in this article:
Erectile Dysfunction Guide You Won’t Find Anywhere Else: Expert Opinions & Tips Included
How is an erection created in humans? What are the different erectile disorders? In this article, zoom on a vital male function and possible disorders that can compromise it, focusing on erectile dysfunction, or ED.
Erectile mechanism in men
Contrary to what some might say, in men too, everything starts from the brain! Under the effect of sexual arousal, sexual stimulation signals are transmitted from the brain to the penis (via the spinal cord and the erector nerves). The penis is covered with blood and the contractions of the muscles of the lower part and the perineum take care of the rest. The sex hardens then and stands up. But do not trust it. Most of the time, the signals from the same upper part of the brain are castrators. Under such circumstances, the penis has only one solution: to keep a low profile…
The penis sometimes takes liberties and does not inform the cerebral cortex before going into active mode. A caress or a stimulating vision, and now stimulating signals are transmitted from the nervous circuit of the spinal cord. They prove to be precious for quadriplegic people for example, who can thus have ‘conditioned’ erections (without however having the feelings of a man in full health).
Beware, some erections in humans are independent of sexual arousal, it is called priapism. It comes from neurological disorders or certain diseases. Blood stagnates in the penis and can cause very painful erections. Only solution: operate if the drug treatment has no effect.
As soon as they enter paradoxical sleep – that of dreams – the brain areas lower the guard. Thus, it is quite normal that in these gentlemen, four to five erections occur each night, whether they sleep alone or not! These episodes occur every 90 minutes or so, and last 20 minutes on average. The morning erection is one of these episodes, but it is often stronger because the testosterone peak is at the rendezvous between 6am and 8am.
The impossibility of obtaining an erection sufficient for the penetration or to maintain a rigid erection: it is thus that one defines the breakdown of erection (the term of impotence is from now on judged too negative). It is a common sexual disorder whose risk increases with age. It affects 1 in 3 men after 40 years; after 50 years, this figure increases to 1 in 2 men.
There are two types of causes for erectile dysfunction. 20% belong to the psychological field, and 80% of the physiological domain.
- Among the psychological causes, one distinguishes various factors: the anxiety of the performance, the stress, a fall of desire, etc. It is necessary to know that the mechanism of erection is involuntary. Forgetting one’s sex and fear of failure, and being guided by eroticism: that’s the key to a good erection.
- Organic causes: they are taken into account in case of absence of erection following masturbation. The most common origin is vascular (the arteries become blocked and prevent a good penis irrigation). Hormonal disorders, alcoholism, smoking, diabetes, etc. the list of aggravating factors is long.
To top it off, these physiological problems rarely go alone since they are accompanied by psychological effects (feeling of degraded manhood, loss of self-confidence…).
Erectile Dysfunction definition and causes
Inability to penetrate his partner with the penis, male impotence is also sometimes characterized by disorders of ejaculation. Why and how does it happen? Explanations follow. Male impotence is defined by the impossibility of obtaining an erection rigid enough to allow penetration without the manual help of the partner. This also translates into the impossibility of maintaining a rigid and stable erection, during the changes of positions or being penetrated. We talk about several stages of impotence: from the total absence of erection to capricious erection, even unstable. The main causes of impotence can be of different origin.
- It can be due to underlying diseases such as diabetes, high cholesterol levels, high blood pressure or depression.
- Lifestyles called ‘at risk’: smoking, alcoholism, cannabis use, etc.
- Some medicines: think about reading the leaflet before.
- Aging organs, and simply put age
Here one can cite stress, annoyance (after a fight with his partner) or lack of self-confidence. It is good to know: people who suffer from impotence for psychological reasons normally have normal nocturnal erections. The most frequently observed cases.
Most often, impotence is caused by:
- The fear of not being up to par with a new partner.
- On the contrary, too great a desire can also cause impotence, which is often transient.
- The lack of ‘training’ after a prolonged period of abstinence. (voluntary or not).
- Lack of desire for his partner.
- Stress, fatigue, professional worries are also very influential.
If the problem has already occurred, the fear of a new failure. This anxiety leads to the secretion of adrenaline, a substance that inhibits erection. Moreover, in this case, the man risks being concentrated on his own sex, which diminishes the receptivity of his brain to the erotic message from his companion. Good to know: the mechanism of erection is an involuntary mechanism. Which means that to have a good erection, it is useless to think about it. You just have to let go.
