Marc Holland
Erectile dysfunction (ED) can be caused by a variety of factors, including vascular disease, neurological disorders, psychological state, trauma, and medication. Vascular disease, such as atherosclerosis, high blood pressure, high cholesterol, diabetes, or tobacco use, can block or narrow blood supply to the penis. Nerves that send impulses to the penis can be damaged by stroke, diabetes, or other causes, leading to ED. Psychological factors like stress, depression, and performance anxiety can also contribute to ED. Additionally, certain medication, injuries, and surgeries can impact erectile function. It is important to consult a healthcare professional to identify the underlying causes and explore treatment options, which may include medication, vacuum pumps, injections, counselling, or lifestyle changes.
| Characteristics | Values |
|---|---|
| Cause of erectile dysfunction | Vascular disease, neurological disorders, psychological state, trauma, medication, surgery |
| Factors that can affect how long an erection lasts | Age, medications, stress, being under the influence of alcoholic beverages |
| How to get and maintain an erection | Eat a healthy diet, maintain a body weight that's right for you, exercise regularly, avoid misusing drugs and smoking cigarettes, try to reduce or minimise your stress |
| How to treat erectile dysfunction | Medication, nonsurgical treatments like using a vacuum erection device, penile injections, suppositories |
| How to deal with sexual problems after a stroke | Talk about your feelings, have an active and healthy lifestyle, get help with low mood or depression, reduce anxiety about sex |
What You'll Learn
The impact of medication on erections
Medication can have a significant impact on erections. Certain prescription and over-the-counter medications can affect erections and lead to erectile dysfunction (ED). ED is a common problem, particularly for men over 40, and can affect self-esteem, cause embarrassment, and create issues in relationships.
Medications can impact erections in several ways. They may affect hormones, blood circulation, or the nervous system, or they may reduce libido. For example, blood pressure medications can decrease blood flow to the penis, contributing to ED. Diuretics and beta-blockers are the most common medications with ED as a side effect. Diabetes medication can also contribute to ED by lowering testosterone and sexual drive. Mental health medications, such as those used to treat depression and anxiety, can also cause ED.
In addition to prescription medications, recreational drugs can also impact erections. For example, cannabis use can restrict blood flow to the penis, leading to ED. Long-term cocaine use can cause ED by affecting blood vessels and reducing libido. Amphetamines can also narrow blood vessels, impacting blood flow and the ability to get or maintain an erection.
It is important to note that most medication-induced sexual side effects are not permanent. If you believe that your medication is affecting your erection, there are treatment options available. You may be able to change the dose or switch to an alternative medication. It is important to consult your doctor before making any changes to your medication.
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The psychological factors affecting erections
Erections are a complex interplay of psychological and physical factors. While physical factors such as vascular diseases, neurological disorders, and medication side effects can cause erectile dysfunction (ED), psychological factors also play a significant role.
Stress, Anxiety, and Depression
Stress, anxiety, and depression are common psychological issues that can affect sexual performance and desire. These mental health conditions can cause increased heart rate, blood pressure issues, and fatigue, hindering sexual arousal and performance. For example, stress triggers the release of hormones like adrenaline and cortisol, which can make it difficult to achieve an erection by decreasing blood flow to the penile arteries.
Relationship Issues and Communication Problems
Troubles in emotional relationships and poor communication with a partner can also impact sexual desire and function. Arguments, anger, and a lack of effective communication can spill over into the intimate aspects of a relationship, affecting sexual performance and satisfaction.
Fear of Sexual Dysfunction and Low Self-Esteem
Experiencing ED can lead to a fear of never regaining normal sexual function, causing low self-esteem and further affecting sexual performance. This can create a cycle of anxiety and sexual dysfunction that may be challenging to break without professional help.
Pornography Dependency or Addiction
Over-exposure to pornography can lead to "stage fright" during actual sexual performances and cause performance anxiety. Additionally, pornography can distort one's perception of sexual potential and performance, leading to nerves and emotional disturbances before sexual activity.
Guilt and Shame
Feelings of guilt and shame, often influenced by religious or cultural beliefs, can interfere with the brain's ability to achieve an erection. These negative emotions can act as a subconscious retaliation mechanism, reducing sexual pleasure.
Sexual Indifference and Lack of Excitement
A lack of excitement and interest in sex can lead to ED. Dopamine, a chemical in the brain associated with pleasure, excitement, and motivation, plays a crucial role in achieving an erection. When there is a lack of dopamine release due to monotony or tension in a relationship, it can contribute to ED.
Addressing these psychological factors often requires therapy, patience, and time. Cognitive Behavioral Therapy (CBT) is an effective treatment for ED, especially when linked to performance anxiety, low self-esteem, and reduced sexual arousal. Prioritizing mental health and seeking professional help are crucial steps in improving sexual function and overall well-being.
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How erections work
Erections occur when the penis becomes engorged with blood, causing it to expand, harden, and stand up and away from the body. This happens when the brain is stimulated, either by something seen, felt, heard, or smelled, or thought, and sends chemical messages to the blood vessels in the penis, causing them to relax and open up to let more blood flow in. The blood is then trapped under high pressure, resulting in an erection.
