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The term “ Erectile dysfunction “ strikes fear in the heart of almost every man who hears it. It is also a condition you think (and hope ) only happens to someone else but think again. India is the impotence capital of the world ! According to global statistics 10 % of men below the age of 40 and 52 % of men beyond the age of forty may suffer from this condition. Given the population statistics for India, it undoubtedly follows that we lead the world in this dubious honour. To make matters worse, we Indians are more genetically disposed to suffer from three conditions which have been proven to lead to ED- namely 1. Heart Disease 2. Hypertension or High Blood Pressure and Diabetes which is the worst offender of all when it comes to impotence. But let us first understand what we are talking about.
What is Erectile Dysfunction ?
Erectile dysfunction ( also known as ED)describes a man's inability to achieve and maintain an erection of his penis sufficient for mutually satisfactory intercourse with his partner.. Having erection trouble from time to time isn't necessarily a cause for concern. But if erectile dysfunction is an ongoing problem, it may cause stress, cause relationship problems or affect your self-confidence. It is important therefore to examine what could be causing this condition in you.
What causes Erectile Dysfunction?
The causes for ED are divided into two types : Psychological and Physical
Psychological Factors : Psychological and emotional problems can play an important role in causing Erectile Dysfunction. To add to the problem, the erection problems themselves can produce emotional and psychological triggers which could further worsen the problem. Performance Anxiety therefore needs to be addressed or it could set off a continuous cycle of anxiety and stress leading to erectile dysfunction. The main psychological factors therefore are
• Stress
• Anxiety
• Depression
• Relationship problems
• Nervousness regarding the sexual act
Physical Factors : Physical causes for erectile dysfunction are much more common than psychological causes. In determining a physical cause, the doctor will first rule out certain conditions, which are associated with erectile dysfunction. Some of the more common causes are listed below. This is not a comprehensive list and there exist many other physical health conditions which may result in erectile dysfunction
• Heart disease
• Atherosclerosis)
• High cholesterol
• High blood pressure
• Diabetes
• Cirrhosis of the liver
• Metabolic syndrome, a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
• Parkinson's disease
• Multiple sclerosis
• Low testosterone
• Kidney Failure
• Peyronie's disease, development of scar tissue inside the penis
Apart from physical and psychological factors, there are a variety of risk factors which may lead to erectile dysfunction. Some of these are
• Tobacco Usage : Smokers especially heavy and continuously using ones, are more prone to erective dysfunction than non smokers
• Obesity : Being overweight has been linked to erectile dysfunction
• Medical treatments such as prostate surgery or radiation treatment for cancer
• Nerve injuries in the area responsible for erections
• Drug Usage : Erectile dysfunction is the inevitable result of long term drug abuse
• Excessive and continuous alcohol usage
• Prolonged bicycling which may compress nerves and affect blood flow to the penis, can lead to temporary erectile dysfunction
Another thing to remember when it comes to ED is the medicinal causes which can trigger erectile dysfunction. Here is a list of medication that have been linked to erectile dysfunction
• Diuretics – medicines that increase the production of urine and are often used to treat high blood pressure (hypertension), heart failure and kidney disease
• Antihypertensive medicines, such as beta-blockers, that are used to treat high blood pressure
• Fibrates – medicines that are used to lower cholesterol levels
• antipsychotics – medicines that are used to treat some mental health conditions, such as schizophrenia
• Antidepressants – medicines that are used to treat depression and some types of pain
• Corticosteroids – a medication that contains steroids, which are a type of hormone
• H2-antagonists – medicines that are used to treat stomach ulcers
• Anticonvulsants – medicines that are used to treat epilepsy
• Antihistamines – medicines that are used to treat allergic health conditions, such as hay fever
• Anti-androgens – a medication that suppresses androgens (male sex hormones)
• Cytotoxics – medication used in chemotherapy to prevent cancer cells from dividing and growing for
However, let all this information not alarm you. Medical science has made great advances in this field and very effective treatments are now available for this condition. In our next column, we shall talk about how you can assess yourself and seek treatments if necessary. Till then stay healthy, stay safe.
(The writer is a noted andrologist with Manipal Hospital. He is also president-elect, South Asian Society for Sexual Medicine (SASSM). Views expressed are personal)