If the cause is organic: different solutions exist and the best known is the blue pill called Viagra, prescribed especially for age-related dysfunctions. Some will like to use ‘vacuum’ devices of the penis using a pump or a vacuum. It is also possible to put rigid prostheses with or without a pump or to make local injections.
Other medications may be prescribed by your doctor if you have an impotent illness. Do not hesitate to talk to your GP. If the cause is psychological: this concerns 80% of men. To remedy this, it is advisable to talk first with his spouse. Then, some doctors advocate going to see a sexologist to proceed in stages until a complete sexual fulfillment.
The excessive consumption of tobacco, drugs or alcohol can trigger a sexual problem in humans. Smokers, alcoholics and drug addicts are at risk of erection problems, including impotence and priapism. They are also victims of low libido, even anorgasmia. Taking certain medications can also have the same effects, reversibly. The abuse of tobacco, alcohol, drugs alter erections.
Abuse of addictive substances such as tobacco, drugs and alcohol decreases sexual ability. Excessive consumption may be the cause of occasional sexual breakdown.
In a smoker (and even in a former smoker), the arteries of the penis are damaged, which promotes venous leakage: the blood is no longer properly retained in the penis, erection fails.
In the longer term, alcohol drugs and tobacco are among the factors causing impotence. Tobacco, for example, is the first organic cause of impotence. It aggravates vascular causes (hypertension and arteriosclerosis) of erectile dysfunction.
Similarly, regular consumption (more than 3 drinks a day, every day) of alcohol deteriorates the arteries, especially those of the sex.
Priapism and Erectile Dysfunction
Some drugs cause, conversely, cases of priapism. Factually, medication is the main cause of priapism. It’s about: antihypertensives, anticoagulants, alpha-blockers, etc.; antidepressants, neuroleptics, etc.; corticosteroids, corticosteroids, etc.; Viagra and other injections used as a treatment for impotence.
Alcohol and certain drugs (marijuana, cocaine, heroin) can cause priapism, that is, a persistent erection. Priapism is also a symptom of lack when weaning these drugs.
Drugs: good against diseases, but can cause a sexual problem. Some medications can reduce the quality of erections, or even make a man quite helpless.
Most often, these effects are reversible and disappear after treatment. Under no circumstances should you stop taking medication if you have a sexual problem.
This is a good time to consult your doctor. Some drugs directly cause a sexual problem.
These are often medications that treat diseases that themselves cause erectile dysfunction, such as: cardiovascular diseases: hypertension, hypercholesterolemia, etc.; psychological disorders: depression, anxiety, psychosis, etc.; age-related diseases: prostate cancer, prostatitis, hormonal disorders, etc. Other drugs that can cause sexual breakdowns are: diuretics, anticonvulsants, cimetidine (gastric acidity), neuroleptics, Parkinson’s disease treatment, etc.
Tobacco, alcohol, drugs, medications: effects on libido and orgasm.
Alcohol, tobacco, drugs and certain medications (antidepressants, anti-cancer drugs, alpha-blockers, beta-blockers, hormones, etc.) have devastating effects on male sexual desire. This is even one of the main non-psychological causes of decreased libido.
Some drugs also cause anorgasmia. These include alpha-blockers and antidepressants, particularly serotonin reuptake inhibitors, which account for nearly 20% of the causes of anorgasmia.
Impotence is the total inability to have an erection. It must be distinguished from the sexual breakdown, or erectile dysfunction, which is punctual. Male impotence has, for the most part, organic causes: diseases, taking drugs, alcoholism, etc. It is essential to go to a doctor because impotence often conceals a more serious condition.
Erectile Dysfunction statistics: how many men are affected?
Erectile dysfunction is the impossibility for the man to have a satisfactory erection. The rigidity of the penis is often insufficient to allow penetration. Unlike a sexual failure, which is occasional, male impotence is chronic. The man cannot then have any erection, including the night and the morning, and he is said ‘impotent’. Nearly one in five men has sexual impotence. This frequency increases with age: 30% of men over 70 are victims, and only 5% of 20-30 years.
Male libido and Erectile Dysfunction
The most commonly cited cause of low male libido is fatigue. Professional changes, extended schedules often cut off all sexual desire to men. In these cases, we observe that sexual desire comes back in rest periods: weekends, holidays. Male libido is often also the first victim of stress, whatever its origin. The economic situation, family problems, health concerns can cause a temporary decline in sexual desire.
