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Bio: Derek is an active blogger for the website Erectile Doctor, an online directory connecting licensed physicians and patients seeking erectile dysfunction treatment.
See related patient information handout on erectile dysfunction, written by the author of this article. Erectile dysfunction is defined as the persistent inability to attain or maintain penile erection sufficient for sexual intercourse. How pharmacists fought medical directors for professional recognition - Onwudike Fulani herdsmen killings, our greatest fear before ACPN conference – Alkali Prof. Erectile dysfunction (ED) and infertility are two major issues generating concerns the world over, and particularly in the Sub-Sahara Africa, where the prevalence of risk factors, such as diabetes, dyslipidaemia, hypertension, is on the increase.
Contrary to the misconception that ED is an age-related condition, a Consultant Urologist at the Lagos State University Teaching Hospital (LASUTH), Ikeja, recently explained that erectile dysfunction has nothing to do with old age. Defining ED or impotency as a state where a man cannot get an erection to have sex or cannot keep an erection long enough to finish having sex, she added that it is not necessarily a symptom of old age, as older men should still be able to get an erection for sexual pleasure. Abolarinwa, therefore advised men to keep their blood sugar and blood pressure under control to prevent erectile dysfunction. In addition to the highlighted causes of ED, Dr Anna Cole, a clinical psychologist with Mental Health Foundation, said psychological issues and problems in relationship with a sexual partner could also cause erectile dysfunction. Feeling nervous about sex, feeling depressed and feeling stressed, including stress from work or family situations could degenerate to ED, she noted.
Also, a new research published in Science Alert with the title, “Erectile Dysfunction and Hypertension among Adult Males in Umudike, Nigeria: A Study of Prevalence and Relationships”, found it that ED affects approximately half of men of over 40 years of age and results in an inevitable loss of quality of life of the sufferer and his partner. As regards the link between ED and infertility, Dr Michael Roizen, Medical Director of Internal Medicine, said ED and infertility are very different terms, noting that a man may be producing perfectly good sperm, but having trouble with his erection, which is what he termed ED. A man’s fertility generally relies on the quantity and quality of his sperm, if the number of sperm a man ejaculates is low or if the sperm are of a poor quality, it will be difficult, and sometimes impossible, for him to cause a pregnancy.
Accurate statistics are lacking on how many men are affected by infertlity, but some doctors estimate that about half of men aged 40 to 70 have frequent problems achieving or maintaining an erection. Circulatory problems: An erection occurs when the penis fills with blood and a valve at the base of the penis traps it.
Peyronie’s disease: This disease causes fibres and plaques to appear in the genitals, interrupting blood flow. Surgery: Surgery to the pelvis, and especially prostate surgery for prostate cancer, can damage the nerves and arteries that are required to gain and maintain an erection.
Spinal cord or pelvic injury: The nerves that stimulate erection can be cut by injury to them.
Hormonal disorders: A lack of testosterone (male hormone or androgen) can result from testicular failure, pituitary gland problems, or certain medications. Alcoholism: Chronic alcoholism can produce erectile dysfunction, even if there is no alcohol in the blood at the time of sex. Performance anxiety: Most men have had erection problems at some point due to worrying about performing well during sexual intercourse.
Situational psychological problems: Some men have problems only in certain situations or with certain people. If a man had regular erections in the past, but suddenly begins to have problems getting an erection, there’s a chance that it’s a nerve or hormonal problem, a circulatory problem, or the effect of alcohol, drugs, or medicine. If a man still gets erections but they’re not as hard or long lasting as in the past, it’s quite likely that a circulatory problem is causing the dysfunction.
If surgery or injury is involved, the sufferer may already know what’s causing the erectile dysfunction.
While erectile dysfunction is inevitably going to cause some anxiety, it’s vital for sufferers to keep their relationship with their partner or spouse as regular as possible until a solution can be found.
