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admin | Category: What Cause Ed | 24.03.2014
Source: Article by the Department of Urology, Singapore General Hospital (SGH), a member of the SingHealth group. Erectile dysfunction (ED) is the inability to get or keep a firm erection that is sufficient for sexual intercourse. In an erection, impulses from the brain and local nerves cause the muscles of the corpora cavernosa, two chambers in the penis, to relax and allow blood to flow in through the arteries and fill the spaces. Psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure.
Chronic illnesses such as diabetes, high blood pressure, nerve disease or damage, multiple sclerosis, atherosclerosis, and heart disease can damage the nerves and arteries to the penis, resulting in ED. Poor lifestyle, such as smoking, excessive alcohol intake, being overweight, and lack of exercise. Medications such as blood pressure drugs, antihistamines, antidepressants, tranquilisers, appetite suppressants, and cimetidine, an ulcer drug. The doctor may discover a circulatory problem by observing decreased pulses in the wrist or ankles. Lifestyle changes such as quitting smoking, reducing alcohol consumption, losing excess weight, and increasing physical activity may help some men regain sexual function. Men who take nitrate-based drugs such as nitroglycerin pills for heart problems should not use any of the three drugs because the combination can cause a sudden drop in blood pressure. Drugs such as prostatglandin E1, papaverine hydrochloride, and phentolamine, are injected into the shaft of the penis to relax the smooth muscles of the corpora cavernosa, causing it to become engorged with blood. Hypertension, or high blood pressure, is a common condition that will catch up with most people who live into older age.
High blood pressure is sometimes called a silent killer because it may have no outward symptoms for years.
African-Americans are more likely to develop hypertension -- and to develop it at a younger age. Sodium, a major component of salt, can raise blood pressure by causing the body to retain fluid, which leads to a greater burden on the heart.
Stress can make your blood pressure spike, but there's no evidence that it causes high blood pressure as an ongoing condition.
Being overweight places a strain on your heart and increases your risk of high blood pressure. Gestational hypertension is a kind of high blood pressure that occurs in the second half of pregnancy. Cold and flu medicines that contain decongestants are one of several classes of medicine that can cause your blood pressure to rise. Some people only have a high reading in the doctor's office, perhaps because they're nervous. While hypertension is more often a problem for older people, even children can have high blood pressure. Beta-blockers work by slowing the heart rate, which means that the heart doesn't have to work as hard. ACE inhibitors reduce your body's supply of angiotensin II -- a substance that makes blood vessels contract and narrow.
Instead of reducing your body's supply of angiotensin II, these drugs block receptors for angiotensin -- as if placing a shield over a lock. Calcium channel blockers slow the movement of calcium into the cells of the heart and blood vessels. Other medications that relax the blood vessels include vasodilators, alpha blockers, and central agonists. Meditation can put your body into a state of deep rest, which can lower your blood pressure. The engorged chambers expand the penis, and the tunica albuginea, a membrane covering the two chambers, helps to sustain the erection.
Unusual characteristics of the penis itself could suggest the source of the problem – for example, a penis that bends or curves when erect could be the result of Peyronie’s disease.
Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. A psychosocial examination, using an interview and a questionnaire, can reveal psychological factors.

Techniques that decrease anxiety associated with intercourse can be taught together with the help of the partner. Oral drugs called phosphodiesterase (PDE) inhibitors enhance the effects of nitric oxide, a chemical that relaxes smooth muscles in the penis during sexual stimulation and allows increased blood flow in the penis.
Patients using such medications should be warned about persistent erection, known as priapism, which requires emergency treatment.
Mechanical vacuum devices cause an erection by creating a partial vacuum, which draws blood into the corpora cavernosa, engorging and expanding the penis.
Surgery may be performed to repair arteries with discrete blockage because of an injury to the groin or fracture of the pelvis. Their blood pressure is consistently just above the normal level -- falling anywhere between 120 and 139 for systolic pressure or 80 to 89 for the diastolic pressure. It becomes more common for both men and women as they age, and more women have hypertension by the time they reach 65. The American Heart Association recommends eating less than 1,500 milligrams of sodium per day.
However, stress may affect risk factors for heart disease, so it may have an indirect connection to hypertension. Guidelines from the American Heart Association state that if you drink alcohol, you should limit the amount to no more than two drinks a day for men, or one a day for women. It might have a temporary effect, but studies haven't shown any link between caffeine and the development of hypertension. Without treatment, it may lead to a serious condition called preeclampsia that endangers both the mother and baby.
