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About Erectile Dysfunction

The inability of a man to achieve an erection firm enough for sexual intercourse is called as Erectile Dysfunction.Delgra a PDE5 inhibitor drug is one of the best drug used in the treatment of Erectile Dysfunction.

Anatomy of Penis
Penis consists of two chambers

  • The Corpora Cavernosa
  • The Urethra.
The Corpora Cavernosa runs the length of the upper side of the penis.The Urethra is the channel for Urine and Ejaculate which runs at the bottom of the Corpora Cavernosa. There is a spongy tissue filling the corpora cavernosa consisting of veins, arteries, smooth muscles and fibrous tissues. The corpora cavernosa is surrounded by a membrane called tunica albuginea. The blood is drained out of the penis by the veins located in tunica albuginea.The corpus spongiosum helps maintain the urethra open during an erection.Thus helping in the smooth passage of sperm and prostatic fluid.

The Erection begins with sensory and mental stimulation. The nerve messages begin to stimulate the penis during sexual arousal. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the open spaces.

The veins in the tunica albuginea is compressed due to pressure from expanding penis which results in trapping the blood in corpora cavernosa.This helps to sustain firm erections.The reduction in cGMP levels in the corpora cavernosa causes the smooth muscles of the corpora cavernosa to contract.This blocks the inflow of blood and opens the veins that drain away the blood from penis.The PDE5 inhibitors destroys the levels of cGMP in the corpora cavernosa.This results in Erectile Dysfunction.

The following is required in order to achieve and sustain Erections:
  • The nervous system that conducts nerve impulses in the brain, spinal column and penis should be healthy.
  • The arteries in and near the corpora cavernosa should be healthy.
  • The smooth muscles and fibrous tissues within the corpora cavernosa should be healthy.
  • The levels of nitric oxide in the penis should be sufficient.
  • There should be appropriate psychosocial interactions.
  • If any one or more of these requirements are not met then it may result in Erectile Dysfunction.

The Signs and Symptoms of Erectile Dysfunction
  • The penile erection is not maintained for the length of sexual activity.
  • If the penile erection is not firm enough to penetrate the vagina.
  • Inability to obtain a penile erection.
The following are causes of erectile dysfunction and many men have more than one potential cause:

Old Age
There are two reasons why older men are more likely to experience erectile dysfunction than younger men. The older men are more likely to develop diseases such as agina, heart attacks , cardiovascular disease, Diabetes, Stroke and hypertension that are associated with erectile dysfunction. The aging process alone can cause erectile dysfunction in some men by decreasing the compliance of the tissues in the corpora cavernosa.There is a possibility that there is also less generation of nitric oxide in the nerves of the corporal smooth muscle within the penis.

Diabetes
Men who have diabetes may develop Erectile Dysfunction ten to fifteen years earlier than men who don’t have diabetes. In a population study of men with type one diabetes for about 10 years 55% of men from age group 50 to 60 years of age reported Erectile Dysfunction. In men suffering from diabetes there may be earlier onset of atherosclerosis that narrows the arteries and thereby lowers the supply of blood to the penis which increases the risk of Erectile Dysfunction.Erection is not possible since the blood supply to penis comes down drastically. In a Diabetic patient both sensory and autonomic nerves are damaged.This condition is referred to as Diabetic neuropathy.

Thus Diabetic Neuropathy results in Erectile Dysfunction. Having Diabetes for a long time, smoking of cigarettes and uncontrolled blood glucose levels may further increase the risk of Erectile Dysfunction in men with diabetes. Men with diabetes also develop a myopathy which is a muscle disorder. In this condition the efficacy of the muscles in the corpora cavernosa is reduced and this results in Erectile Dysfunction.

High Blood Pressure:There is an increased risk of Erectile Dysfunction in men with essential hypertension or arteriosclerosis. In men with essential hypertension there is less production of nitric oxide in the arteries of the penis.Hypertension enhances the progression of arteriosclerosis. This results in Erectile Dysfunction.

Cardiovascular Disorder:The arteries supplying blood to penis are narrowed down due to atherosclerosis.This results in reduction of blood flow to the penis.This leads to Erectile Dysfunction.

Cigarette Smoking:It was found that smoking aggravates atherosclerosis .This increases the risk for erectile dysfunction in men who smoke.

Nerve or Spinal cord damage:
Erectile Dysfunction is common in men who have injured their spinal cord or pelvic nerves.

Drug Abuse
Erectile Dysfunction is common in drug addicts and alcoholics.Alcohol can damage the nerve which can lead to shrinking of testicles and reduce testosterone levels.

Low testosterone levels

The primary sex hormone in men Testosterone is required to maintain nitric oxide levels in the penis and also necessary for sex drive.Therefore men with low Testosterone levels may result in low sex drive and erectile dysfunction.

Medications
Medications used to treat hypertension,antidepressants, antihistamines,tranquilizers and appetite suppressants may cause Erectile Dysfunction. Propranolol or other beta blockers, digoxin, famotidine, cimetidine, hydrochlorothiazide, cimetidine,amitriptyline, metoclopramide, indomethacin, lithium, verapamil, gemfibrozil, phenytoin, amphetamine, dextroamphetamine and phentermine can cause Erectile Dysfunction.

Depression and Anxiety
It's seen that anxiety, stress, depression, guilt, widower syndrome, post traumatic disorder and fear of sexual failure may be responsible for Erectile Dysfunction.Most of the anti-psychotic medicines used in the treatment of Depression may cause Erectile Dysfunction.