To find out what’s causing erection problems, a doctor will begin by asking about other medical conditions the man might have, what medications he’s taking, when his erection problems occur, and what form they take. Standardised questionnaires or surveys about erectile function and the satisfaction of sexual intercourse may be used to identify the nature of erectile dysfunction. There are tests that aim to distinguish between psychological, nervous, and circulatory causes. Several devices, including a Doppler radar, can track blood flow in and out of the penis and identify circulatory problems. Medications for erectile dysfunction include phosphodiesterase inhibitors, prostaglandins, and testosterone. Phosphodiesterase inhibitors: This class of medications includes sildenafil,* tadalafil, and vardenafil. Prostaglandins (alprostadil): Alprostadil can be injected into the penis or inserted as a pellet through the urethra. Testosterone: This is only useful for people with specific disorders like hypogonadism (small testicles) that result in lower than normal amounts of testosterone in the blood stream. Vacuum devices: This involves placing a tube over the penis, forming an airtight seal around the base. Penile implants: This treatment involves permanent implantation of flexible rods or similar devices into the penis. There are two broad categories that the causes of erectile dysfunction (ED) fall into physical and physiological. Physical health problems are the most likely cause of erectile dysfunction as earlier mentioned, particularly in older males. For younger men, ED is often related to anxiety, stress or psychological trauma due to a distressing sexual experience. Pills such as Viagra can help a man overcome psychological obstacles and give him confidence that everything is working perfectly. In most cases, blood vessel deterioration is the main cause of erectile dysfunction, so you want to make sure that your blood vessels are in good condition to allow normal blood flow. Type 2 diabetes stems primarily from unhealthy diet and lack of exercise (yet another reason to maintain a healthy lifestyle to prevent ED). Young men often suffer from “performance anxiety, which can result in erectile dysfunction.
Seeking help from a sexual health expert can prove very effective, especially to work through relationship issues or anxiety, both of which may result in ED. When your confidence is at stake, taking pills such as Viagra can help you to realise that there is no problem with the engine and give you that confidence boost.
However, if you are facing bigger issues, then expert help and knowing fully what you are dealing with can help relieve your fear and anxiety.
This will help you to find out the real causes of the problem too, which will help you reach the best solution for you.
If you feel too embarrassed to raise the topic with your doctor, you can use our online services to directly contact one of our GPs.
While you are working out the causes of your problem or being treated, it’s fundamental that you focus on your relationship. Couples who have difficulties communicating on both sexual and heart matters are more likely to develop issues related to intimacy and sex.
Just remember, if you are having problems with your impotence, your partner will be affected by this too.
A recent research by the University of the West of England, Bristol, suggests that erectile dysfunction exercises may be a very effective way of improving your erections.
The scientists from Bristol compared the effectiveness of these exercises to that of Viagra and believe regularly exercising your pelvic floor muscles may be the best way of preventing erectile dysfunction. Exercising regularly is a great way to improve the state of your general health and boost your performance.
When combined with a healthier lifestyle, regular physical activity can contribute to improving your blood flow and restore your ability to get erections. Infertility affects nearly 25 per cent of couples in Nigeria and experts claim that 40 to 45 per cent of all consultations in gynaecological clinics are infertility-related.

Secondary infertility: where a mother who has had one or more pregnancies in the past, is having difficulty conceiving again. There are numerous clinics and medical centres in Nigeria that can help couples having difficulty conceiving children. Note that while some couples find it easy to get pregnant quickly, it can take longer for others. SlideShare verwendet Cookies, um die Funktionalitat und Leistungsfahigkeit der Webseite zu verbessern und Ihnen relevante Werbung bereitzustellen. If you are facing a problem of erectile dysfunction than use orviax, IT is the best natural remedies for male unfruitful treatment. Watermelon to cure Erectile DysfunctionWatermelon is a rich source of iron, vitamin C, and vitamin A.
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Can Stock Photo has the royalty free illustration, line art drawing, EPS vector graphic, or stock clipart icon that you need. In order to post comments, please make sure JavaScript and Cookies are enabled, and reload the page. The majority of cases have an organic etiology, most commonly vascular disease that decreases blood flow into the penis.