Others include NSAID pain relievers, steroids, diet pills, birth control pills, and some antidepressants. The DASH Diet -- Dietary Approaches to Stop Hypertension -- involves eating more fruits, vegetables, whole-grain foods, low-fat dairy, fish, poultry, and nuts.
Also called "water pills," they help the body shed excess sodium and water to lower blood pressure. They are also used to treat other heart conditions, such as an abnormal heart rate called arrhythmia. The result is more relaxed, open (dilated) arteries, as well as lower blood pressure and less effort for your heart. This blockade prevents the chemical's artery-tightening effects, and lowers your blood pressure. Since calcium causes stronger heart contractions, these medications ease the heart's contraction and relax the blood vessels.
Side effects can include dizziness, a fast heart beat or heart palpitations, headaches, or diarrhea.
The erection ends when muscles in the penis contract to stop the inflow of blood and open the veins for blood outflow. The medical history can disclose diseases that lead to ED, and a simple recounting of sexual activity might identify problems with sexual desire, erection, ejaculation, or orgasm. For example, if the penis is not sensitive to physical touch, a problem in the nervous system may be the cause. Measuring the amount of available testosterone in the blood can yield information on problems with the endocrine system and may explain why someone has decreased sexual desire. A man’s sexual partner may also be interviewed to determine expectations and perceptions during sexual intercourse. An elastic ring is moved from the end of the cylinder to the base of the penis as the cylinder is removed to maintain the erection. Surgery to block off veins, called ligation, can reduce the leakage of blood that diminishes the rigidity of the penis during an erection.
When it's too high, it raises the heart's workload and can cause serious damage to the arteries. Internally, it can quietly damage the heart, lungs, blood vessels, brain, and kidneys if left untreated. People in this range have twice the risk of developing heart disease than those with a lower reading.
You have a greater risk if a close family member has high blood pressure or if you are diabetic.

In people who have a gene that makes them salt-sensitive, just a half-teaspoon of salt can raise blood pressure by 5 mm Hg. Stress may lead to other unhealthy habits, such as a poor diet, alcohol use, or smoking, which can contribute to high blood pressure and heart disease. They typically call for cutting fatty foods and added sugars, while increasing fruits, vegetables, lean protein, and fiber. They define a drink as one 12-ounce beer, four ounces of wine, 1.5 ounces of 80-proof spirits, or one ounce of 100-proof spirits. The condition can limit blood and oxygen flow to the baby and can affect the mother's kidneys and brain. If you have high blood pressure, talk to you doctor about what medicines and supplements you are taking that may affect blood pressure. Those people may have a higher chance of developing high blood pressure, a recent study shows.
Children are at greater risk if they are overweight, have a family history of the illness and if they're African-American.
Side effects can include a dry cough, skin rash, or dizziness, and high levels of potassium. Your doctor may suggest them if other blood pressure medications are not working well enough or if you have another condition. These relaxation techniques should be combined with other lifestyle changes, such as diet and exercise. If you keep it under control, you can reduce your risk of stroke, heart disease, and kidney failure.
The use of certain drugs can also suggest a chemical cause as drug effects are a frequent cause of ED. Abnormal secondary sex characteristics, such as unusual hair pattern or breast enlargement, can point to hormonal problems, which would mean the endocrine system is involved. Once a man has either a malleable or inflatable implant, he must use the device to have an erection. Over time, uncontrolled high blood pressure increases the risk of heart disease, stroke, and kidney disease.
The lower number (diastolic) measures pressure at rest between heartbeats, when the heart refills with blood.
To get a more accurate reading, take your blood pressure at home, chart your readings, and share them with your doctor. Muscle-strengthening activities are recommended at least two days a week and should work all major muscle groups. Some diuretics may deplete your body's potassium, causing muscle weakness, leg cramps, and fatigue. Side effects can include insomnia, dizziness, fatigue, cold hands and feet, and erectile dysfunction. Possible side effects include dizziness, muscle cramps, insomnia, and high levels of potassium. Take them with food or milk and avoid grapefruit juice and alcohol because of possible interactions. Be aware that herbal therapies may conflict with other medications you take, and some herbs actually raise blood pressure. Possible problems with implants include mechanical breakdown and infection, although the incidents of mechanical problems have decreased in recent years because of technological advances.
A hypertensive crisis can lead to a stroke, heart attack, kidney damage, or loss of consciousness. It is also a good idea to bring in your home monitor in for a check of the device and your technique.
Symptoms of a hypertensive crisis can include a severe headache, anxiety, nosebleeds, and feeling short of breath.
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