The scientific definition of erectile dysfunction sounds like this: "the inability to achieve / maintain an erection necessary to fully satisfy sexual needs." You can talk about such a disorder if a man has problems in the genital area for three months. ED is a relatively new term. Offer himwhether American health professionals instead of the familiar word "impotence". The fact is that the old term sounds too categorical, burdens the perception of pathology and is not associated with the possibility of a successful cure.
WHO statistics are disappointing - about 10% of men over the age of 20 have erection problems. And among the representatives of the older age category (over 60 years old), every third is not able to carry out sexual intercourse. In addition, there is a negative trend in this problem. Now, according to rough estimates, in the world 150 million men have ED. Doctors predict that in a quarter of a century this number may double.
There are no data on the epidemiology of ED in the Russian Federation. But given the prevalence of bad habits, the high level of injuries, the practice of taking medications without a medical consultation, it is easy to assume that the problem of erectile disorders in our country is very urgent.
According to medical statistics, only one in five men with ED see a specialist. And only 37% of those who applied undergo the necessary course of treatment. Many people mistakenly believe that ED is not a medical pathology, but simply manifestations of fatigue and nervous strain. That is, the pathology is very common, but men are in no hurry to seek help from specialists. They prefer to ignore the problem or engage in ineffective (and sometimes dangerous) self-medication.
According to recent studies, an erection occurs in the following way. Sexual stimulation activates the parasympathetic nervous system. Neurotransmitters (in this case, nitric oxide) are released from the vascular tissue of the corpora cavernosa, due to which cyclic guanosine monophosphate (cGMP) accumulates in the cavernous tissues, which reduces the concentration of intracellular calcium, which leads to relaxation of the walls of the vessels and cavernous bodies.
This gives grounds to identify the main causes of erectile dysfunction: a significant lack of cGMP, a decreased response of vascular tissues to cGMP, insufficient compression of the penile veins due to overgrown connective tissues. In severe cases, ED is caused by a combination of all of these factors.
Psychogenic causes Organic causes Depression Stress Fear Anxiety Vascular or vasculogenic Neurogenic (diseases of the nervous system and spine) Hormonal (diabetes mellitus, andropause or "menopause" in men) Diseases of the penis Medication Mixed.
Male sexual problems have traditionally been associated primarily with the mental component. It was believed that stress and nervous tension directly affect the quality of sex life. Today another point of view has appeared.
Doctors concluded that the vast majority of ED cases (up to 80%) are caused by organic causes. That is, ED is a complication of any physical illness. It has been observed that erection problems are related to lifestyle. Factors such as physical activity and bad habits play an important role here.
Naturally, the age of a man has a certain influence on the quality of his sexual life. In an elderly person, testosterone levels drop, the blood flow rate decreases, the nervous system is no longer so sensitive, and the vessels lose elasticity. But these natural age-related processes in themselves cannot underlie erectile dysphounces.
The main cause of sexual dysfunction is a more serious physical illness. If a man does not suffer from chronic ailments, he can retain the ability to have sexual intercourse until very old age.
Multiple medical studies confirm a direct link between ED and atherosclerosis, diabetes mellitus (DM), and arterial hypertension (AH). The presence of one of these pathologies increases the risk of ED by several times. Some medical scientists even believe that an erectile disorder that has arisen may indicate the presence of one of these chronic ailments in an initial latent form.
The vessels of a person suffering from atherosclerosis become less elastic, their lumen decreases.