Erectile Dysfunction
Erectile dysfunction (ED) or impotence is defined as the inability to achieve and/or maintain a penile erection sufficient for satisfactory sexual performance. Erectile dysfunction is a common, worldwide condition. In the UK, there are an estimated 2.3 million men with the condition. This works out to around 1 in every 10 men.
In approximately 80% of cases erectile dysfunction has a physical cause and it is a common symptom of other illnesses including diabetes, heart disease, high blood pressure or nerve damage. However in many cases there will be a combination of both physical and psychological factors.
The penis essentially consists of two cylinders of sponge-like tissue and when these become engorged with blood an erection follows. Thus the degree of erection depends on the balance between blood flowing in and blood draining out of the penis. When the inflow is low and in balance with outflow the penis is flaccid; when inflow increases and outflow falls, an erection occurs. Sexually stimulated signals pass from the brain, via nerves, to the muscles that control blood flow into the penis. These signals cause the muscles to relax and blood flow into the sponge-like tissues increases. The engorged tissues compress the veins that drain the penis of blood; the penis expands and becomes rigid.
Following ejaculation or the withdrawal of sexual stimulation, a change in the signalling from the brain causes the muscles controlling blood flow into the penis to contract and so limit the blood entering the sponge-like tissue. The veins that drain the penis of blood are no longer compressed, the pressure within the penis falls and it quickly returns to its flaccid state.
It is clear that for this train of events to occur there needs to be an intact system of nerves, normally working blood vessels and a good blood supply to the penis. It is therefore not surprising that the commonest causes of erectile dysfunction are conditions that affect these, like high blood pressure, narrowing of the arteries, diabetes, spinal cord injuries, diseases of the nerves such as multiple sclerosis and damage to the nerves following some kinds of surgery.
Erectile dysfunction can therefore affect men of all ages, however it does become more common with increasing age. In many cases treatment is simple and effective and since erectile dysfunction can be an early symptom of an underlying condition you should not be embarrassed to bring it to the attention of your doctor or nurse.
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