Erectile dysfunction is linked to a large number of causes, few of which are directly related to the penis. These causes are related to psychological problems, lifestyle and other diseases. They can occur in specific age groups or at any age. Understand:
The anxiety is a normal physiological reaction at times when you need to play something. However, it can occur at inopportune moments and this is a psychological disorder.
Regarding the erection, anxiety impairs this function due to the release of adrenaline in the bloodstream.
This hormone causes blood vessels to narrow and, therefore, the blood has difficulty reaching the penis.
Another psychological disorder related to erection is depression, characterized by intense sadness and loss of interest in pleasurable activities.
It is known that, in many cases, depression decreases libido and, consequently, erection is difficult.
Stressful situations release several hormones into the bloodstream that hinder circulation to the penis.
Since erection depends on the flow of blood to the penis, any condition that may hinder this process may be the cause of erectile dysfunction.
Some of these problems are hardening of the arteries (arteriosclerosis) that usually happens with age, stroke, hypertension, heart problems and high cholesterol.
Spinal cord injuries, multiple sclerosis and nerve degeneration are all conditions that can be linked to sexual impotence.
This is because, not infrequently, these conditions cut the path of the nerves, preventing the arrival of nerve signals to the penis, or even damage the penile nerves themselves.
Hormonal imbalances, especially the lack of testosterone, greatly influence the possibility of having a quality erection.
Priapism is a condition in which an erection not caused by sexual desire appears, with an unusually long duration: 4 hours or more.
This usually happens because of an abnormal entry or impediment of the blood flow in the penis, generating a prolonged erection.
The problem is that this condition damages the tissues of the penis, which can subsequently result in erectile dysfunction.
Not infrequently, diabetes causes damage to the nerves or blood vessels that draw blood to the penis, preventing an erection.
There are several drugs that have sexual impotence as a side effect. Antihypertensives, antidepressants and diuretics are just a few examples.
Surgeries and radiotherapy
Some surgical procedures can be the cause of the dysfunction, especially those performed in the abdomen, such as surgery of the large intestine, rectum, among others.
Radiotherapy treatment in the pelvic area can also be blamed.
Prostate surgeries, in particular, are the most likely to trigger the disorder.
This is because these procedures can damage nerves and blood vessels related to the erection process.
Most common after middle age, Peyronie’s disease is characterized by the formation of a plaque of hard tissue along the inner tubes of the penis (corpora cavernosa).
This plate prevents the organ from becoming flexible and makes erection more difficult, as well as causing it to “bend”.
It is very rare that the penis is the target of trauma, but it does.
When erect, the cavernous bodies become so hard that they can be broken, just like a bone.
So don’t be surprised if you hear someone saying that they “broke their penis”: this is, in a way, possible.
However, this type of trauma occurs only when the penis is erect.
When soft, the corpora cavernosa are malleable and withstand several types of impacts.
Therefore, the most common situation in which these traumas occur is precisely sexual intercourse.
Alcohol is a central nervous system depressant drug that, when consumed in excess, causes relaxation of the muscles.
This relaxation occurs at the level of the penis as well, which is unable to maintain an erection because the muscles are unable to remain tensioned.
Smoking is one of the major risk factors for the emergence of sexual impotence, being one of the biggest causes of the problem in the younger population.
This is because tobacco brings changes in the vascular system, which can prevent the blood from reaching the penis.
In general, the risk factors associated with erectile dysfunction are the same as those for cardiovascular diseases.
This even makes sense, if we think that the erection is the intense flow of blood in the penis.
Therefore, some factors are:
Although there is no indication that sexual impotence is related to aging, cardiovascular problems are more common after 40 years of age.
Very significant risk factor for cardiovascular diseases, obesity can also make erection difficult.
It is estimated that half of men with diabetes also have some degree of erectile dysfunction.
Hypertension (high blood pressure levels) is linked to cases of severe erectile dysfunction.
The possibility of cholesterol “clogging” the arteries ( atherosclerosis ) can be a risk factor for sexual impotence.
