As many as half of men over the age of 40 suffer from erectile dysfunction, or difficultly achieving or maintaining an erection. Generally, erectile dysfunction is caused by one of two major categories: psychological factors and physiological factors. The good news for those suffering from physiological erectile dysfunction is that treatment is often possible, but it helps to understand the cause in order to address the symptoms. This guide gives readers a more in-depth understanding of what physiological erectile dysfunction is, what physical factors might cause it and what some of the more common treatment methods are today.
Understanding Physiological Erectile Dysfunction
Physiological erectile dysfunction, commonly referred to as impotence, is a sexual dysfunction. The primary symptom of physiological erectile dysfunction is the inability to achieve an erect penis during sexual intercourse or related activity. It may also refer to the inability to maintain that erection for as long as desired.
Although for years erectile dysfunction was ignored, its prevalence, along with a rise in the effectiveness of treatment methods, has encouraged more patients to visit medical professionals for advice. Roughly 5% of men aged 40 suffer from long-term erectile dysfunction, and up to 25% of men aged 50 and above do. Only 10% to 20% of erectile dysfunction cases are caused by psychological factors, which means that the overwhelming majority of erectile dysfunction is caused at least in part by physiological factors.
Causes of Physiological Erectile Dysfunction
Physiological erectile dysfunction is not caused by just one health issue. In fact, it can be caused by dozens of different factors, and many men find that several factors are compounded at once. The roots of erectile dysfunction are highly individual to every man, but most people can find their specific cause from this list.
• Peyronie’s Disease: This disease is characterized by the formation of plaque along the length of the penis. As plaque builds up in the area of the penis called the corpora cavernosa, it is not visible, and it may not be noticeable when the penis is flaccid. When erections are desired, however, the hardened plaque can cause pain or discomfort in the penis, and it may even lead to a reduced or oddly-shaped erection.
• Venous Leakage: In order for an erection to be achieved and then maintained, there needs to be adequate blood flow through the penis, which is accomplished thanks in large part to the veins. If there is any leakage in the veins, it will be challenging to achieve enough blood flow for the desired erection. Patients with venous leakage as well as erection dysfunction can often resolve the latter by addressing the first.
• Prescription Medications: There are a number of different prescription medications that can lead to physiological erectile dysfunction. In some cases, these medications are only to be used for a short amount of time, which means that erectile dysfunction often disappears after the medicine leaves the blood stream. However, some medications like antihistamines and high blood pressure drugs are meant to be taken on a regular basis and can lead to chronic physiological erection dysfunction. Anyone suffering from erectile dysfunction should find out if they are taking any medications that could lead to impotence.
• Diabetes: This illness often correlates to a higher chance of impotence. There are several factors, such as obesity and high blood sugar, that could be the root of the problem. However, there is also evidence suggesting that since diabetes can effect both the nervous system and the circulation system, that in and of itself could lead to physiological erectile dysfunction.
• Penis Injury: Although rare, injuries to the penis can also be the cause of physiological erectile dysfunction. Fractured penises, bruising or other issues can all cause pain during erection, which may in turn mean that men have a hard time sustaining that erection during sexual activity.
• Priapism: While many people tend to think of physiological erection dysfunction as impotence, the opposite end of the spectrum can be just as frustrating. Priapism is a condition where sufferers have painful erections that can last upwards of four hours. This occurs without sexual activity or stimulation and can go on to lead to permanent erectile dysfunction. Anyone dealing with short bouts of priapism should address it immediately with a medical professional in order to prevent long-term problems with sustaining erections.
• Smoking: One of the leading causes of physiological erectile dysfunction is smoking. Although tobacco use leads to a number of health ailments, one of the most significant in relation to erectile dysfunction is arterial narrowing. Narrow arteries reduce blood flow and inhibit circulation to the penis, which causes problems for men who wish to achieve an erection. Thankfully, cessation of smoking can sometimes have an immediate effect on sustaining erections for sexual activity.
• Heart Disease: One of the leading factors in physiological erectile dysfunction is heart disease. Many men over the age of 35 are at risk for heart disease, which can cause problems for the arteries and circulation system in the body, all of which leads to erectile dysfunction. When addressing heart disease with prescription medication, it is important to avoid any drugs that have a history of causing physiological erection dysfunction, as mentioned above.
• Age: Unfortunately, this cause of physiological erection dysfunction is something that all men will encounter eventually. Generally, between the age of 40 and 60, men will notice that achieving an erection takes more effort and time, and sustaining that erection can also be more challenging than it was in their youth. In these cases, medication can often be a relatively simple and effective way to regain erection control.
