Erectile dysfunction (ED) or impotence is a common sexual dysfunction, especially among men over the age of 40, resulting in difficulty getting or maintaining an erection. Although most men experience difficulties with this at some point, erectile dysfunction is characterised by regular, repeated issues in this area.
In many cases, erectile dysfunction is temporary and can often be a symptom of tiredness, anxiety or stress. Moreover, alcohol and certain medications can sometimes interfere with a man’s ability to develop or maintain an erection. However, long-term erectile issues may be indicative of a more serious underlying health problem.
There are a number of potential physical causes of impotence because it is often the result of interference with regular blood flow. However, some of these are more serious than others. For example, diabetes can impact upon blood supply and can also hinder the nerve endings in the penis, resulting in an inability to get an erection.
Other vasculogenic conditions which may result in impotence include high blood pressure, or hypertension, and heart disease. Meanwhile, there are a number of conditions which impact upon hormone production, which can cause erectile dysfunction, including having either an over-active or under-active thyroid gland.
According to the National Health Service, erectile dysfunction can affect as many as one in four men who experience a serious head injury. Meanwhile, a variety of other neurogenic disorders can be responsible for the manifestation of this problem, including Parkinson’s disease and multiple sclerosis, as these affect messages from the brain.
In addition to the aforementioned physical causes, there are a number of potential psychological explanations for erectile dysfunction. A significant percentage of cases of ED have a psychological root, although this is usually short-term anxiety or the result of stress. Occasionally, however, it is something more serious.
Many patients experiencing clinical depression, or similar mood disorders, including bipolar disorder and seasonal affective disorder, report issues surrounding impotence. This is often because depression leads to a loss of libido or sex drive, but it may also be the result of intrusive thoughts or sleep disturbance.
Similarly, anxiety disorders can also be responsible for erection problems. This can be something of a self-fulfilling prophecy, as a fear or anxiety surrounding impotence, often characterised as a type of performance anxiety, can often result in the physical development of the same problem.
There are many treatments available for those suffering from erectile dysfunction, including the prescription of oral medications, like Viagra. However, if erectile dysfunction is caused by a serious health condition, it is usually necessary to treat the underlying problem first.
For example, in instances where impotence is caused by diabetes or heart disease, it is important that medication and lifestyle changes are implemented to help with this. In many instances, treating the underlying cause will also resolve erectile dysfunction, but even when it does not, it allows for ED treatments to follow.
Where erectile dysfunction has a psychological cause, it may be sensible to treat the psychological disorder, rather than the erectile dysfunction. For those suffering from depression or anxiety disorders, cognitive behavioural therapy is usually the main treatment. However, if the erectile dysfunction is contributing to psychological issues, a decision may be made to treat the impotence through medication and then provide psychological therapy.