Sexual life is one of the factors that directly affect the quality of life and longevity. Research conducted by the World Health Organization shows that a healthy sex life is closely related to a person’s overall health, especially for men, and it is an important part of keeping men physically and mentally healthy. Unfortunately, we often neglect the quality of men’s sex life. While a number of health issues can cause erectile dysfunction, there are still solutions. In fact, erectile dysfunction is treatable with a visit to a regular hospital where your doctor will explain your condition in detail while providing you with the best treatment options. Structure of the penis Erection is mainly related to the two penile corpus cavernosum and the nerves, arteries and veins distributed in them. What is erectile dysfunction? Erectile dysfunction, commonly known as “impotence”, is a condition and a symptom that means a man is unable to achieve or maintain the level of erection needed for satisfactory sexual activity. Men may occasionally face erectile dysfunction during their lifetime, but for some men, the problem may occur from time to time. In this country alone, more than 100 million men suffer from erectile function. Under what conditions does the penis become erect? An erection first requires the brain to receive appropriate sexual stimulation, and then the nerves, blood vessels, and testosterone begin to work in concert. When a man is sexually stimulated, the arteries within the penis relax and expand, allowing more blood to flow into the penis. As the arteries within the penis expand until the penis stiffens, the veins responsible for exporting blood out of the penis are then squeezed, reducing the flow of blood out of the penis. Thus, as more blood enters the penis than flows out, the penis enlarges and an erection is maintained. Weak state: In the absence of sexual arousal, the penis is in a weak state because blood flows through the arteries into the cavernous body of the penis and then flows back through the veins. Swollen state: When stimulated by audio-visual stimulation or sexual fantasy, more and more blood starts to flow to the penis, and the penis starts to swell and harden, but it is not hard enough to start sexual life. Erectile state: When the penis is filled with more and more blood, the tissues compress the veins so that the blood cannot flow back, the blood fills up in the cavernous body of the penis, and the penis is firm to reach sufficient hardness. What causes erectile dysfunction? Men with erectile dysfunction have abnormal penile erection chemistry, where the arteries cannot expand sufficiently and the penis cannot fill with blood. It used to be thought that erectile dysfunction was mainly a psychological problem or an inevitable part of the aging process. However, we now know that in most men who suffer from erectile dysfunction, personal health is closely related to the occurrence of erectile dysfunction. The penis can only be erected when the blood flow, testosterone levels, nerve conduction and brain arousal in your body are normal, and problems in any link in this chain of reactions can lead to erectile dysfunction. Causes in blood flow: If the blood flow in the penis is too low, such as arterial blockage, or fibrosis in the corpus cavernosum, the blood inflow will be slow and the penis will not be able to get an erection; diabetes, smoking, taking certain drugs, or pelvic radiotherapy can also cause changes in its hemodynamics. Testosterone level: Testosterone is an important male hormone, if the level of testosterone is low, sexual arousal will be slow to start, thyroid or pituitary gland lesions and testicular insufficiency can lead to a decrease in testosterone level, a blood test can detect your body testosterone level. Psychological reactions: Fatigue, depression, anxiety and depression can all reduce the excitability of the brain, leading to a shift in attention and a decrease in your own sexual attractiveness. Neurological effects: Sexual stimulation signals can be transmitted through the nervous system to the brain. Spinal cord injury, uncontrolled diabetic blood sugar or pelvic surgery (e.g. rectal, prostate, bladder surgery) may damage the nerve pathways and thus affect erectile function. In general, erectile dysfunction can be divided into three types from etiology: organic, psychogenic and mixed. Organic: caused by abnormalities or damage to blood vessels, nerves, sex hormone levels, or the penile corpus cavernosum itself. It is characterized by a slow onset and clinically significant contributing factors. Most patients do not have penile erection in the morning when they wake up. Psychogenic: caused by purely psychological factors, such as economic stress in life or marital disharmony. It is characterized by a sudden onset, a young age, and a normal erection in the morning when waking up or under other conditions. Mixed: Patients with a combination of organic and psychological factors that cause erectile dysfunction. Age and erectile dysfunction In men in their 20s, erections do not require much stimulation, are rapid, and a second erection can begin quickly after orgasm. Men in their 40s require longer stimulation and caresses before erection, usually several minutes, and the time between orgasm and second erection is longer than in younger men. In men around 60 years of age, erections are less likely to occur, take more time to occur, and there are difficulties in maintaining an erection. Men around 80 years old can enjoy sexual pleasure as much as their health allows, but erections do not always lead to orgasm and the sexual pleasure at orgasm is much less than before. Diabetes and Erectile Dysfunction It is well known that diabetes is one of the most common causes of erectile dysfunction. As many as three out of five men with diabetes will have varying degrees of erectile dysfunction. Penile erection depends on two factors. One is adequate blood flow to the