The Treatment Of Erectile Dysfunction

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Erectile Dysfunction (ED)

The sad fact is that a very large number of men in America have erectile dysfunction to some degree. And even though erectile dysfunction is a  problem for men of all ages, it does become more common as a man's age increases.

A recent study found that 52% of men aged between 40 years of age and 70 years of age have had some degree of erectile dysfunction, a finding that will not make you feel any better, but at least you'll know that you are not alone....

Nothing generates as much shame and embarrassment – and even downright fear – as a man's inability to get an erection. It's possible that only the loss of his job can make a man feel more impotent & powerless than he does after the loss of his erection.

And of course impotence is exactly what erectile dysfunction signifies to most men: an absence of power, masculine strength, and masculine vitality.

Since most of us regard our self-esteem as entirely contingent upon our ability to get an erection whenever we are in a sexual situation, it is clear that the loss of erectile function can have a massive impact on men's self-esteem.

Women do not understand the difficulties that erectile dysfunction causes for a man.

But then again women have no similar experiences to compare with the failure to get or maintain an erection. It is possible for a woman to have sexual intercourse  – or indeed any other form of sexual activity – without being lubricated or indeed even interested in what she's doing. And whether or not she has an orgasm is irrelevant to whether or not she can continue with a sexual act.

For a man, the absence of a stiff penis caused by erectile dysfunction makes him feel nothing can help him have a  successful sexual experience.

Not only that, but if his self-esteem depends on his ability to become erect, then his failure in this matter will be only too obvious, hanging in full view of both him and his partner.

So no matter how sympathetic and supportive his partner may be, a man can actually become so distraught and shamed by the loss of his erection that he can't accept consolation from his partner....and, needless to say, this generates further bad feeling on both sides, and it's inevitable that if it goes on for any length of time, erectile dysfunction will make a woman feel just as powerless as it makes her man feel.

 In fact, a woman will often blame herself, perhaps taking the view that she's neither attractive enough nor skilful enough to sexually arouse her partner.

And because women's self-esteem is often dependent on being sexually attractive to their man, it's entirely understandable why two sexual partners can sometimes end up turning away from one another, blaming both themselves and each other for the man's erectile dysfunction and its consequences.

And this, of course, is the antithesis of clear thinking, which is absolutely necessary to resolve the situation: because there is almost certainly a solution for every man with erectile dysfunction - if he can find it.

For some men it could be that simply getting and maintaining an erection at the beginning of a new relationship is the problem. After a man becomes more comfortable with his new sexual partner, his erectile dysfunction may fade and his performance in bed may become more reliable.

Such transient difficulties can be seen merely as part of an active sex life.

There are of course more persistent and chronic erectile difficulties – some men have difficulty getting an erection, and others have difficulty maintaining an erection.

For some men, the problem is that their erectile dysfunction manifests as a semi-hard penis. And of course there are men who are completely impotent.

To resolve these difficulties there are basically three strategies: the first is medical intervention, which usually means pharmaceutical remedies such as Viagra. There may of course be other ancillary treatments available for erectile dysfunction, treatments directed at the cause of the problem, such as high cholesterol levels.

The second approach to erectile dysfunction is sex therapy, which involves exercises of the kind presented in the self-help treatment program for ED on this website. And the third, you may not be surprised to learn, is a combination of these two approaches.

The point is this: before you can decide which approach is necessarily the best one for your erectile dysfunction, you need to know what's actually causing it.

Some impotence is primarily physical or drug-related in origin, whilst other erectile dysfunction is primarily psychological. The fact of the matter is that the majority of cases of ED have both physical and emotional components, for the reasons that we described earlier.

That is to say, when a man loses erection he also tends to become extremely emotional about it, which may then feedback into a vicious circle of self-doubt, anxiety, and erectile dysfunction.

So the first question you need to consider if you're experiencing erectile dysfunction is whether or not you are putting some substance into your body which may be affecting your ability to rise to the occasion. There are many prescription drugs which can cause erectile difficulties, a list of which is available here.

If you're taking any of these, or anything like them, or even if you're not taking these but you are taking some prescribed medication and you have suffered a loss of your erectile function, then you should talk to your doctor. Remember too that alcohol can be a potent chemical in the body, or rather it can be a chemical that causes men to become impotent.

Smoking, and consumption of fats, both of which contribute to clogging and hardening of the arteries, can be another contributory factor. In fact men who smoke have a lot more problems with erectile dysfunction than men who do not smoke.

Now, if you usually have sexual desire, that is to say if you have an appetite for sex, either with yourself or with somebody else, then it is a reasonable assumption that your testosterone levels lie within normal limits and you don't need to get it checked out.