It is sometimes also the life of a couple that is in question. The daily grind or the arrival of a child can use the male libido. Too regular refusals of the partner can scald the man, make him doubt his manhood. The solution to lower male libido is often in dialogue: within the couple, the family, with a doctor or a psychologist. Unraveling the source of anxiety helps solve libido problems.
Sometimes, no psychological explanation is valid.
Be aware that a drop in male libido can also be caused by:
- medicines: antidepressants, anti-cancer drugs, beta-blockers, hormones, etc.;
- diseases: diabetes, obesity, thyroid disorders, etc.;
- toxic substances: alcohol, tobacco, drugs.
A sudden drop in sexual appetite may therefore reveal an undiagnosed illness. In any case, if this low libido embarrasses you, if it deteriorates your daily life, consult your doctor. He will reassure you or refer you to a specialist if necessary.
Erectile Dysfunction and orgasms: what are the options?
Men who suffer from impotence are quite capable of having orgasms. A soft penis does not mean no pleasure or ejaculation. The only person who may not be completely satisfied is the woman. That’s why the first thing to do, from the first time, is to talk about it.
The role of a woman in erectile function
Most men are anxious not to underperform. Not only in bed but also professionally and socially. In the face of competition from younger people, or even their children. We are in a cruel competitive society, which fires seniors. Women have the same fears. ‘
Women play a decisive role, for most men, in stories of erectile failures. Even taking Viagra, without desire, a man does not get an erection. Women remain the great aphrodisiac, as the source of major anxiety. Many of the male reactions depend on how women judge their physique and abilities. If many react with understanding, others may show less tact, or complain making a feel bad about himself. Today, many women are financially independent, sometimes earn more than men, compete at work, and have to share domestic chores. In bed, they want to take pleasure, develop their sexuality and sometimes, as doctors note, also develop a form of worship of performance. They want their sex life to be successful, perfect.
But a man is not always ready, inspired, at the desired moment. In the face of these strong women, many men are destabilized – it has become a cliché of the time, well analyzed by the sociologist Daniel Welzer-Lang. This is reflected in the figures of male eroticism, his ‘affective cards’ as the American psychologist John Money calls them (Lovemaps, sexual fantasies, affective ‘cards’ and perversions).
Founded in part on the imagery of the dominance of welcoming women, the great archetypes of male desire are troubled. So men are losing their firmness. In return, period paradox, women blame them. All these frictions of desire arouse discomfort and specialists now treat them quite well by combining conjugal therapy with erectile medications. It is important that the couple reflect on themselves, with understanding that sexual disorders often come from a lack of erotic imagination, or even a sense of play, a fantasy scene that is often enough to raise desire, whatever the age.
Today, all doctors say it, we have a toolbox, both pharmacological and psychotherapeutic, that can cure almost all virile failures. Some resist despite everything. For impotent psychogens reluctant to any treatment, new silicone prostheses exist, that the surgeon slides under the skin of the penis, between the cavernous bodies, while he lodges a small pump in the testicles. On the one hand, the object is invisible. Then it is easy to use. It allows you to make love for a long time and does not alter any sensation.
The role of porn in developing Erectile Dysfunction
Many doctors note the growing influence of porn in sexual and erectile disorders of adolescents. If cinema X can help an adult to fantasize, find the archetypes that excite him, it often serves sex education to boys from 10 to 18 years, as shown by the recent investigation. For starters, the imposing sex of such movies traumatizes many of them. They think that such a mandrel gives the standard of size. As a result, teens develop complexes, believe they are under-equipped and do not achieve erection easily anymore.
Many young men consult andrologists after watching a porn movie and ask for a solution for enlarging their penis. The sexual durability of the films also impresses a lot these young people, who think they are worthless if they do not show the same quality of performance. Scenarios are also not true to real life. Reality disillusions them. So they cling to porn and experience sexual failures in life. Today, after the feminist wave, many women no longer know how to play courtesans, to give pleasure, to make men excited, giving up on the world of voluptuousness, caresses, tantrism, knowing how to restrain oneself. Some people fall into the porn trap. It is not enough to give them pills, it would be necessary to resume all the erotic education.
Sexual problems: when and who to consult?
Erection or ejaculation disorders are not always serious. However they are always embarrassing, even handicapping, to maintain a suitable sex life. When the sexual disorder becomes a weight on the morale and the life of couple, it is advisable to consult. The general practitioner is the first person to go see. If necessary, he will send you to a specialist, andrologist, sexologist or psychotherapist.