The corpora cavernosa are composed of a mesh-work of interconnected cavernosal spaces lined by vascular endothelium.
Normal erectile function requires a complex set of dynamic neural and vascular interactions. Most causes of erectile dysfunction were once considered to be psychogenic, but current evidence suggests that up to 80 percent of cases have an organic cause.1 Organic causes are subdivided into vasculogenic, neurogenic and hormonal etiologies. Aging is an independent risk factor, and although the incidence of erectile dysfunction increases steadily with age, it is not an inevitable consequence of aging. Information from references 7 and 8.Excessive and long-term use of a number of substances may also cause erectile dysfunction.
In all instances, medical conditions having an impact on erectile function should be corrected or their progression controlled. It is the inability to conceive or produce offspring, despite having regular unprotected sex. On the other hand, he explained that a man may have no trouble raising the rifle, but he is shooting blank, that he called infertility. Conversely, a woman’s fertility can be measured through various means, like the regularity of the menstrual cycle, among other things.
The number of men with erectile dysfunction is low for those under the age of 40, but it increases with age. Diabetes, high blood pressure, cholesterol, clots, and atherosclerosis (hardening of the arteries) can all interfere with this process.
Depression is a physical disorder as well as a psychiatric one, and it can have physical effects. If this happens often, the anticipation of sex can trigger nervous reactions that prevent erection, setting up a vicious cycle.
In troubled relationships, men may be unable to achieve erection with their partner but have no problem away from home. It is most common in people who suffered child abuse and those who have been brought up in strict religious surroundings.
This is often a sign of a psychological problem that may or may not have to do with that particular relationship.
Common chronic diseases such as obesity, diabetes and high blood pressure are often associated with ED and therefore, a healthy lifestyle is the best way to avoid ED. However, for older men, consulting a doctor can be an important step towards uncovering and treating underlying physical causes. Depending on the state of your health, taking pills might not always prove the most effective solution.
The damage caused to the blood vessels by abnormal blood sugar levels can, in the long run, result in ED. You should note that, while recreational drugs and low levels of testosterone are not directly responsible for erectile dysfunction, they may well affect a man’s sexual drive. Look for diversity and new experiences with your partner so that you can focus on present pleasure again rather than reviewing past failures.
Talking about your feelings and anxieties, although this may sound difficult, is crucial: your partner needs to understand how you feel and what you need. There is nothing to lose by talking about it; so it’s often beneficial to be pro-active by raising the issue and then working through it together. Similar to the pelvic floor exercises recommended to women after childbirth, these exercises involve clenching the muscles you use to control urination. The study conducted by a team of scientists in Bristol involved participants who had been suffering from erectile dysfunction for at least six months. The exercises train the muscles surrounding your penis, which improves the blood flow and improves your ability to gain and keep an erection.
A series of prolonged bad habits can damage the tissue responsible for erections over the years. All you need to do is to maintain a regular activity, even if it’s just 30 minutes a day, to improve your blood pressure, blood flow, cardio and overall health. Long-term and long hours of outdoors cycling can damage the nerves in your pelvic area which control erections. Common causes of infertility in women include lack of regular ovulation (the monthly release of an egg), blockage of the fallopian tubes, age and endometriosis. The cost for fertility treatments varies, with IVF treatments costing between N800,000 and N1,000,000. However, if you have been unable to conceive after one year of trying, it’s time to consult your doctor or medical provider. Wenn Sie diese Webseite weiter besuchen, erklaren Sie sich mit der Verwendung von Cookies auf dieser Seite einverstanden. It is the wrost moment is men's life when you are suffering from Erectile Dysfunction. Our designers and illustrators provide royalty free stock images, clip art, clipart graphics, and pictures for as little as 1 dollar. Regardless of the primary cause, erectile dysfunction can have a negative impact on self-esteem, quality of life and interpersonal relationships.