However, if your desire is actually rather low – and that means not just your level of sexual arousal, but your sexual desire - in the sense that you don't notice how attractive a woman is, or you don't fantasize about sex, and you certainly don't want to masturbate, then you need to have a testosterone check.

When male  testosterone levels drop below normal not only does sexual desire significantly decrease, but it becomes extremely difficult for the penis to function and erectile dysfunction is a common result.

However, you need to find a competent doctor who's got a lot of experience in this field, because the opinion of what is a normal testosterone level varies from doctor to doctor and laboratory to laboratory.

Hormone replacement or supplementation is actually a very effective way of restoring a man to full sexual health, particularly in midlife, although for the complete reversal of erectile dysfunction, it may also be necessary for a man to use Viagra.

One of the complications here is that depression can be both a cause and effect of erectile dysfunction; not only that, but depression can also be caused by testosterone deficiency, so the whole complex can become a vicious and self-perpetuating cycle. It's well worth researching the male andropause on the internet (andropause is a name for the loss of testosterone in mid life similar in its effects to the female menopause).

It will also probably be clear to you by now that if you have erectile dysfunction only with one particular sexual partner, or only in certain circumstances, then your erectile difficulties are probably not primarily physical in origin, but are largely dependent on relationship issues and feelings: how you feel about one or more of your sexual partners, or how stressed you are feeling....for example. In these circumstances lifestyle changes will be the most effective approach to dealing with erectile dysfunction.

However, if you never get an erection - either during sleep, when you awaken, or during any kind of sexual stimulation - it's highly likely that your erectile dysfunction has some kind of physical cause, or is the side-effect of some medication: the best strategy in such circumstances is to start by seeing a doctor.

Should you happen to be a man who can get erections but who can't maintain them, the problem behind your erectile dysfunction could be either psychological or physical. It's possible that you may have some kind of physical issue that is causing difficulties with blood flow to the penis, for example, or it may be that it some psychological factors have come into play, such as the fact that you regard sexual intercourse as a demonstration of relationship commitment to a sexual partner, and you're not ready to make this step.

Overall, I think the message that I would like to convey more than anything else in this article is that it's important to be clever about diagnosing the cause of your erectile dysfunction.

And the problem is that a lot of doctors, and indeed many therapists, don't actually have enough experience or skill in sexual and relationship issues to decide whether the cause of erectile dysfunction is physical or emotional.

If you see a doctor, there are certain diagnostic tests that you should undergo so that the whole picture emerges. These include questions about the exact nature of the erectile issues you face, including when it started, how it has evolved, your general health, your medications, and details of  injury and illness or surgery, caused, for example, by pelvic trauma or prostate surgery, and anything else that may be relevant.

Physical tests to determine the state of your arteries and blood pressure may be necessary, too; as may a rectal exam to check your prostate gland. There are also tests to determine whether the nerves and blood vessels supplying the penis are functioning normally. Other tests include the testosterone level check mentioned earlier, and attaching a device to your penis to record whether or not you get erections during the night. If you do, and not at any other time, it is a very clear indication that your erectile difficulties are psychological in origin..... as this study revealed:

Eighty-seven patients were allocated into three groups as psychogenic, arterial and venous erectile dysfunction after investigations. Nocturnal penile tumescence recording parameters between psychogenic and vascular erectile dysfunction and arterial and veno-occlusive dysfunction were compared. Mann–Whitney U-test, Pearson's χ2 test and correlation coefficient tests were used for statistical analysis.

Depending on intracavernous injection, penile Doppler ultrasonography and cavernosometry tests, 37 patients (43%) had psychogenic impotence while 50 (57%) had organic pathologies. Of the 50 patients diagnosed with vascular impotence, 29 (48%) had arterial failure and 21 (42%) had veno-occlusive dysfunction. Nocturnal penile tumescence recording revealed psychogenic erectile dysfunction in 34 patients (39%) and vascular erectile dysfunction in 53 patients (61%). Nocturnal penile tumescence recording has been regarded as the gold standard and, in our series, it showed 90.6% sensitivity and 88.2% specificity in differentiating the cause of erectile dysfunction.

And so the question is: what will happen if you or your doctor decide upon some kind of treatment for erectile dysfunction?

Well, to some extent that's up to you – and you must bear in mind that while treatment for ED can most likely restore your erection, the problem is that many men let their expectations of erectile dysfunction treatment get the better of them: because, no matter what you use to recover your stiffness, be it Viagra, injections, vacuum devices, sex therapy, or sensate focus and masturbation exercises, it will actually only so that...i.e., change the stiffness of your penis, not your personality, your lovemaking technique, your skill at relationships, or your sexual behavior.


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