The presence of any mental disorder can greatly increase the stress levels of the man, who may end up suffering from erectile dysfunction.
Psychological erectile dysfunction
Few people know, but one of the most common causes of erectile dysfunction is psychological, and sometimes it is not even related to mental disorders in itself!
Men grow up with their sexuality exalted, as if good sexual performance is synonymous with value.
It is not uncommon to see men who are “failed” because they do not find a partner or because they are still virgins.
Thus, the psychological pressure related to male sexuality is very great and, many times, this ends up hindering sexual performance, generating anxiety and fear crises.
In addition, men who have difficulties in finding partners may suffer from low self-esteem and depression due to the importance that society attaches to this aspect.
Nowadays, it is not uncommon to hear about psychosomatic illnesses, that is, illnesses that start in the mind but manifest in the body.
Often, erectile dysfunction is nothing less than a disease of this type.
Some psychologists believe that erectile dysfunction may be related to childhood traumas related to parental rejection and disapproval, especially at the stage when the boy begins to masturbate.
Many parents do not understand that child masturbation is a natural process of discovering the body and end up disapproving of the boy’s behavior.
This rejection generates feelings of guilt that prevent the boy from acquiring pleasure through the manipulation of the genitals, causing the psychic energy not discharged in the physiological pleasure to be discharged in the disease.
Thus, we can see how the psychological influences a lot on the ability to acquire and maintain a quality erection.
Therefore, do not be alarmed if the doctor recommends a treatment based only on psychotherapy and psychotropic medications.
Erectile dysfunction in young people
There is a certain stigma that treats sexual impotence as an age thing, but that is not true.
Because it is often caused by chronic diseases that appear from the age of 40, many people believe that it is age that causes the problem.
However, young people with the same conditions may also experience the disorder.
It is worth remembering that the causes of erectile dysfunction in younger men are more related to lifestyle – drug use, alcohol and tobacco consumption – and psychological problems that young people may have.
If a man under 40 has impotence, the problem is unlikely to be related to heart disease, hypertension and diabetes.
However, this does not mean that the appearance of the problem in the younger man does not need to be investigated: it may be a sign that there is something wrong with the body.
If the problem is of psychological origin, the treatment of mental conditions can help a lot in the patient’s general quality of life.
Broxei, now what? Do I have erectile dysfunction?
Every man has gone through this: at the time of “let’s see”, the penis withers or simply does not rise.
The famous “broxada” is viewed with shame by many, who end up apologizing to (the) partner (a) and say they do not know what is happening, which is the first time – as much as it may have happened before.
Well, for a start, flirting at one time or another is normal.
This can happen for several reasons, such as stress, emotional problems, hormonal disruptions, among others, and it does not necessarily constitute sexual impotence.
Even the environment can influence erection.
There are days when things just don’t go ahead and there is nothing wrong with that.
So don’t worry if it happened to you recently.
It is important, however, to pay attention to how often this happens.
If, for every 4 sexual relations, the bruise is manifested in at least one, it can be a sign that it is a problem.
If you think that erectile dysfunction simply means that the penis does not get hard, you are mistaken!
There are several ways that impotence can manifest itself. Understand:
Inability to get and maintain an erection
The most classic symptom of erectile dysfunction is the inability to obtain an erection: no matter how many stimuli are present, the penis simply does not become erect!
Other times, he may even be able to stand upright, but for a short time. A few minutes pass and he starts to return to the flaccid state.
It takes time to get an erection
In some cases, the man can even have a long-lasting erection, but it takes time to happen. This time can even increase depending on the position.
Small erection or insufficient stiffness
Often, the erection mechanism even works, but it cannot collect enough blood for the penis to increase its volume considerably and become truly rigid.
In such cases, he seems to be stagnant in the middle of the process of getting erect.
Although it can be a completely different disorder, premature ejaculation is sometimes present in sexual impotence.
It can occur shortly after the penis has achieved an erection or even during a partial erection.
Absence of spontaneous erections
You have certainly heard that sometimes the penis is erect out of nowhere, is it not?
In the morning or during sleep, this is a common phenomenon that simply means that the body is working well during sleep and that a man’s sexual health is perfectly fine.
It is normal for a man to spend 20% of his sleep with his penis erect.
However, men with erectile dysfunction may have less erection time while sleeping or simply not having it.
Difficulty in maintaining erection with different partners
Men who have more than one sexual partner may have difficulties maintaining an erection with some and, with others, not.
This can end up limiting your sex life, in addition to the fact that the problem tends to reappear and compromise, too, those relationships in which you are able to have an erection normally.
Some other symptoms that are not part of sexual impotence but that may be related to the problem are:
- Marked curvature of the penis;
- Reduction of body hair;
- Atrophy or absence of testicles;
- Anxiety crises.
Diagnosis: which doctor to look for?
In general, the diagnosis of erectile dysfunction can be made by the patient himself, when he realizes that the phenomenon happens during several sexual relations.
However, this self-diagnosis does not allow the patient to know the cause of the problem and, in these situations, he should see a general practitioner or urologist to have a concise diagnosis.
In the office, the doctor should ask questions about the patient’s sexual life and general health.
Based on the responses, it can identify the underlying risk factors and diseases that may be causing the problem.
To confirm the condition, the doctor conducts questionnaires, some physical and psychological evaluations of the patient, in addition to requesting imaging tests.
The following assessments and tests are part of the diagnosis:
At first, the urologist may want to evaluate the penis for any signs that may indicate a cause for erectile dysfunction.
From this assessment, it is possible to identify problems such as Peyronie’s disease, hypogonadism or hyperprolactinemia, among others.
International Index of Erectile Function (IIFE)
The IIFE is a questionnaire widely used by urologists to investigate the patient’s erectile function.
The questions are focused on the frequency and quality of erections, and the better the answers, the higher the final score.
In total, it is possible to score 25 points and men below 21 points are considered powerless.
The questions that make up the questionnaire are as follows:
- How do you rate your confidence in maintaining an erection?
- When you have erections with sexual stimulation, how often do these erections reach the necessary stiffness for penetration?
- During sexual intercourse, how often can you maintain an erection after penetration?
- During sexual intercourse, how difficult is it to maintain an erection until the end?
- When you have sex, how often are they satisfactory to you?
In some cases, the doctor may order an exam called a penile echocardiography, specially developed to identify the causes of sexual impotence.
The test is done by means of an intra-cavernous injection of a substance that causes an erection quickly.
From then on, it is possible to evaluate the erectile response to the drug, the flow of the penile arteries, the speed of this flow, the resistance index, among other aspects related to the erection mechanism.
This measurement is made by means of an ultrasound device that uses sound waves to create images of the tissues and internal fluids of the body.
The entire process takes about 30 minutes.
When the problem is suspected to be psychogenic, the patient may undergo a psychological evaluation.
Together with a psychiatrist and psychologist, he will be able to identify if there are any mental disorders or situations in his life that can hinder his erection.
In order to diagnose the cause of the problem, the doctor may order blood and urine tests to determine if there are problems such as high cholesterol, high blood glucose levels, low testosterone levels, among others.
Can erectile dysfunction be cured?
-Yeah . Fortunately, erectile dysfunction is curable . Currently, there are many treatments for the various causes of impotence and, although some underlying conditions cannot be cured, many can be treated and controlled, restoring the patient’s erection possibility.
Treatment depends largely on the underlying causes of the disease. However, there are some specific methods for the problem. Are they:
Men who smoke, drink and use drugs must stop these habits in order to restore blood flow to the penis.
In addition, a study published in the British Journal of Sports Medicine argues that physical exercise improves erectile dysfunction.
However, these should only be performed with medical clearance.
Psychotherapy and psychiatry
If the problem is psychogenic, treatment with a psychologist is one of the best alternatives.
The psychotherapist is the mental health specialist capable of identifying and treating mental disorders and disorders that can lead to sexual impotence.
The patient can also consult with a psychiatrist , who treats mental disorders with medication.
It is worth remembering that, in these cases, treating yourself with only one without consulting the other may not be as effective as the two treatments combined.
There are some medications that help the erectile mechanism to work better.
Generally, these are phosphodiesterase 5 inhibitors, which act on blood pressure, releasing passage for the blood to go to the penis.
In addition, these drugs amplify the signal of nitric oxide, a natural substance that causes the relaxation of the penile muscles and promotes the dilation of local arteries.
That is, these drugs are not aphrodisiacs and need sexual stimulation to work.
When this is done, the drugs help to maintain the erection.
The vacuum pump is a non-invasive treatment that allows erections due to the generation of negative pressure, which causes the corpora cavernosa to be filled with blood.
This device is formed by a cylinder, a pump that removes the air and constricting rings to maintain the erection. It works like this:
- A constricting ring is placed on the open end of the cylinder;
- The man puts his penis inside the cylinder;
- The pump is used to draw air out of the cylinder and generate a vacuum;
- This vacuum creates a negative pressure, which causes blood to enter the penis;
- When the penis is erect, the constricting ring is moved to the base of the penis, making it difficult for the flow to flow out of the region and prolonging the erection.
Oral medications do not always work and, therefore, there are other alternatives.
One of them is the penile injection, which the patient applies to himself at the base of the penis before sexual intercourse.
This injection increases blood flow and allows for an erection.
Another alternative is the application of a medicine capsule in the urethra, which allows for an increase in local blood flow.
If none of the previous treatments has worked well, the application of a penile prosthesis through a surgical procedure is considered.
There are several types of prostheses to better satisfy the client.
While some may be apparent when the penis is relaxed, others provide a more natural look.
Depending on the doctor and the accessibility, the patient can choose between malleable (semi-rigid), articulating or inflatable prostheses.
In general, the prostheses consist of two synthetic cylinders – of variable materials – that are placed inside the cavernous bodies, occupying 70% of the space of these bodies.
In this way, the arteries need to fill only 30% of the space, facilitating the erectile process.
In the case of inflatable prostheses, the cylinders are connected to a pump with liquid, which must be activated in order to have an erection.
A major disadvantage is that, after the placement of this type of prosthesis, the man will no longer be able to have spontaneous erections.
It is worth remembering that this is an irreversible treatment and, therefore, it is only considered as a last option.
Low Intensity Acoustic Wave Therapy
There are studies that show that the use of low intensity acoustic (electric) waves helps to improve penile blood circulation by stimulating the generation of new blood vessels.
However, these studies are still very limited and the process needs to be further investigated so that this treatment option is accessible to everyone.
There are several foods with aphrodisiac power that can help in cases of mild to moderate erectile dysfunction.
However, the effectiveness and safety of homemade aphrodisiac recipes cannot be scientifically proven and, therefore, caution is necessary.
Always consult your doctor before starting any type of home treatment, as only he will know if this can cause undesirable side effects or dangerous drug interactions.
Some recipes that can be tried are:
You will need:
- 100g of Rosemary;
- 100g of Leather Hat;
- 100g of Catuaba (the plant, not the alcoholic drink).
- In a container, add the 100g of each of the herbs. Prefer a closed container so that you can store the herbs for new infusions;
- Boil 1 liter of water and turn off the heat;
- Add 2 tablespoons of the herbal mixture to the boiled water;
- Cover and let stand for 15 minutes;
- Strain the mixture and drink a cup of tea 3 times a day for 15 days.
Honey, ginseng, mint and guarana
You will need:
- 1 tablespoon of powdered guarana;
- 1 tablespoon of mint leaves;
- 1 tablespoon of powdered ginseng;
- 1 cup and ½ of honey.
- Mix all the ingredients in a pot that can be stored – there is no need to boil;
- Take 1 tablespoon of the mixture every morning.
This drug is contraindicated for hypertensive, diabetic and pregnant women.
Boil 15g of oregano in half a liter of water and drink 1 cup of tea every day.
Peel 2 cloves of garlic, mash and soak in 1 liter of water for 6 hours. There is no need to boil. Strain and divide the water into 3 equal doses.
Take one dose of the solution 3 times a day.
Some foods that we consume on a daily basis are very useful when it comes to guaranteeing sexual performance.
Add the following foods to your diet and notice the difference:
Despite being mainly composed of water, watermelon is also rich in lycopene, an antioxidant substance with beneficial effects on the skin, prostate and heart;
These seafoods help keep testosterone levels high, giving you greater sexual desire;
Caffeine is a substance naturally present in coffee that helps in blood circulation.
If you don’t like coffee, there are several other drinks that contain significant amounts of the substance, such as teas, soft drinks and sports drinks;
Chocolate is rich in flavonoids, a chemical present in plants that bring several benefits to the heart and circulation.
The best chocolate in this regard is bitter, as it contains higher concentrations of cocoa.
However, remember to be cool: it is recommended to consume 25g (4 squares) of chocolate per day.
Eating more than that can do more harm than good.
Walnuts are rich in arginine, an amino acid that the body uses to produce nitric oxide (which helps to relax penile muscles and initiate an erection).
However, one should not overeat: nuts are very caloric, which contributes to weight gain.
Grape and pomegranate juice
These two juices also help in the production of nitric oxide, helping at the time of erection.
Wine, however, does not have the same effect.
Garlic is a food that has more effect in the long run, as it helps to keep arteries clean, preventing the formation of fatty plaques – one of the possible causes for erectile dysfunction.
The consumption of fish, like garlic, is beneficial for the arteries. That’s because some species are rich in omega 3, a “good” fat that helps keep arteries clean.
Examples of these species are sardines, salmon and fresh tuna.
Some types of vegetables, such as kale, help with nitric oxide levels and provide several important nutrients for the body.
In addition, they can be rich in omega 3, helping in the health of the arteries.
Cayenne, jalapeño, habanero and chili peppers contain substances that help relax the arteries, promoting better blood flow throughout the body – including the penis.
This oil, widely used in Brazilian cuisine, is quite beneficial for impotent men: it helps the body to produce greater amounts of testosterone, as well as monounsaturated fats, which help to maintain healthy arteries.
There are also some techniques that can be tried to alleviate erectile dysfunction.
However, there is no scientific evidence that these work.
There are those who believe that massages in the prostate region can help impotence.
This technique consists of massaging around the groin to assist blood flow to the penis.
However, there are not many studies proving the effectiveness of this technique.
Although research is scarce and inconclusive, it is believed that acupuncture may help in cases of psychological erectile dysfunction.
This technique consists of applying fine needles to the skin in order to put pressure on certain points that promote a therapeutic action.
Pelvic floor exercise
The pelvic floor is composed of several muscles that act directly on the erection.
A small study involving 55 men used the exercises on these muscles to try to regain erectile function and, after 6 months, 40% of these men had positive results.
Want to try to exercise your pelvic floor? Well then:
- First, you need to identify your pelvic floor muscles. To do this, when urinating, try to stop the jet. The muscles used in this process are the pelvic floor. Also, notice that the testicles contract when you use these muscles;
- Knowing what the pelvic floor muscles are, it is time to exercise them: keep the muscles contracted for 5 to 20 seconds and then relax;
- Repeat this process 10 to 20 times, about 3 times a day.
Erectile Dysfunction Medications
In some cases, erectile dysfunction requires the use of medications, as with other therapies it is not possible to treat the problem. Among the indicated remedies, there are those that are used orally (tablets) and intravenously (injection).
In both cases, a medical prescription is essential .
Among the prescribed are some options that contain the following active ingredients:
It is one of the best known drugs for the treatment of erectile dysfunction. One of its trade names is Viagra .
It is an oral medicine with the aim of helping to maintain and obtain an erection, but it works through sexual stimulation.
It should be used when necessary and with caution. It should be taken approximately 1 hour before sexual intercourse.
It is important to discontinue use in the event of any adverse reaction and seek medical attention as soon as possible.
It is also a pill that helps to treat the patient’s inability to have or maintain an erection.
It should be used when the doctor understands that it is necessary to improve the patient’s sexual life.
It is known by the trade name Levitra .
