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Erectile dysfunction and impotence: symptoms, causes, and treatment methods


Erectile dysfunction and impotence: symptoms, causes, and treatment methods

Erectile dysfunction and impotence: symptoms, causes, and treatment methods

You might hear about it in a pop song, or in a movie scene on TVYou may hear one of the men in the café say it to another, but everyone deals with the matter as a scandal that must be hidden, it is known that no man wants to talk about this, but we must be frank with ourselves, if something is not working then this thing needs to be fixed!
If you have ever had erectile dysfunction, two questions often come to mind: "Is erectile dysfunction permanent?" And "Can it be cured?"

What is erectile dysfunction

  • Erectile dysfunction (impotence) is the inability to reach or maintain an erection sufficient for sex, or the inability to ejaculate normally.
  •  A form of impotence in which the penis is completely absent or lasts long enough to successfully complete sexual intercourse.
  • Erectile dysfunction is not a rare disease, all men may experience this symptom infrequently due to psychological stress and the like, but the increased frequency of the symptom may mean that there is a health problem that needs treatment, or there are emotional difficulties in the relationship that may require specialized intervention, and its recurrence may affect A man's psychological state, and his self-confidence, as it may affect his relationship with a partner.
  • Erectile dysfunction is not the only form of impotence in men, there is also premature ejaculation, delayed or no ejaculation, and loss of sexual desire.

There are several factors that contribute to erectile dysfunction problems, including emotional and physical disturbancesHowever, it is necessary to obtain an immediate diagnosis when the problem is noticed so that the patient does not experience complications.

Symptoms of erectile dysfunction in men and young adults

The most important symptom of impotence is the inability to achieve or maintain an erection, and this condition is often a temporary condition in which a man is unable to maintain an erection for a long enough period to continue or complete sexual intercourse.

 Symptoms of erectile dysfunction

  • A clear decrease in sexual desire.
  • Inability to achieve or maintain an erection, despite exposure to sexual stimuli.
  • The erection ends quickly, leading to failure of the sexual relationship.

Erectile dysfunction may be associated with several other diseases, such as:

  • Not to experience morning and evening erections during sleep.
  • Premature or delayed ejaculation.
  • Failure to reach orgasm with availability of stimuli.

If you suffer from any of these symptoms, you should contact your doctor, especially if it lasts for more than two months, to determine if the symptoms are due to a problem that requires treatment.

The topic may seem embarrassing to you, but don't worry, the solution to the issue may be very simple, and the treatment for it may only be to follow the health problem that leads to erectile dysfunction (such as diabetes or blood pressure problems).

Causes of erectile dysfunction usual and sudden

Male sexual arousal is a complex process that is affected by several factors, the most important of which are:

  •  Mood
  •  Hormones and Emotions  
  • Nerves, muscles, and blood.

 And sexual dysfunction may result from a defect or a problem any of the above.

Sometimes, both physical and psychological problems cause erectile dysfunctionFor example, a slight physical problem may slow the sexual response, causing anxiety and tension that leads to complete sexual dysfunction.

That is, erectile dysfunction may occur for psychological reasons (10% of cases), or organic (80% of cases), and erectile dysfunction may occur as a result of an organic and psychological factor at the same time, for example, an organic problem may cause a slight delay in your sexual response. (The occurrence of an erection), which may cause anxiety or tension that makes the situation worse.

Physical causes

  • Heart disease
  • Lack of blood flow inside the penis, which is due to several diseases, including atherosclerosis , heart diseasehigh cholesterol, obesity, high blood sugar (diabetes) and smoking.
  • The inability of the penis to hold blood pumped during an erection.
  • Nerve damage caused by diabetes
  • Treating prostate , colon or bladder cancer often leaves men with erectile dysfunction.
  • Cancer treatment (radiation or surgery) near the pelvis can damage the tissues of the penis and affect its function.
  • Medicines used to treat other health problems can negatively affect erections.
  • Doing drugs or drinking a lot of alcohol.

 Psychological causes

  • Depression.
  • Anxiety and stress.
  • Problems in personal relationships.
  • Psychological stress at home or at work.
  • Stress resulting from social, cultural or religious differences.
  • Anxiety about performance during sexual intercourse.

The diagnosis

First, the doctor examines the general health of the patient

The doctor asks about symptoms and disease history, performs several tests to determine the cause of the condition, and examines the patient’s body, including: his heart, lungs, blood pressure, local examination of the penis and testicles, and an anal examination of the prostate gland, and he may also order blood and urine tests to rule out other diseases.

Second, special tests

Condition screening tests include the following

  • Physical examination  This includes a thorough examination of the penis and testicles, in addition to examining the nerves to confirm the degree of sensation in the penis.
  • Blood tests  By taking a sample of blood, it is sent to a laboratory to detect signs of heart disease, diabetes, low testosterone levels , and other diseases.
  • Urine tests (urinalysis)Like blood tests, urine tests are used to look for signs of diabetes and other underlying diseases.
  • UltrasoundThis test is usually performed by a therapist, using a wandlike device, and this device is placed on the blood vessels that supply the penis with bloodIn the end, the device provides moving images through which the doctor can know whether the patient has problems with blood flow to the penis or not.