An estimated 10 to 20 million American men have some degree of erectile dysfunction.1,2Increased understanding of the male erectile process and the development of several agents to improve erectile function have generated great public interest among men and their sexual partners. Penile erection can be elicited by at least two distinct mechanisms, central psychogenic and reflexogenic,3 which interact during normal sexual activity. Vasculogenic etiologies represent the largest group, with arterial or inflow disorders being the most common. Several studies have indicated that patients and providers are reluctant to address sexual topics. It occurs when a poor reproductive system impairs the ability of the body to perform necessary functions of reproduction. Aversion can also exist in homosexual or bisexual people who attempt to lead a heterosexual life against their basic inclinations.
The danger with this method is that too high a dose can cause priapism, an erection that won’t go away. Common non-medication ways of treating erectile dysfunction include vacuum devices and penile implants. The latest (and most expensive) device consists of inflatable rods activated by a tiny pump and switch in the scrotum.
It’s simply important to be open with your feelings, and it may be beneficial to express and discuss how you feel.

You may well find yourself addressing broader issues in your life, which can also improve your mood and relationship.
40 per cent of participants reported that they regained their erectile function within 3 to 6 months. Even walking is a good option, although it’s better to practice a sport or do some hard exercise to push yourself!
Indoors cycling is much less hazardous as the seat is generally wider and less prone to damaging your body. Citrulline is transformed into arginine, anamino acid that relaxes blood vessels and increases the blood flow to the penis without sideeffects. Lycopene,however, is fat-soluble, meaning that it wants certain fats in the blood for better absorption bythe body.
The initial step in evaluation is a detailed medical and social history, including a review of medication use. These advances are expanding the treatment options available to primary care physicians in the management of erectile dysfunction. 3 Blood flow is provided primarily by the cavernosal branches of the internal pudendal artery. Psychogenic erections are initiated centrally in response to auditory, visual, olfactory or imaginary stimuli. Consideration should be given to discontinuation of any medication suspected of contributing to the erectile problem or, if required, switching to an alternative medication less likely to interfere with erectile function.
Men without physical disorders usually have erections during REM (rapid eye movement) sleep.
Inhibiting the enzyme makes more cGMP available, which leads to relaxation of smooth muscles in the penis, allowing more blood to enter and helping to produce an erection. A further 35 per cent reported, that they noticed a significant improvement to their condition.
Not only does watermelon help to get strong your erections, but it is also a way toincrease your libido naturally.Watermelon can be a powerful natural remedy for erectile dysfunction because it containsplenty phyto-nutrients, which are necessary for the overall well-being and health of the humanbody.
Each branch divides into numerous terminal branches that open directly into the cavernous spaces. Reflexogenic erections result from stimulation of sensory receptors on the penis which, through spinal interactions, cause somatic and parasympathetic efferent actions.3On arousal, parasympathetic activity triggers a series of events starting with the release of nitric oxide and ending with increased levels of the intracellular mediator cyclic guanosine monophosphate (cGMP).
Regardless of the primary etiology, a psychologic component frequently coexists.5The severity of erectile dysfunction is often described as mild, moderate or complete, although these terms have not been precisely defined. These medications are taken before sex and will cause an erection only when the man is sexually stimulated. The penis itself remains flaccid, however, so the diameter and length are usually less than a natural erection, and hardness is lacking, although it’s sufficient for intercourse.
Increases in cGMP cause penile vascular and trabecular smooth muscle relaxation.3,4 Blood flow into the corpora cavernosa increases dramatically.
First, provide information about conditions that are commonly associated with sexual dysfunction, then follow with a question about the individual's concerns.
The time the dose should be taken and how long the effects last depend on the medication used.
Some doctors may prescribe a combination of alprostadil with additional ingredients such as phentolamine to help the medication work more effectively. Laboratory tests are useful to screen for common etiologic factors and, when indicated, to identify hypogonadal syndromes. The rapid filling of the cavernosal spaces compresses venules resulting in decreased venous outflow, a process often referred to as the corporeal veno-occlusive mechanism. The male sexual response cycle consists of four major phases: (1) desire, (2) arousal (erectile ability), (3) orgasm and (4) relaxation. Before the initiation of testosterone therapy, the patient should be evaluated for the possibility of an occult prostate malignancy, which may be stimulated by supplemental testosterone.