When to consult: as soon as the need arises. Male sexual disorders, such as sexual breakdowns, low libido or premature ejaculation, are common. Yet, few men will consult for a problem that seems benign. It is a mistake! Sexual problems always end up weighing on the daily life, the balance of the couple or even the mental health of the man. It is therefore perfectly natural to consult a doctor as soon as the need arises.
On the other hand, if you suffer from impotence, anejaculation or anorgasmia for example, the problem may have organic causes. Seeing a doctor will allow you to rule out or confirm a hormonal, cardiovascular or age-related illness. Male sexual disorders can also be the side effects of medication. In this case, your doctor will adapt your treatment to limit your sexual problems.
Who to consult: a battery of specialists at your service. Many different doctors can help you with your sexual problems. The choice of the specialist depends mainly on the nature of the problem, psychological or physical. You can therefore consult:
Whatever the problem:
- Your GP: This is the first person to go see, first of all because she knows you well and it is easier to talk to her. It can eventually help you solve your problem or, failing that, refer you to the right specialist, including an oncologist, endocrinologist, neurologist, etc.
- A sexologist: sexual disorders are her specialty. The sexologist often combines several specialties. He will be able to define the nature of the disorders and treat them, or possibly send you to another specialist.
If the problem is of physical origin:
- An andrologist: it is the equivalent of the gynecologist for men. He is a surgeon and can put penile implants in case of impotence.
An urologist: he treats tumors and diseases of the urinary and genital system. Like the andrologist, he specializes in men’s ailments.
If the problem is of psychological origin:
- A psychiatrist: doctor specialized in psychic disorders often serious, his consultations are reimbursed. He can perform psychotherapy and prescribe medication.
- A psychologist: a graduate of psychology, he can perform psychotherapies. The psychologist specializes in behavioral problems. It can also offer couples sessions.
- A psychotherapist or a psychoanalyst: be careful, they are not state graduates! Anyone can therefore call himself a psychotherapist or a psychoanalyst. Check that they are also a psychologist, psychiatrist or doctor.
When and who to consult: urgently in case of priapism!
Sexual Problems In Men: Specialists To Consult By Problem Type
|Issue / Specialist||General||Andrology||Urology||Psychiatry||Psychology||Sexology|
Treatment of Erectile Dysfunction and other sexual disorders
There are several possible treatments for different male sexual disorders. Sexual breakdown or impotence can be treated with medication. Psychotherapy is also possible, as for a decrease in libido or problems of anorgasmia or anejaculation. Aphrodisiacs have mostly a placebo effect. Premature ejaculation can be solved by masturbatory exercises.
The different treatments for male sexual disorders vary according to the condition, the patient and his medical history. Their price is also variable, from a few to a few hundred dollars for a session of psychotherapy.
- masturbatory exercises: they allow the man to regain control of his body and ejaculation;
- natural aphrodisiacs: they mainly have a placebo effect. The few that are effective can become dangerous without medical advice;
- prescription drugs, like Viagra, they solve erection problems. In self-service and on the Internet, they claim to treat everything, without always much success;
- psychotherapy: it allows to treat all the diseases of psychological origin, such as anorgasmia and the decline of the libido;
- vacuum pumps: they allow a mechanical erection, resulting in a blood flow into the penis, for problems of impotence;
- penile implants: implanted under the skin, inflatable or not, they allow a mechanical erection. They are less and less used because irreversible.
Treatment of erectile dysfunction: drugs
Male sexual disorders affect a large part of the population. In the case of sexual failures, helplessness and low libido, more and more men are looking for medications to restore a correct erection. Not all are effective: many charlatans offer placebo remedies. The consultation of a doctor is recommended. Once the diagnosis is made, he will prescribe the appropriate drugs, avoiding any risk of priapism for the patient.
Among pharmaceutical drugs: several solutions for erectile dysfunction. The conditions that are best corrected with medication are sexual breakdowns and impotence.
Several kinds of drugs exist:
- Tablets: Viagra, Cialis, Levitra, Ixense, Uprima, to take before intercourse. They help the penis to fill with blood for a proper erection. They are not recommended for people with heart problems.
- Intra-cavernous injections: Caverject, Edex, to be injected before intercourse. Without pain, they cause an erection.
- Intra-urethral gels: Muse, to be applied in the urethra. There are several unpleasant side effects, such as dizziness or visual disturbances.
There are also skin gels, like AndroGel, to apply to the skin. Prescribed to patients who suffer from testosterone deficiency, they diffuse this hormone. They can therefore help to solve the problems related to lack of testosterone: sexual breakdowns, impotence, low libido, premature or delayed ejaculation.
