We know sex is good for us.
Now scientists say it can also protect against disease.
Erectile dysfunction (ED) affects the lives of many middle-aged men and their partners to one degree or another. ED, formerly called impotence, refers to the inability to obtain an adequate erection for satisfactory sexual activity.
Although ED is more common in older men, it can occur at any age. An occasional episode of ED happens to most men, and is normal. As men age, it''s also normal to experience changes in ED. Erections might take longer to develop, will not be as rigid or could require more direct stimulation to be achieved. Men also notice that their orgasms are less intense, the volume of ejaculate is reduced and recovery time increases between erections.
When ED proves to be a pattern or a persistent problem, it can interfere with a man''s self-image as well as his sex life. It can also be a sign of a physical or emotional problem that requires treatment. While it was once a taboo subject, currently it is acceptable to discuss; therefore, more men are comfortable in seeking help.
Occasional inability to obtain a full erection
Inability to maintain an erection throughout intercourse
Complete inability to achieve an erection
The penis contains two cylindrical, sponge-like structures that run along its length, parallel to the tube that carries semen and urine (urethra). When a man becomes sexually aroused, nerve impulses cause the blood flow to the cylinders to increase about seven times the normal amount. This sudden inflow of blood expands the sponge-like structures and produces an erection by straightening and stiffening the penis. Continued sexual arousal or excitement maintains the higher rate of blood flow, keeping the erection firm. After ejaculation, or when the sexual excitement passes, the excess blood drains out of the spongy tissue, and the penis returns to its normal, non-erect size and shape.
If anything affects these factors or the delicate balance among them, ED can result. These include:
Nerve damage from longstanding diabetes (diabetic neuropathy)
Cardiovascular disorders affecting the blood supply to the pelvis
Operations for cancer of the prostate
Fractures that injure the spinal cord
Alcoholism and other forms of drug abuse
Psychological problems. The most common nonphysical causes are stress, anxiety and fatigue. Impotence is also an occasional side effect of psychological problems such as depression.
Negative feelings. Feelings that you express toward your sexual partner — or that are expressed by your sexual partner — such as resentment, hostility or lack of interest also can be a factor in ED.
The physical and nonphysical causes of ED commonly interact. For instance, a minor physical problem that slows sexual response may cause anxiety about attaining an erection. Then the anxiety can worsen your ED.
It''s normal to experience ED on occasion. But if ED lasts longer than two months or is a recurring problem, you should seek treatment, even if you view it as a personal or embarrassing problem. In most cases, ED can be successfully treated with medications.
It can help to know whether you obtain erections while you sleep. Most men experience many erections, without remembering them, during sleep. A simple test that involves wrapping a special perforated tape around your penis before going to sleep can confirm whether you have nocturnal erections. If the tape is separated in the morning, your penis was erect at some time during the night. Tests of this type confirm that there is not a physical abnormality causing ED, and that the cause is likely psychological, but you still might need treatment to overcome your control and get your confidence back.
A wide variety of options exist for treating ED. They include everything from medications and simple mechanical devices to surgery and psychological counseling. The cause and severity of your condition are important factors in determining the best treatment or combination of treatments for you. You also want to consider how much money you''re willing to spend and compare the personal preferences of you and your partner. Wearing uncomfortable mechanisms on your penis and/or risking expensive and painful surgeries are usually waived in light of the readily available oral medications that can be tried quickly and easily, without much time or expense.
Oral medications available to treat ED include:
The Food and Drug Administration (FDA) approved Viagra in 1998, and it became the first oral medication for ED on the market. Since then, Cialis was approved, providing more options for oral therapy.
Viagra and Cialis work in much the same way. Chemically known as phosphodiesterase inhibitors, these drugs enhance the effects of nitric oxide, a chemical messenger that relaxes smooth muscles in the penis. This increases the amount of blood and allows a natural sequence to occur — an erection in response to sexual stimulation. These medications don''t automatically produce an erection. Instead they allow an erection to occur after physical and psychological stimulation. Many men experience improvement in erectile function after taking these medications regardless of the cause of their impotence.
Remember that if it doesn''t work right away, you might need to adjust your dosage, or alter when you take the medication.
Whether the cause is physical factors or psychological factors or a combination of both, ED can become a source of mental and emotional stress for a man, and his partner. If you experience ED only on occasion, try not to assume that you have a permanent problem. Don''t view one episode of ED as a lasting comment on your health, virility or masculinity, and don''t be afraid to get a little help from time to time.
In addition, if you experience occasional or persistent ED, remember your sexual partner. Your partner might see your inability to have an erection as a sign of diminished sexual desire. Your reassurance that this is not the case can be helpful in this situation, and avoid unnecessary stress about the issue.
To appropriately treat ED and strengthen your relationship with your partner, try to communicate openly and honestly about your feelings. Try to maintain this communication throughout the treatment process. In fact, treatment is often more successful if couples work together as a team. The sooner you begin, the better your success rate will be.