This mixture is prepared by the pharmacy according to the directions of the prescribing doctor. Appropriate evaluation of erectile dysfunction leads to accurate advice, management and referral of patients with erectile dysfunction.
This information may help assess the patient's sexual problems as well as identify high-risk behaviors and other concerns affecting the patient's overall health.Once a concern with the patient's sexual function is identified, the next step is to differentiate erectile dysfunction from other sexual problems, such as loss of libido or ejaculatory problems. The physician should use appropriate vocabulary, avoiding slang or excessively technical terminology.
Patients with suspected vasculogenic or neurogenic causes can be considered for a trial of therapy in the primary care setting. Having the patient define the terms in his own words will help the physician and patient communicate more effectively.13 The International Index of Erectile Function (IIEF)14 is a valuable tool for defining the area of sexual dysfunction (Figure 4).
Patients with a suspected psychogenic etiology should be considered for sexual counseling or psychiatric referral as well.Patients requesting a more comprehensive evaluation or those not responding to initial therapy should be referred for further evaluation and treatment. The IIEF is designed to be a self-administered measure of erectile dysfunction, but it also assesses a patient's function in other phases of sexual function. As such, it should be viewed as an adjunct to, rather than a detailed sexual history.Reprinted with permission from Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile dysfunction (IIEF): a multidimensional scale for assessment of erectile dysfunction. Because erectile dysfunction is frequently caused by medication, a review of the patient's drug therapy is essential and should include prescription and over-the-counter medications. Life stressors such as change in social status, divorce, death of spouse, loss of job, or family problems may have an effect on erectile function. Difficulty in erectile function affects the patient and his partner, so it is important to assess whether the erectile problem is troubling one partner more than the other, and if so, who and why.
Finally, the physician should determine the patient's and the partner's level of understanding of sexual anatomy and function, as well as what expectations each has with regard to treatment outcome. Men with erectile dysfunction and their partners often lack a full understanding of sexual processes or have unrealistic expectations regarding sexual performance and satisfaction.5PHYSICAL EXAMINATIONThe physical examination should assess the patient's overall health. Particular attention should be given to the cardiovascular, neurologic and genitourinary systems, as these systems are directly involved with erectile function.
The cardiovascular examination should include assessment of vital signs (especially blood pressure and pulse) and signs of hypertensive or ischemic heart disease. Abdominal or femoral artery bruits and asymmetric or absent lower extremity pulses are indicative of vascular disease.
Skin and hair pattern evidence of vascular insufficiency should be noted.The patient's demeanor, dress, speech and overall appearance should be noted for signs suggestive of anxiety or depressive disorders. The superficial anal reflex, indicative of normal somatic function of sacral cord levels S2–4, is assessed by touching the perianal skin and noting contraction of the external anal sphincter muscles. It is performed by placing a finger in the rectum and noting contraction of the anal sphincter and bulbocavernosus muscle when the glans penis is squeezed. External anal sphincter tone can be assessed during this maneuver as well.The genital evaluation should assess for local abnormalities, such as hypospadias or phimosis, and evidence of hypogonadism.
The penis should be palpated to determine the presence of local abnormalities such as fibrous plaques of the fascial covering (Peyronie's disease).
The prostate gland should be assessed for size, consistency and symmetry.ADDITIONAL STUDIESIf not previously done, some basic studies should be considered to identify unrecognized systemic conditions that may predispose to erectile dysfunction.
The specific testosterone assay to be obtained is debated.15,17 Testosterone is predominately protein-bound and is influenced by a variety of clinical conditions. An age-adjusted, first-morning, free testosterone level is probably the most accurate measure.17 If the initial testosterone level is low, follow-up studies should include luteinizing hormone and follicle-stimulating hormone levels to differentiate testicular from hypothalamic-pituitary dysfunction.
These tests are not usually performed in the family physician's office and are not necessary before the initiation of therapy for most patients. Many of these tests are subject to significant variation in interpretations and are most appropriate for use in refractory cases.

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