Erectile dysfunction, ED, or impotence, is a category of sexual dysfunction which is associated with the inability to develop or sustain an erection during sexual activity. Erectile dysfunction is a physical issue, but often causes psychological damage from the resulting self-esteem blow and relationship issues. For a disease to qualify as erectile dysfunction, it must be repeated over a long period of time. A single instance of whiskey dick, for example, would not be considered erectile dysfunction. Erectile dysfunction was once considered a crime in the 16th century and grounds for a divorce. Modern therapy made its first advance in 1983 when Giles Brindley discovered the effects of papaverine. His work would lay the foundation for later development of drugs such as sildenafil and vardenafil.
Physical erectile dysfunction is typically caused by old age, kidney failure, surgery, hyperprolactinemia, cavernosal disorders, cardiovascular diseases, diabetes, neurological problems (trauma), smoking, unbalanced hormones, and as a side effect from drugs, particularly nicotine. Psychological erectile dysfunction is a more infrequent version where there are no physical causes. It occurs from thoughts and feelings alone. Psychological erectile dysfunction requires psychotherapy rather than drugs, although placebos can often solve the issue to a degree. Physical erectile dysfunction is typically treated by addressing the underlying issue or with sildenafil, a drug designed to promote blood flow. Sildenafil can be taken as tablets or injected.
Diagnosis for erectile dysfunction begins with determining whether the patient is able to (however infrequently) obtain an erection. This could happen while asleep, for example. If so, then the underlying physical infrastructure is likely functional and the issue is probably mental. Thus, the patient would most likely be diagnosed as having psychological erectile dysfunction.
Ultrasounds are often used to diagnose erectile dysfunction. It allows the doctor to evaluate blood flow, venous leakage, atherosclerosis, and scarring. Injections of prostaglandin may be used in conjunction with ultrasounds to temporarily induce an erection for better examination. The bulbocavernosus reflex test can be used to determine if the penis nerves are functioning correctly. Men normally have five to six erections while asleep, particularly during rapid eye movement or REM. If a man does not have these erections, it may indicate an issue with blood flow or nerve damage. However, many otherwise healthy men do not have these erections, so the simple absence of them does not indicate that one is suffering from erectile dysfunction. Magnetic resonating angiography is a technique similar to magnetic resonating imaging and uses magnetic fields and radio waves to analyze blood vessels.
Erectile dysfunction treatment varies based on the cause. Aerobic exercise is often useful to prevent the disease from occuring in the first place, but has not been studied as an after-the-fact treatment. Smokers can almost always benefit from quitting. Vacuum erection devices are sometimes used as well. Drugs such as sildenafil, vardenafil and tadalafil are often used as a first-response treatment. Finally, if all other methods have failed, surgery is possible. However this often has unwanted side effects and should only be used as a last resort. Drugs such as â€œherbal Viagraâ€ will at best will do nothing and at worst contain toxic substances such as battery acid.