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Erectile dysfunction (ED) tends to affect the lives of most middle-aged men and their partners somehow or the other. The term ‘erectile dysfunction’, which was earlier called impotence, covers a wide range of sexual disorders in men, but usually refers to an inability to achieve or maintain an erection adequate enough to fulfill his own sexual needs or those of his partner.
It is quite normal for changes in erectile function to occur as men progress with age. Erections may take longer to be obtained, may not be as stiff or may require more effort and stimulation to achieve. Men may also observe that their orgasms are less intense, the ejaculate 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. Erectile dysfunction has many causes, most of which can be treated, rendering it as not an inevitable consequence of aging. Although erectile dysfunction is more common in men older than 40, it can possibly occur at any age.
Erectile dysfunction can be categorized under the following patterns:
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.
When a man is stimulated sexually, 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 expands the spongy tissues, and straightens, elongates and stiffens the penis to produce an erection. Sustained sexual excitation maintains this rush of blood 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 flaccid 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, nonphysical or both.
Physical causes
Physical causes account for about 80% cases of ED:
Nonphysical causes
Nonphysical causes may account for the remaining 20% cases of ED:
Most often, the physical and the nonphysical causes tend to interact with each other. For example, a partial ED could lead to low self-esteem and anxiety, which could actually make the case even worse.

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 increase 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.
Diseases like diabetes, kidney disease, alcoholism and atherosclerosis account for as high 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 first step is to acknowledge that there could possibly be a problem, and then to seek professional medical advice. The physician usually conducts a complete investigation to determine the actual 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. If an apparent physical cause is suspected, blood tests are immediately conducted to check male hormonal levels. Additional specialized clinical tests may also be recommended to determine 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: