Male arousal is a complex process of brain, hormones, emotions, nerves, muscles, and blood vessels. Therefore, a medical problem in any of these processes can result in erectile dysfunction. And while people suffering from the disorder mostly focus on the reasons, hardly anybody discusses the impace of ED that is much more than just biological.

To understand the consequences of erectile dysfunction on men, we shall first understand the problem in depth.

Some of the most common erectile disorders men face are as follow-

• Trouble getting or maintaining an erection
• Premature ejaculation
• Delayed ejaculation
• Decreased libido or reduced sex drive.

If you or someone close to you is suffering from any of the above mentioned problems, keep reading.

Most of the times, ED can be the result of an underlying disease such as hypertension, ischemic heart disease, and diabetes mellitus. Prevalence of ED also rises with age. However, ED can also affect younger men aged 18 to 25. Men with radical prostatectomy for prostate cancer are also frequently diagnosed with ED.

Brief overview of male arousal

The relationship between the individual’s mind and body during regular sexual activity is complex. For example, an erection results from interactions between the neurological, circulatory, and endocrine (hormonal) systems. The interaction of these systems controls the male sexual response

Following are the major elements of male arousal-

Desire:- The desire to participate in sexual activities is sometimes referred to as sex drive or libido. Words might set it off, images, smells, sounds, or physical contact. Excitement is the initial stage of the sexual response cycle, triggered by desire.

Excitement:- The next step is excitement or sexual arousal. Nerve impulses from the brain are transmitted to the penis during excitation via the spinal cord. A larger opening of the corpora cavernosa and corpus spongiosum arteries, which provide blood to the erectile tissues, results in a response (relaxing and dilating). These areas see a considerable increase in blood flow due to the enlarged arteries, which causes them to swell up. This growth strains the veins that typically drain blood from the penis, compressing them and delaying the blood flow, which raises blood pressure inside the penis.

Erection and rigidity are the results of this increased penile pressure.

All around the body, muscle tension rises as well. As a result, excitation and tension in the muscles increase throughout the plateau stage.

Orgasm:-The height of arousal during a sexual encounter is called an orgasm. When an orgasm occurs, the body’s muscles become even tenser, the pelvic muscles clench, and ejaculation follows.

Ejaculation:-Male reproductive organs such as the ducts of the epididymis, the seminal vesicles, the prostate, and the vas deferens all have muscles that are stimulated by nerves to contract during ejaculation. Semen is forced into the urethra by these contractions—the muscles surrounding the urethra contract, pushing the semen out of the penis even further. Additionally, the bladder’s neck tightens, obstructing the flow of semen backward into the bladder.

Causes of Sexual dysfunction

There are several causes of sexual dysfunction. There may be physical causes or psychological causes. Some of these causes are mentioned below:-

Decreased Libido

Decreased libido is one of the most common causes of sexual dysfunction. Some of the key factors contributing to a reduced sex drive or libido are:

• Unhealthy or desultory lifestyle
• Unhealthy eating habits
• Relationship difficulties
• Stress, worry, or depression
• Hormone levels decline as you age
• Alcohol or drug abuse
• Low testosterone

Post-Traumatic Stress Disorder

Witnessing or suffering a traumatic event, such as a major accident, physical or sexual assault, or war and conflict can lead to post-traumatic stress disorder (PTSD), a mental health condition.

Some of the Symptoms of PTSD include:

• Persistent, unsettling thoughts, flashbacks, or dreams about the traumatic incident.
• Isolation from anybody or anything that might bring back bad memories of the traumatic experience.
• Extremely strong reactions to stimuli, both emotionally and physically, as well as a shift to a negative frame of mind.

Medication Side-effects

Medications such as those for high blood pressure and depression, as well as alcohol and recreational drugs, can all interfere with proper sexual functioning. Some medical interventions may also impact sexual ability. Nerve injury, which can occur during some surgical procedures, is one potential reason for diminished sexual function.

Psychological effects of Sexual Dysfunction

Sexual dysfunction can be upsetting. One qualitative investigation indicated that the most common immediate reaction was emasculation. Many young men have described this experience as ‘absolute humiliation’ and a ‘deep feeling of being less than everybody else’.

This might intensify insecurities and affect love relationships.

Some individual’s incapacity to please their spouses was another key problem; some felt they were ‘letting their partners down’ or feared their partners would leave them because of it.

