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Erectile dysfunction (ED) is common among most middle-aged men and affects their lives and by extension those of their partners. The term erectile dysfunction, previously known as impotence, involves a wide field of sexual disorders in men, but usually refers to an inability to achieve or maintain an erection adequate enough to fulfil his own sexual needs or those of his partner.
Changes in erectile health are quite normal with advancing age. Older men find that it takes them longer to get erections, erections may not be as strong as before and they may need more stimulation and effort. Orgasms also tend to be less strong, with a reduction of ejaculation volume reduced and refractory period between erections may have increased. An occasional episode of erectile dysfunction may occur to most men, but it may not affect some psychologically.
Some men experience complete and chronic erectile dysfunction, while others retain the ability of achieving partial or short erections. Frequent ED can cause emotional problems and relationship drifts, which often lead to low self confidence in both partners. Most of the many causes of erectile dysfunction can be treated so it does not have to be an unavoidable part of aging. Although erectile dysfunction is commonly seen in men older than 40, it can occur at any age.
Erectile dysfunction can be categorized under the following patterns:
Occasional inability to get erections
Inability to maintain erections during sexual intercourse
Complete lack of erections
The penis consists of two spongy, cylinder-like vascular chambers (corpora cavernosa) that run along its length, parallel to the urethra which expels semen and urine. There are erectile tissues, two main arteries and several veins and nerves surrounding the urethra. The longest part of the penis is the shaft, at the end of which is the head known as the glans penis. The opening at the tip of the glans is the meatus, which allows urination and ejaculation.
Upon sexual excitation, nerve impulses lead to relaxation and cause an almost seven-fold increase in the blood flow to the corpora cavernosa. This sudden rush of blood fills and swells the spongy tissues, straightens, elongates and stiffens the penis to produce an erection. As the excitement is continued this rush of blood maintains and keeps the erection firm. After ejaculation, or when sexual excitation ceases, the excess blood drains out of the spongy tissue, and the penis returns to its limp state.
If any factor affects/ disrupts any of the above steps or the delicate balance between them that lead to a complete erection, it may result in erectile dysfunction. Causes of ED could either be physical, non-physical or both.
Physical causes
Physical causes account for about 80% cases of ED:
Nerve damage from chronic diabetes
Cardiovascular disorders affecting blood supply to the pelvis
Some prescription medications
Some operations e.g. removal of the prostate gland
Fractures that might damage the spinal cord
Hormonal disorders
Multiple sclerosis
Substance abuse or addiction
Non-physical causes
Non-physical causes may account for the remaining 20% cases of ED:
Stress, anxiety, fatigue and depression.
Resentment, hostility or disinterest exhibited from any of the partners.
Most often, the physical and the non-physical causes tend to interact with each other. For example, a partial ED could lead to low self-esteem and anxiety, which worsens the situation further.

Kenneth said
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Erectile dysfunction has many definitions, which makes estimating the incidence of cases difficult because it is difficult to incorporate the factors of all of these while considering the statistics. In 2002, the National Institutes of Health (NIH) estimated that between 15 and 30 million men in the US suffer from chronic degrees of ED. According to the National Ambulatory Medical Care Survey (NAMCS) in 1999, around 22 of every 1000 males in the US consulted medical help for ED.
Incidences of ED go up with increase in age. Chronic ED affects about 5% of men in their 40s and 15–25% of men around the age of 65. Partial ED affects up to 50% of men between 40 and 70 years of age.
Some diseases like diabetes, kidney disease, alcoholism and atherosclerosis account for as much as 80% of chronic ED cases while psychological factors such as stress, anxiety and depression may account for about 10 – 20% of the total number of cases. About 35-50% of men with diabetes also suffer from ED.
The road to treating ED starts with the acceptance of the existence of the problem. The physician will carry out a thorough examination to find out the cause and time of origin of the condition. A list of medications is also checked against and a number of tests are conducted to eliminate other potential diseases like diabetes. A check on hormonal level has to be done every time physical causes are suspected to be the cause. If an apparent physical cause is suspected, blood tests are immediately conducted to check male hormonal levels. There are other clinical tests that can be carried out to check the adequacy of penile function.
Although most men experience episodes of erectile dysfunction from time to time, general practices to maintain good overall health may prevent or reduce the chances of developing ED at a later stage. Habits like smoking and drinking must be avoided or greatly minimized. Conditions of stress, depression, anxiety, etc. should be effectively managed and permanent solutions must be worked out. Regular exercise, complete peaceful sleep and routine checkups are extremely essential.
Whether the resulting disorder has physical or psychological causes or a combination of both, ED may become a source of emotional and mental stress for both the man and his partner. It is important to note the following points which are essential in helping you cope with your problem:
Communicate more frequently and openly about your problem with your partner. This will help you build your relationship. A treatment plan set within a couple team will succeed better because good communication must be maintained throughout diagnosis and the treatment process.
Seeking counseling is a great idea, because it may be prove to be very difficult to overcome ED on your own.
Do not assume that you have a permanent problem if you experience ED occasionally. If you expect the problem to occur again during your next sexual encounter, chances are your psychological state might prevail.
One occurrence of ED is not proof of the end of on your masculinity and virility. ED is more common than you think it is.
It is important that your partner understands that ED does not mean a lack of sexual desire. Talk to your partner about this.