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What is impotence?

 Some interesting facts about ED

• ED is a highly prevalent and undertreated disease with a significant impact on total health.

• ED is not an overtreated condition, despite media representations. On the contrary, studies have revealed that 90% of those suffering from ED, never go for treatment.

• The expected increase in the number of men who suffer from ED is the direct result of ageing populations, unhealthy eating habits, the earlier onset of diabetes and obesity and stress.

• In studies worldwide, about 10% of men are believed to be affected. Incidence rises with age: about 5% of men at the age of 40 and between 15 and 25% of men at the age of 65 suffer from erectile dysfunction, and the percentage grows to 70% as men reach 80.

• ED is a barometer of cardiovascular health.

• In a US survey, it was found that 71% of participants never raised the issue of ED with their doctors, because they thought they would dismiss sexual concerns. 68% feared the doctor would be embarrassed and 76% thought there would be no medical treatment available.


Lifestyle changes

If you only experience occasional episodes of erectile dysfunction, you may be able to treat it at home without medication.

• Some of the causes of erection failure are within your control, such as stress, smoking, and alcohol use. Regular exercise and the correct diet help to prevent and treat ED.

• Talk to your partner. Often sharing your worries about sexual performance with your partner can break a vicious cycle of anxiety. You may find out that your partner does not view the problem as seriously as you do. This may leave you freer to enjoy sexual activity instead of consciously tracking your performance.

• Make some time together to enjoy simple sensual pleasure, such as caressing and massaging without the goal of having sexual intercourse or even an erection. You may discover new kinds of sexual pleasure while you reserve intercourse for another occasion when you are more at ease.

• Sexual problems are often the result of underlying difficult feelings between you and your partner. Are you angry with him or her? Are you worried about rejection? Talk openly about these feelings and try to resolve conflicts. At the same time you might want to reassure your partner that erectile dysfunction very seldom arises from lack of sexual interest.

• Pelvic-floor exercises (similar to Kegel exercises) may be helpful in some men with erection problems. These exercises have no risks.

• Don’t be embarrassed about seeking professional help if home strategies don’t help and erection problems are persistent and troublesome.


What are the physical causes of ED?

The most common cause of erectile dysfunction is damage to arteries, smooth muscles and fibrous tissues.

• Problems with the blood vessels (vascular problems) make up 48% of erection problems.

• Problems with the nerves (neurological problems): 14%

• Problems with the structure of the penis or surrounding tissues: 3%

These problems can in turn be caused by a variety of factors:

• Disease: illnesses account for 70% of erectile dysfunction. These may include diabetes, kidney disease, and multiple sclerosis. Atherosclerosis or “hardening of the arteries” can prevent adequate blood from entering the penis.

• Injury to the penis, spinal cord, prostate, bladder or pelvis: such injury can be the result of sports or car accidents, or even riding on hard bicycle seats.

• Complications of surgery or radiation (for example, for prostate cancer): these can interfere with nerve impulses or blood flow to the penis. When the nervous system cannot transmit arousal signals, or when the blood vessels in the penis cannot fill or stay filled with blood, you cannot have an erection.

• Side effects of common medication: these include drugs taken for high blood pressure, antidepressants, antihistamines, tranquillisers, appetite suppressants, and the ulcer drug cimetidine.

• Substance abuse: chronic use of alcohol, marijuana or other drugs often causes impotence, which may be aggravated by decreased sexual drive. Excessive tobacco use can also block penile arteries.

• Hormonal factors, such as low testosterone levels

• Zinc deficiency


What are the psychological causes of ED?

Psychological problems, such as anxiety, interfere with the erection process by distracting the man from things that would normally arouse him. These problems cause between 10 and 40% of erectile dysfunction. Even in cases where the underlying problem is physical, these factors can play an important secondary role, for example when a man who has had some erectile difficulty starts to anticipate and fear sexual failure. As a result, psychological factors play some causal role in at least 80% of cases of erectile dysfunction. These factors include:

• Depression: erectile dysfunction is twice as likely among men suffering from depression as it is among those without depressive symptoms.

• Relationship problems: a man who loses sexual interest in or desire for a particular partner may develop erection problems.

• Anxiety and stress, including that caused by major life changes.

• Grief and other reactions to major loss: recently widowed men may have erection problems.

• Low self-esteem

• Erection problems in men under 50 are more likely to be due to psychological causes.


Does ED sometimes clear up by itself?

Yes, it does. Especially if it was the result of a stressful situation which has been resolved, or an injury that has healed.