Hormonal abnormalities:

Male hormone levels too low.

These disorders of erection having a physical origin concern especially men over 50 years. These dysfunctions are generally progressive onset over several years and not suddenly.

Surgery related to prostate cancer?

Prostate cancer is the most diagnosed cancer in men and the most commonly performed procedure. The prostatectomy total has generally resulted in loss (temporary) erections. Surgeons very often perform a large ablation to avoid leaving cancerous tissue and as the erector nerves are very close to the prostate, they are often damaged. When possible, these nerves are left in place, which allows to find erections in less than 1 year but in general, it is not uncommon for it to take two years to find an erection quality satisfactory.

Tobacco, alcohol, drugs?

Most men with erectile dysfunction are or have been smokers. Indeed, smoking aggravates hypertension and deposition of atheroma plaques, while promoting venous leakage, that is to say, an inability of the veins of the penis to retain blood.

The alcohol, if it can be used initially as disinhibiting, has a very harmful effect on the control of the erection as it is responsible for a decrease testosterone. The same effect is noted for drugs, especially for cannabis.

What does the doctor prescribe?  

It is an oral treatment  that is usually offered as first-line, we find:

-          Sildenafil

-          vardenafil

-          tadalafil

These three molecules act on the relaxation of the smooth muscles of the cavernous body and thus increase the arterial blood flow at the origin of the erection. This Erectile Dysfunction Treatment for Men is erection facilitators and sildenafil citrate is effective only if they have associated with sexual stimulation (foreplay, caresses).