Medications for erectile dysfunction: attention to the risks of priapism
Trying to cure impotence could cause you to suffer priapism as described above. It is a persistent erection that does not fall back, and eventually becomes painful. It is most often the direct result of the use of drugs to stimulate erection, including intracavernous injections. This risk is not to be taken lightly. After several hours of continuous erection, other problems may appear, such as thrombosis, or potentially permanent impotence.
Therefore, it is not recommended to use erectile dysfunction medications without first consulting a doctor. He alone can prescribe the right medicine, according to your antecedents, and the right dosage. In the case of an intracavernous injection, the doctor will define with you the right dose to inject, to avoid any problem.
Couple psychotherapy against erectile dysfunction
Male sexual disorders such as sexual breakdowns or impotence can be solved through medication. But for some problems when they become recurrent, such as low libido or premature ejaculation, the best treatment is couple psychotherapy. The psychological origin of disorders such as anorgasmia is now verified, and the dialogue with a doctor is a rapidly effective solution.
The main cause of male sexual disorders is psychological, whatever the condition (except priapism which is purely mechanical). Psychotherapy or sex therapy are therefore possible in all cases. Couple therapy is recommended. It helps to identify any marital problems that interfere with sexual life. In general, about twenty sessions are necessary for a complete therapy. These sessions can be reimbursed by social security if they are prescribed by a doctor and performed with a psychiatrist.
Undertaking psychotherapy, sex therapy or couple therapy can update and relieve many psychological problems. These include:
depression, anxiety, stress, tension: these conditions, however benign, destroy the sex life and the daily life.
A doctor may prescribe antidepressants or anxiolytics to improve the general condition of the patient, while waiting for the therapy to take effect:
- a lack of self-confidence, a fear of sexual failure: sometimes following a previous failure, an operation, the fear of aging, the difference in age or experience with the partner, etc.;
- homosexuality that is repressed or badly experienced: this can provoke anorgasmia, anejaculation and sexual breakdowns;
- a strict education: resulting in sexual inhibition, ignorance, guilt or even fear of contaminating the partner by ejaculating;
- fear of pregnancy: often linked to marital conflict, etc.
Your general practitioner will refer you to the appropriate specialist. You can consult: a psychiatrist or psychologist: in a doctor’s office or in a medico-psychological center (CMP); a psychoanalyst or psychotherapist: consultations are never reimbursed; a sexologist: he can offer you a couple therapy.
Aphrodisiacs as natural aid in Erectile Dysfunction
Aphrodisiac products are known to cause or intensify desire. The concept is interesting for men suffering from low libido or erectile dysfunction. Many products are called aphrodisiacs: chocolate, oyster, ginger, rhinoceros horn, etc. Yet few of them are effective, and many are toxic at high doses!
Countless substances have long been considered as aphrodisiacs.
- food: chocolate, oysters, champagne, garlic, truffle, banana, avocado, cucurbits, red fruits, citrus fruit, red wine, etc.;
- condiments: nutmeg, mustard, saffron, ginger, chilli, cloves, cinnamon, coriander for women, etc.;
- exotic plants: ginseng, banded wood, guarana, maca, catuaba, etc.
Among these different products, very few actually have a vasodilating effect that leads to an erection. In case of persistent sexual disorder, it is advisable to consult a doctor rather than to test different aphrodisiacs little effective.
Some substances considered as aphrodisiacs have a high dose vasodilator effect, such as yohimbine and muira puama. That is to say that they allow an influx of blood into the vessels, especially those of the penis, thus causing an erection.
But this vasodilatation is not limited to the vessels of the genitals. In other words, these aphrodisiacs have an effect on the entire cardiovascular system. this effect can be dramatic, especially for men with hypertension or kidney failure. Similarly, Spanish fly is a product that causes inflammation of the urinary system, causing an erection. But this inflammation is very dangerous and can cause sometimes fatal kidney bleeding. Other products are toxic in high doses, like mandrake and nutmeg. Their consumption as an aphrodisiac is therefore strongly discouraged.
In the end, very few so-called aphrodisiac products have a real effect. Their intrinsic effectiveness is therefore not at all confirmed. The associated dangers make it an unattractive solution. In contrast, the placebo effect of aphrodisiacs is undeniable. The person who uses an aphrodisiac is convinced of its effectiveness. The psyche is relaxed, and the psychological worries blocking erection fade away. This placebo effect has worked for centuries in all civilizations and cultures.