Nocturnal Penile Tumescence (NPT)

It is a test that uses a small device placed around the patient’s thigh while sleeping to measure the extent of the penis’s erection during sleep, which is a normal occurrence during deep sleep, and stores this information for later examination by the doctor. This test determines whether the cause of erectile dysfunction is organic or psychological, so the penis does not get erect during sleep. If the cause is organic, and erects naturally if it is psychological.

 How is the erection?

  • To understand an erection first, an erection is simply the result of increased blood flow to the penis. This increase may be the result of sexual thoughts and fantasies, or the result of direct contact with the penis.
  • When a man becomes aroused, the muscles around the penis relax. This relaxation allows for increased blood flow in the penile arteries. This blood fills two cavities inside the penis called the cavernous bodies. When these bodies are filled with blood, the penis becomes rigid, the erection ends as a result of muscle contraction, which leads to the exit of the existing blood Into these chambers through the penile veins.
  • Erectile dysfunction can occur as a result of a problem at any step during this process, for example: the penile arteries may be dilated or narrowed, not allowing blood to pass into the cavernous bodies.

Erectile dysfunction treatment

Treating erectile dysfunction throughout history, from popular myths to the real cure:

As far as we know, attempts to treat erectile dysfunction began more than 1,000 years ago!

In the eighth century, for example, men in Rome and Greece hung the genitals of roosters and goats on their bodies or clothes, believing that it gave them sexual power!

When was erectile dysfunction treatment as we know it discovered today?

  • The first step on the road to accessing medications available today was taken by a British scientist named Giles Brindley in 1983, when Giles suddenly removed his pants in the middle of a medical conference to show shocked viewers the erection of his penis resulting from an injection of an opioid substance called Papaverine. By expanding blood vessels in the penis, Giles' discovery laid the groundwork for making currently available drugs.
  • Thirteenth century: Albertus Magnus, a Catholic saint, advised eating a roasted wolf penis as a remedy for impotence!
  • During the sixteenth and seventeenth century: impotence was considered a crime in France, and a legal justification for divorce after the accused had been examined by the court experts, this law was repealed in 1677 to consider this practice a shame on them.

How is the treatment?

The treatment of erectile dysfunction varies according to the cause and severity of the problem, and on the basis of which the appropriate treatment is determined for it, and each of them has its risks and benefits.

Treatment may include oral drugs or tablets, testosterone therapy, penile injections, penile implants or surgery.

Medicines treatment

The following medicines increase blood flow to the penis, treating erectile dysfunction:

  • alprostadil (Caverject)
  • avanafil (Stendra)
  • sildenafil (Viagra)
  • tadalafil (Cialis)
  • testosterone (Androderm)
  • vardenafil (Levitra)

How do these drugs work?

These drugs raise the levels of a substance in the blood called nitric oxide, which leads to widening the blood vessels, increasing blood flow to them, and the drugs work specifically on the blood vessels inside the penis, but the matter is not so simple, as with any medicine, there are always side effects Possibly, let's talk about the most important of them a little

What are the main side effects of medications?


Headache is the most common side effect of erectile dysfunction medications. The sudden change in blood flow due to the change in nitric oxide levels in the blood that we talked about earlier causes headachesHeadaches are a constant effect of all erectile dysfunction medications, so switching medications may not be effective. Talk to your doctor about other ways to prevent headaches.

Physical pain

Some people suffer from pain in different areas of their body, and others suffer from pain in the lower back.

Digestive problems

Erectile dysfunction medications can cause digestive problems, the most common of which are: indigestion and diarrheaThe condition can be treated by adjusting the diet, switching caffeinated drinks with water, and consulting a doctor if symptoms persist.


The high level of nitric oxide in the blood causes some cases to become dizzy. Dizziness is often slight, but in rare cases it reaches the point of fainting, which is a serious problem that requires a visit to the doctor immediately.

Changes in vision

  • Medicines may affect vision temporarily, and may cause blurry vision, so erectile dysfunction medications are not recommended in cases of low vision and the like.
  • Complete vision loss or permanent changes are indications of a more serious problem that requires emergency medical intervention.


Flushing is a temporary redness of the skin, and it often appears on the face, and its intensity may vary, but in general the flushing is harmless, apart from the discomfort of its appearance, the flushing may increase when eating spicy food or drinking alcohol, or being in a hot atmosphere.

Congestion and runny nose

It often resolves without treatment.

Treatment with natural herbs

In some cases, the patient or doctor may prefer to use natural herbs to treat weakness, but care must be taken as most of these herbs are not subject to the control of the competent authorities, as they may contain harmful substances not mentioned, so the doctor should be asked about guaranteed and safe types, and avoid buying them online. .

