What is Erectile Dysfunction (ED)?
By definition, erectile dysfunction is characterized by repeated inability to achieve and/or maintain erection necessary to engage in a satisfactory sexual intercourse. Since 1992, the term „impotence” has not been used due to its pejorative meaning.
Erection is a result of a number of cooperating neurological, vascular and hormonal factors, which lead to firming and enlarging of the penis due to inflow of blood into the cavernous bodies within it. Under the influence of nervous impulses, flowing from the brain structures (the thalamus, the hypothalamus and the limbic system) to the spinal cord, the peripheral nervous system is stimulated, blood flow increases and so does the pressure in the cavernous bodies of the penis. Improper functioning of this complicated mechanism leads to temporary or permanent erectile dysfunction.
There are many causes of erectile dysfunction. The most frequently reported concomitant diseases, which predestine the patient for ED, include diabetes, atherosclerosis, arterial hypertension, increased concentration of cholesterol in the serum and disorders of the prostatic gland. Other factors include obesity, injuries of the spinal cord, multiple sclerosis, neurological diseases, endocrine disruptions, damages to the cavernous bodies and excessive use of alcohol and smoking. Erectile functions can also be influenced by psychological factors, such as chronic stress, tiredness, lack of sleep, anxiety state, low self-esteem, fear of encounters with women, depression and many others.
Sporadic erection problems are not classified as erectile dysfunctions – these relate to situations, in which at least 25% of attempts made to engage in a sexual intercourse are failed. Erectile dysfunctions of various intensity concern millions of men around the world, resulting in anxiety, lack of confidence, tension in relationships and depression. They are related to many factors, such as lifestyle, concomitant diseases and medications used. It is assessed that various degrees of erectile dysfunction may occur even in 50% men after 40 years of age.
In the face of such complex problem, “customized” therapy of erectile dysfunctions should take into account modification of all risk factors, associated with a given patient. Apart from pharmacological treatment, psychological consulting should be treated as a significant therapy component.
Prepared on the basis of:
- Heruti et al. Prevalence of Erectile Dysfunction Among Young Adults: Results of a Large-scale Survey. J Sex Med 2004;1:284-291
- W. Skrzyński. Wybrane Zagadnienia Psychologii Klinicznej. Warszawa 2011. Available at http://pedagogium.pl/dokumenty/materialy/Materialy_Skrzynski.pdf (cyt. 20.09.2016).