It has the same action as other drugs for sexual dysfunction, and is also for oral use.
This is also a medicine used to treat patients with benign prostatic hyperplasia, a condition in which an enlarged prostate gland occurs.
Some of the trade names for this medicine are Cialis , Ciavor , Zyad and Tada Diário .
It is a medication administered by injection, which helps to relax the smooth muscles of the corpora cavernosa, stimulating vasodilation and helping the patient to have an erection.
It is a medication that must be used with medical supervision. One of the trade names is Caverject .
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Living with erectile dysfunction may not be very easy, since sexual activity is important for human well-being.
However, with treatments, this should be easier.
Some other tips that you can adopt to help with treatment are:
- Maintain a balanced diet: Feed yourself with the necessary nutrients to maintain a healthy body. Avoid saturated fats that promote an increase in cholesterol and high calorie foods that facilitate weight gain;
- Often do physical exercises: A regular exercise is beneficial for circulation and help you lose weight;
- Avoid smoking and drinking: These two habits are very harmful not only in sexual performance and you have a lot to gain by fighting smoking and alcoholism;
- Keep up with the medications: If you need to take medications for any condition, such as high blood pressure, it is extremely important that you are following the treatment correctly to avoid sexual impotence;
- Solve problems as a couple: Often, the problem gets even worse when there is tension between the couple. Consider couple therapy if communication between the two is very difficult.
In most cases, the prognosis of erectile dysfunction is good, since there are many treatments for the problem today.
The worst prognosis, on the other hand, is linked to cases in which there is an adjacent disease that causes damage to the nerves or arteries of the penis, such as diabetes.
The main complications of erectile dysfunction involve the patient’s well-being, mental health and sexual and social life, which are impaired by the condition when there is no adequate treatment capable of helping with the problem.
Difficulty having sex
Because of the difficulty in obtaining and maintaining an erection, the impotent untreated patient may face challenges to maintain sexual relations.
However, it is worth remembering that these are not just about penetration and the patient will still be able to provide pleasure to the partner by other means.
If, on the one hand, erectile dysfunction can be caused by mental disorders, it can also cause them.
This is because men are taught that sex is one of the most valuable things for them and that the lack or difficulty in carrying out this practice makes them lose their value.
The fact often ends up creating negative feelings that can lead to low self-esteem and depression .
Inability to have children
Not being able to have an erection makes penetration and ejaculation in the vaginal canal impossible, an important step for the woman to conceive.
If this is the couple’s desire, this task is quite difficult.
However, today there are options fertilization in vitro that can solve the problem.
If the partner is not understanding, the man may experience problems in the relationship, which can culminate in the separation of the couple.
How to prevent erectile dysfunction?
There is no proper way to prevent erectile dysfunction, especially because it is usually the result of some underlying condition.
However, having a healthy lifestyle that helps prevent cardiovascular disease can be of great help.
In addition, keeping up with mental health can also prevent the loss of the libido characteristic of depression or the very common feelings of anxiety at the time of sexual intercourse.
When does a man begin to become impotent?
Although erectile dysfunction is a greater risk for men over the age of 70, there is no age group in which men begin to be impotent, as, in addition to age, there are several factors that influence it.
It is known, however, that the problem does not only affect men in old age, it can also be a condition that affects younger people as well. To some degree, erectile dysfunction affects about 25 million Brazilians over the age of 18.
Within the age group of 40, about 30% of men report problems with maintaining or having an erection.
However, there is no milestone for this problem, which can affect men at different ages and due to different risk factors.
What is the best natural remedy for male impotence?
It is not possible to state which is the best natural remedy to treat erectile dysfunction, nor even to state that they really work, as there are several causes for this problem, such as hormonal, pathological and psychological issues.
However, the use of some natural remedies can bring benefits, which should be discussed with the doctor beforehand.
What is the doctor who specializes in erectile dysfunction?
Generally, the doctor responsible for diagnosing and treating erectile dysfunction is the urologist . However, patients can also go to the general practitioner or the family doctor.
They can assist in assessing the cause of erectile dysfunction and refer the patient to the specialist o