The penis consists of two chambers called the corpora cavernosa, which run the length of the penis and contain a maze of blood vessels shaped like a sponge. The urethra, or tube that carries urine and semen, runs along the underside of the corpora cavernosa. The shaft is the longest part of the penis, and the head or glans is at the end of the shaft. The opening at the tip of the head, where urine and semen come out, is called the meatus.
Erections typically occur when a person with a penis is sexually aroused, but they can also happen spontaneously. There are three types of erections: reflexogenic erections, which are triggered by physical touch; psychogenic erections, which are triggered by sexual memories or fantasies; and nocturnal erections, which occur during sleep.
Erections can be reversed when the muscles in the penis contract, stopping the flow of blood, and the pressure decreases, allowing the blood to flow out and the penis to become soft again.
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The physical factors affecting erections
Erections are a complex process that involves hormones, nerves, and a person's psychological and physical health. An imbalance in any of these areas can lead to erectile problems, including erectile dysfunction (ED). Here are some of the physical factors that can affect erections:
- Blood pressure and medication: Higher blood pressure can damage blood vessels, including those necessary for an erection. Additionally, some medications used to treat high blood pressure can cause problems in achieving and maintaining an erection.
- Weight: Being overweight can contribute to high blood pressure, diabetes, and hormonal shifts, all of which can impact erections.
- Depression and its medication: Depression and other mood disorders can lead to issues with erections. Similarly, medications used to treat depression can affect erections and libido.
- Sleep disorders: Researchers have found a correlation between sleep disorders such as sleep apnea and ED.
- Alcohol consumption: Excessive alcohol intake can damage the liver, brain, and testicles, which produce testosterone. This can have a significant impact on sexual health.
- Vascular disease: Blood supply to the penis can become blocked or narrowed due to vascular diseases like atherosclerosis, which can be caused by high blood pressure, high cholesterol, diabetes, or tobacco use.
- Neurological disorders: Nerve damage due to stroke, diabetes, or other causes can affect the nerves that send impulses to the penis, leading to ED.
- Physical trauma: Injuries to the pelvic region or reproductive organs can contribute to ED.
- Surgery: Surgeries involving the prostate, bladder, or other organs in the reproductive system can impact erections.
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Treatment options for erectile dysfunction
- Oral medications: Prescribed medications such as sildenafil (Viagra), vardenafil (Levitra), or tadalafil (Cialis).
- Testosterone replacement therapy: Can be considered if testosterone levels are low, but it is not recommended as a first-line treatment.
- Urethral suppositories: Small drug pellets inserted into the tip of the penis to induce an erection in about 10 minutes, lasting 30 to 60 minutes. May cause minor bleeding or a burning sensation.
- Penile injections: A medicine that improves penile blood flow is injected at the base of the penis using a small needle. This is a self-injection that patients can administer themselves after proper training. Side effects may include minor pain, bleeding, prolonged erection, and scar tissue formation.
- Penile implants: A surgical procedure that places a water-based device into the erection chambers of the penis, allowing control over erections. It has a high satisfaction rate but may not be suitable for everyone.
- Vacuum erection device (VED): A penile pump that uses suction to manually pull blood into the penis, combined with a tension ring to maintain the erection for about 30 minutes. This method may restrict ejaculation and cause the penis to feel cold.
- Addressing underlying health conditions: ED is often linked to other health issues like high blood pressure, heart disease, anxiety, or depression. Treating these conditions may help alleviate ED symptoms.
- Lifestyle changes: Recommended changes may include limiting alcohol consumption, increasing physical activity, maintaining a healthy body weight, and stopping illegal drug use.
- Alternative medicines: Some people find that certain natural remedies or supplements help them get and maintain an erection. However, not all of these are safe, and they should be discussed with a healthcare professional.
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Frequently asked questions
There are many reasons why you might not get an erection until you stroke your penis. These include:
- Vascular disease: Blood supply to your penis can become blocked or narrowed as a result of vascular diseases like atherosclerosis due to high blood pressure, high cholesterol, diabetes or tobacco use.
- Nerve damage: Nerves that send impulses to your penis can become damaged from stroke, diabetes or other causes.
- Medication: Some antidepressants and blood pressure medicines reduce libido and performance.
- Lifestyle factors: Obesity, stress, anxiety, depression, smoking, alcohol and drug use can all contribute to erectile dysfunction.
- Hormone imbalances: Hormone imbalances can sometimes be due to a stroke, leading to a wide range of problems including difficulty getting an erection.
- Fatigue: Tiredness and fatigue are common problems after a stroke and can make it harder to engage in sexual activity.
If you are concerned about not getting an erection until you stroke it, you should consult a doctor. They may be able to prescribe medication such as Viagra or Cialis, or recommend lifestyle changes such as losing weight, stopping smoking, reducing stress and increasing physical activity.
Other common issues with sex after a stroke include:
- Loss of interest in sex: This could be due to body image concerns, fatigue, or medication side effects. It may help to have sex after resting or in the morning when you have more energy.
- Communication issues: If you are experiencing communication issues after a stroke, you can learn other ways to communicate your sexual needs, such as through touching and caressing.
- Physical discomfort: You may need to experiment with different positions to find what is most comfortable. Pillows or props can protect the weaker side of the body, and the more mobile person should assume the top position.