These herbs and natural supplements have varying degrees of effectiveness in treating erectile dysfunction:

  • L-Arginine
  • DHEA
  • ginseng
  • yohimbe
  • Asparagus racemosus


Besides medication treatments, the psychological aspect also plays a role in solving erection problemsHowever, it may not be as simple as taking Viagra.

Psychotherapy can depend on:

  •  Meditation.
  • Rhythmic breathing
  • Imagining images depends on calming nerves and clearing the mind
  • Positive self-talk, which helps dispel negative thoughts and acquire positive thoughts.

Surgical treatment

  • The resort to resolve surgical or cultivation of the pillars of the erection of the penis in cases of sexual weakness and severe when you do not respond to drug therapy
  • We implant all kinds of stents, whether flexible or inflatable stents, under local anesthesia and through a small incision in the bottom of the penis, which does not exceed 2 cm
  • After implantation of penis implants, sexual intercourse is possible without the need to use any drugs or sexual stimulants
  • Silicone penis implants are considered one of the safest and most successful procedures for treating impotence, with a success rate of more than 98%.

Alternative treatments

If erectile dysfunction is a result of stress, alternative treatments may help, such as: yoga or massage.

Prostate massage

Some men resort to a special type of massage, which is massaging the prostate gland , in which tissues are massaged in and around the pelvic area to increase blood flow to the penis, but studies on its feasibility are limited.


In some cases resulting from a psychological cause, acupuncture may be useful in treating the condition, although studies on the feasibility of acupuncture are limited and inconclusive, in the case of choosing this treatment, a licensed therapist must be chosen, and adherence to the rules for preventing the spread of general infection, such as: sterilization of needles And dispose of it properly after one use.

Pelvic floor muscle strengthening

Pelvic floor muscle exercises may also help, as a small study (of 55 men) showed that the exercise completely cured erectile dysfunction in 40% of cases.

Kegel exercises

These are simple exercises that can be done to strengthen the muscles of the pelvic floor, as for how to do them:

1.      The first step is to get to know the muscles of the pelvic floor, to do this, stop urination before you finish, the muscles used in this are the muscles of the pelvic floor, the muscles also lift the testicles.

2.      After you know the muscles, make them contract for 5 to 20 seconds.

3.      Repeat this exercise 10 or 20 times in a row 3 or 4 times a day.

Modify lifestyle and diet

A healthy lifestyle may prevent erectile dysfunction from occurring in the first place or may treat it after it has occurred, some helpful steps:

1.      Exercise.

2.      Treating blood pressure and keeping it low.

3.      A balanced and nutritious diet.

4.      Maintain a healthy weight.

5.      Avoid smoking and alcohol .

6.      Avoid stress triggers.

Erectile dysfunction is often related to blood flow, so maintaining healthy blood vessels with exercise and healthy eating reduces the chances of erectile dysfunction.

Change medications

Some medications may cause erectile dysfunction as a side effect. Ask your doctor about your medications and about their potential for causing erectile dysfunction. Your doctor may give you better alternatives, but avoid stopping any medication without talking to your doctor.

In the end, the first, most important, and hardest step in the way of treating erectile dysfunction is to talk about the matter, whether to your partner or your doctor, once you complete the first step, the rest will become easy, and soon you will be able to find out the cause and treat it appropriately.

Erectile dysfunction and its relationship to depression

For some men, depression can accompany erectile dysfunctionIt is common for men with ED to feel angry, frustrated, sad, insecure, or even "manly". These feelings may lead to a lack of self-esteem and, in severe cases, to depression.

Diagnosis of depression in men with erectile dysfunction

Diagnosing depression begins with a physical examination and an interview by a health care professionalThe patient will be asked about several issues including family history and chemical dependencyThere is no single test that can diagnose depressionHowever, there are certain patterns that health care professionals look for in order to make a proper diagnosisThese patterns may include general sadness, irritability, and withdrawal from daily activities.

Treating depression in men with erectile dysfunction

Treatment for depression may include antidepressant medication, psychotherapy (talking therapy), or a combination of the two.

  • Antidepressants: Many different medications are used to treat depressionNote that some antidepressants can get worseHealth care providers can recommend appropriate antidepressants for men with erectile dysfunction.
  • Talk therapy : During treatment, a person with depression talks to a licensed and trained mental health care professionalThis provider will help the person identify and act on issues related to depressionTypes of modern therapy include couples therapy, individual therapy and group therapy.

The first step in addressing your concerns about depression related to ED is being honest with yourself, your partner, and your doctorAfter depression appears outdoors, it will be easier and less stressful to deal with.

Erectile dysfunction due to diabetes or high blood pressure

Shock wave therapy can now be done using the Piezowave2 device.
Treatment with this device is very safe and does not have any side effects. Erectile dysfunction can be treated for the elderly.

Treatment method

The patient's condition is diagnosed in the clinic after a full examination of the patient and laboratory analyzes are made, and the number of sessions is determined according to the patient's condition, and the patient often needs 4 to 6 sessions depending on the situation.