Erectile dysfunction (ED) or impotence is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual activity in humans.
Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility; this is somewhat less frequent but can often be helped. Besides treating the underlying causes such as potassium deficiency or arsenic contamination of drinking water, the first line treatment of erectile dysfunction consists of a trial of PDE5 inhibitor drugs (the first of which was sildenafil or Viagra). The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina; it is now mostly replaced by more precise terms, such as erectile dysfunction (ED).
Erectile dysfunction is characterized by the regular or repeated inability to obtain or maintain an erection. Surgical intervention for a number of conditions may remove anatomical structures necessary to erection, damage nerves, or impair blood supply. ED can also be associated with bicycling due to both neurological and vascular problems due to compression. Penile erection is managed by two mechanisms: the reflex erection, which is achieved by directly touching the penile shaft, and the psychogenic erection, which is achieved by erotic or emotional stimuli.
Exercise, particularly aerobic exercise during midlife is effective for preventing ED; exercise as a treatment is under investigation. During the late 16th and 17th centuries in France, male impotence was considered a crime, as well as legal grounds for a divorce. Modern drug therapy for ED made a significant advance in 1983, when British physiologist Giles Brindley dropped his trousers and demonstrated to a shocked Urodynamics Society audience his papaverine-induced erection. Gene therapy is being developed that would allow for weeks or months long effect, supporting erections. A study done at the Medical College of Georgia has found that venom from the Brazilian wandering spider contains a toxin, called Tx2-6, causes erections. Flexibility of the penis is greatly reduced due to this disease, which can surface overnight or develop gradually. A penile erection is the hydraulic effect of blood entering and being retained in sponge-like bodies within the penis. In some cases, treatment can involve prostaglandin tablets in the urethra, injections into the penis, a penile prosthesis, a penis pump or vascular reconstructive surgery.
The study of erectile dysfunction within medicine is covered by andrology, a sub-field within urology.


While these two causes have not been proven they are likely suspects as they cause issues with both the blood flow and nervous systems. Erectile dysfunction is a common complication of treatments for prostate cancer, including prostatectomy and destruction of the prostate by external beam radiation, although the prostate gland itself is not necessary to achieve erection. The former uses the peripheral nerves and the lower parts of the spinal cord, whereas the latter uses the limbic system of the brain.
Some blood tests are generally done to exclude underlying disease, such as hypogonadism and prolactinoma. Magnetic resonance angiography uses magnetic fields and radio waves to provide detailed images of the blood vessels.
One of the following drugs is injected into the penis: papaverine, phentolamine, and prostaglandin E1. The practice, which involved inspection of the complainants by court experts, was declared obscene in 1677.
The drug Brindley injected into his penis was a non-specific vasodilator, an alpha-blocking agent, and the mechanism of action was clearly corporal smooth muscle relaxation.
This gene therapy involves injection of a transfer gene, calcium-sensitive potassium channel (hMaxi-K), into the penis. Scientists believe that combining this toxin with existing medication such as Viagra may lead to an effective treatment for erectile dysfunction. The process is most often initiated as a result of sexual arousal, when signals are transmitted from the brain to nerves in the penis.
Erectile dysfunction can have severe psychological consequences as it can be tied to relationship difficulties and masculine self-image. Research indicates that erectile dysfunction is common, and it is suggested that approximately 40% of males suffer from erectile dysfunction or impotence, at least occasionally. As far as inguinal hernia surgery is concerned, in most cases, and in the absence of postoperative complications, the operative repair can lead to a recovery of the sexual life of patients with preoperative sexual dysfunction, while, in most cases, it does not affect patients with a preoperative normal sexual life. Impotence is also related to generally poor physical health, poor dietary habits, obesity, and most specifically cardiovascular disease such as coronary artery disease and peripheral vascular disease.
Doctors may inject a "contrast agent" into the patient's bloodstream that causes vascular tissues to stand out against other tissues. Many products are advertised as "herbal viagra" or "natural" sexual enhancement products, but no clinical trials or scientific studies support the effectiveness of these products for the treatment of erectile dysfunction, and synthetic chemical compounds similar to sildenafil have been found as adulterants in many of these products.


The effect that Brindley discovered established the fundamentals for the later development of specific, safe, and orally effective drug therapies. In order to control weight, the person adopts extremes measures such as exercising for long periods of time, self-inducing to vomit and frequent use of laxatives and water pills. The most important organic causes are cardiovascular disease and diabetes, neurological problems (for example, trauma from prostatectomy surgery), hormonal insufficiencies (hypogonadism) and drug side effects. Stimulation of the penile shaft by the nervous system leads to the secretion of nitric oxide (NO), which causes the relaxation of smooth muscles of corpora cavernosa (the main erectile tissue of penis), and subsequently penile erection. Therefore, a thorough physical examination is helpful, in particular the simple search for a previously undetected groin hernia since it can affect sexual functions in men and is easily curable. The contrast agent provides for enhanced information regarding blood supply and vascular anomalies. The United States Food and Drug Administration has warned consumers that any sexual enhancement product that claims to work as well as prescription products is likely to contain such a contaminant. His radio programs recommended expensive goat gland implants and "mercurochrome" injections as the path to restored male virility, including operations by surgeon Serge Voronoff.
Additionally, adequate levels of testosterone (produced by the testes) and an intact pituitary gland are required for the development of a healthy erectile system. As can be understood from the mechanisms of a normal erection, impotence may develop due to hormonal deficiency, disorders of the neural system, lack of adequate penile blood supply or psychological problems.
This enhanced circulation in the brain causes an improvement in the short and long term memory, increased time in reacting and improved mental clarity. Restriction of blood flow can arise from impaired endothelial function due to the usual causes associated with coronary artery disease, but can also be caused by prolonged exposure to bright light. Apart from aiding to the digestion process, papaya enzymes help treat enemas, inflammation and wounds.



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