Men with sexual dysfunction oten feel isolated. A young man wrote that he felt embarrassed and unsupported if he told his friends. Based on this narrative, many discuss or laugh about their sex lives as if nothing was amiss. There is a cultural expectation that ‘men are meant to always want sex’. When you don’t live up to that norm, you are bound to feel humiliated. Such situations sometimes intensify the impact of the problem.

Sexual dysfunction can damage relationships outside of them. Those who are single may be hesitant to create new relationships or find sexual partners. Even when starting a new relationship, a person with sexual dysfunction may be afraid of rejection and hesitant to share it.

BIOLOGICAL IMPACTS OF ERECTILE DYSFUNCTION:

Erection dysfunction can cause relationship problems, affect your confidence, and may cause stress. But more than anything, it can lead to diseases and disorders.

Common health conditions associated with erectile dysfunction:

• ED and cardiovascular disease: ED patients tend to have cardiovascular disease by 1.5 times in the future more than any other man. The risk of having this disease is the same for a person with a family history of heart attack, dyslipidemia, or smoking.
• ED and diabetes: Erectile dysfunction can often be the first symptom in the men who have diabetes. However, in some men, these conditions occur simultaneously.
• Hypertension and ED: Erectile dysfunction and high blood pressure can also occur simultaneously in most men. 35% of the men who have hypertension may suffer from ED, and 40% of the men who have ED may suffer from hypertension.
• Lower urinary tract disorders: Men with ED are likely to suffer from lower urinary tract infections 2-9 times more. Some studies also show that with the severity of lower urinary tract infections, the risk of erectile dysfunction increases.

Diagnosis for all sexual dysfunction

A physical exam by a healthcare professional is often the first step of diagnosing ED. These exams can consist of the following:

• Blood tests
• Checking blood pressure.
• Prostate examination with a rectal exam.
• Testicles and penis examination.
• If you have issues with blood flow to the penis, another test can reveal this.

Your symptoms, medical history, and sexual history must be discussed with your doctor. Do not feel uncomfortable, even though some questions could sound private. Therefore, it is crucial to respond honestly to prescribe the best course of treatment.

Treatment options for ED

• Mechanical devices
  A constriction ring can help men who get an erection but can’t keep it up. As soon as an erection happens, an elastic ring is put around the base of the penis to stop blood from retreating and keep the penis tight. If the man cannot get an erection, he can place a hand-held vacuum erection gadget over his penis. The ring is then placed on the penis’s base to maintain the erection after this gadget gently vacuums blood into the penis. This method has some downsides, including penis bruising, coldness at the tip, and lack of spontaneity. A constriction ring and vacuum device may occasionally be used with medication.

• ED pills
  Oral phosphodiesterase inhibitors are the main treatments for ED. Due to their ease of use and ability to promote spontaneity in sexual activity, oral phosphodiesterase inhibitors are used far more frequently than other medications. For example, some men prefer tadalafil because its effects can last up to 36 hours longer than other medications. When taken before meal and at least an hour before sexual activity, most phosphodiesterase inhibitors perform optimally.

• Counseling or sex therapy
  For men whose ED is psychological, couselling by a certified expert can help. If there is trouble in paradise or you haven’t been doing fine mentally, a therapy might be your solution to cure erectile disorders.

• Occasional testosterone treatment
  If low testosterone is the cause of ED, more testosterone may be administered as an injection, a patch, or a gel applied to the skin. Previous research suggested that these treatments may marginally raise the risk of a heart attack or stroke. The bulk of investigations, nonetheless, have not supported these conclusions. For example, unless a guy has low testosterone levels in his blood, more testosterone is not advised. A doctor can think about treating the man with a different medication if a pill seems to be the source of low testosterone levels.

Conclusion

Sexual dysfunction certainly has psychosocial risk factors. Therefore, in addition to medical examination and therapy, women and men with sexual dysfunction should receive psychosocial evaluation and treatment if available. More research is needed on how social and cultural influences affect sexual function. For instance, researchers should conduct a clinical assessment for occult cardiovascular disease in men who do not already have known cardiovascular disease but develop organic erectile dysfunction, especially in men under 70. This recommendation is based on solid evidence that erectile dysfunction is a sign of other types of cardiovascular disease.

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