• Sleep Disorders: An often overlooked causes of physiological erection dysfunction is problems with sleep. Without question, sleep is a vital need for humans and an important building block for overall health. Sleep apnea, for example, is often tied to erectile dysfunction. When the body is getting insufficient amounts of sleep, it compensates for the lack of energy by reducing sex drive and leading to erectile dysfunction.
• Hormonal Imbalance: Physiological erection dysfunction can be caused by a hormonal imbalance, which can in turn be caused by several factors. Obesity is a common reason for men to have a hormonal imbalance, because high percentages of body fat can cause the creation of excess estrogen in the body. Other causes of hormonal imbalance can include pituitary gland problems where prolactin, a hormone linked to erectile dysfunction, is produced in large amounts.
• Surgery or Other Invasive Medical Procedures: Anyone who has recently undergone a surgery in the pelvic region, or who has received treatment for prostate cancer, rectal or bladder cancer, may have problems achieving or sustaining an erection. Major surgeries are a big stress on the body, and it is not unusual for recovering patients to take weeks or months before their normal sexual activity can resume.
When to See a Doctor About Physiological Erectile Dysfunction
A common question among men is when, exactly, they should visit a doctor for information or advice about physiological erectile dysfunction. If there is any ever pain caused by an erection or serious issues caused by a lack of erection, immediate medical attention is vital.
For men who experience physiological erectile dysfunction on occasion, perhaps during 1%-5% of all sexual activity, medical attention may not be necessary. This infrequent type of erection dysfunction, called transient ED, can be quite common and generally does not require treatment or medication.
If physiological erection dysfunction persists, is becoming a problem in a relationship or is getting more and more common over time, medical attention may be required. In some cases, erectile dysfunction can be addressed quickly, allowing patients to resume healthy sexual activity once again.
Men who are able to achieve erections naturally, can masturbate on their own or who have erections in their sleep are probably not suffering from physiological erectile dysfunction. Their issues with erections during sexual activity are likely psychological, which means that they might best be addressed by a psychiatrist, sexual therapist or psychologist.
Men suffering from physiological erectile dysfunction should generally start with a visit to their primary care physician. If the physical causes of erectile dysfunction are obvious, this physician may be able to treat the problem in a single visit. If the cause is unclear, doctors may ask several questions about drug use, tobacco use, alcohol use, exercise habits, diet, sexual activity and stress in order to pinpoint a problem. In some cases, patients will be referred to a urologist who can dig deeper in order to understand the underlying physical causes of erectile dysfunction.
Common Treatment Methods for Physiological Erectile Dysfunction
There are several different treatment methods that can be effective against physiological erectile dysfunction. Possible options range from prescription oral medications to regular exercise or a more nutritious diet.
An erectile dysfunction vacuum, better known to many as the penis pump, can be used to manually achieve an erection for sexual activity. A cylinder gets placed on the end of the penis and is constricted so that no air escapes and a vacuum is achieved. A pump forces blood flow to the penis, and the constricting band keeps blood trapped in the penis so that the erection can be sustained. This is generally considered to be the least intrusive means of immediately treating physiological erectile dysfunction caused by reduced blood blow, circulation issues or heart disease.
An uncommon method of treating physiological erectile dysfunction is vascular reconstructive surgery. This procedure involves creating a clear path for blood flow to the penis by attaching an abdominal artery to a penile artery. This is rare and generally not a step to be taken unless there are major blood flow problems and the candidate is young.
Most men with physiological erectile dysfunction think of oral medications as the simplest form of treatment. Most of these medications enhance the nitric oxide that already exists in the body, which helps increase blood flow to the penis and allows users to achieve an erection during sexual stimulation. Dosages and frequency can vary, and the right medication can depend on a man’s age, weight, overall health and sexual activity.
After other treatments have been tried, some men resort to penile implants. These work by surgically implanting rods on either side of the penis. These rods, which can be be inflatable, allow users to control their erections on demand. Although this surgical treatment is generally considered a last resort, it can be incredibly effective for some men.
One of the most effective remedies for physiological erectile dysfunction is also the simplest. Men with Type II Diabetes, poor diets, obesity or metabolic syndrome can all benefit from staying active, eating a more nutritious diet and losing weight. Those who use or abuse tobacco, alcohol or narcotics can also drastically improve their erection control by eliminating or reducing consumption of those substances. Many physicians will recommend, at least as a first course of treatment, that men with erectile dysfunction complete several key lifestyle changes in order to enjoy better overall health. This, in turn, can lead to better sexual health, more frequent erections and longer, stronger erections as desired.
Physiological erectile dysfunction can be caused by a variety of factors, and every man will have a different set of issues to consider. Treatment methods also vary, but they can be an effective way to combat the physical causes of erectile dysfunction and regain sexual health.