penis, and the other is local nerve stimulation. Diabetes causes lesions in the blood vessels, reducing the flow of blood to the penis; diabetes causes loss of sensation in the nerves near the penis, limiting the nerve endings that contribute to the stimulation response to an erection. Men with type I diabetes (insulin-dependent diabetes) generally have the disease for a longer period of time and can develop erectile dysfunction early in life. In contrast, men with type II diabetes (insulin non-dependent diabetes) tend to develop the disease later in adulthood and develop erectile dysfunction later. When diabetes is not properly controlled, it can lead to transient erectile dysfunction until it is corrected by medication or diet. In addition, there are men who have had diabetes for many years and have irreversible erectile dysfunction, but these patients are also treatable. Heart disease and erectile dysfunction If you have heart disease or other cardiovascular disease, the function of the arteries that carry blood to the organs of the body may be affected, and without an adequate supply of oxygen and nutrients, these organs may be damaged and their function diminished. Because erections depend on adequate blood flow to the penis, any disease that affects the blood vessels may be associated with the development of erectile dysfunction. It is estimated that four out of five men with cardiovascular disease have experienced or are experiencing erectile dysfunction; three out of five men with heart disease have suffered from erectile dysfunction; and about half of men who have undergone heart bypass surgery also face this problem. Cardiovascular drugs and erectile dysfunction According to a study, 28% of men taking cardiovascular drugs experience erectile dysfunction. Diuretics and beta blockers have the highest chance of erectile dysfunction. When men experience erectile dysfunction as a result of taking cardiovascular medications, they should seek medical advice as soon as possible. Most patients can change the type of medication without delaying the treatment of the disease and will improve their erections. Certain antihypertensive drugs have been shown to cause erectile dysfunction. When a man has erectile problems as a result of being treated for high blood pressure, your doctor may be able to adjust your medication so that the same efficacy is maintained while also improving erectile function. High blood pressure and erectile dysfunction High blood pressure is often compared to the “silent disease,” and in the absence of symptoms, high blood pressure may already be causing a variety of health problems. One of these is erectile dysfunction. Not only does high blood pressure increase the load on the heart, but it can also put an unnecessary burden on the blood vessels, causing them to harden and constrict. In this case, the arteries are unable to carry the amount of blood needed for organs such as the penis, causing damage to these organs and diminishing their function. Prostate disease and erectile dysfunction Men should be well prepared when deciding to have prostate surgery. Surgery can solve important health problems caused by prostate disease, but after surgery, they may have to face another new problem in their lives – erectile dysfunction. The most common procedure used to treat BPH is removal of the prostate through the urethra, while radical prostatectomy is often used for prostate cancer. Erectile dysfunction is the most common side effect of both surgeries. Since penile erection depends on healthy nerves and blood vessels, surgery or trauma that affects the nervous or vascular system associated with the penis is associated with the development of erectile dysfunction. It is estimated that up to 57% of men who have ever undergone surgery for prostate cancer have problems with erectile dysfunction. Most patients with erectile dysfunction are also treatable, whether or not it is related to surgical trauma or therapeutic drugs. Spinal cord injury and erectile dysfunction Spinal cord injury can affect the function of many systems in the body, and sexual function is often involved. Many men with severe spinal cord damage have a troubled sex life and are unable to enjoy it. Erections depend on healthy nerves and blood vessels, and for patients with spinal cord injuries, the degree of erectile dysfunction is related to the severity of the trauma and the location of the spinal cord injury. In general, patients with severe trauma to the lower spinal cord have a higher chance of developing erectile dysfunction than those with upper spinal cord injuries. Although only one out of four patients with spinal cord trauma had a level of erection that allowed them to perform**, most patients could regain sexual function with treatment. Depression and erectile dysfunction Depression can take all the fun out of life, affecting not only one’s mood, but also one’s physical condition. Many men who have been treated for depression have been found to suffer from erectile dysfunction. For depressed patients, erectile dysfunction can be caused by either psychological or physical factors, or both. Erectile dysfunction had exacerbated feelings of depression in most men, causing them to lose self-esteem, have a low self-image, feel anxious, and at the same time become strained in their relationship with their spouse. These worsening emotions can make it more difficult to get an erection. A study showed that 25% to 90% of depressed men may have varying degrees of erectile dysfunction, and the cause of depression-induced erectile dysfunction is not yet known. But most of these patients are treatable. Of course, the side effects of certain antidepressants have also been shown to cause erectile dysfunction. Lifestyle habits and erectile dysfunction Certain lifestyle habits may contribute to erectile dysfunction. Changing or quitting these habits will help improve one’s health and quality of sexual life. Smoking: In addition to causing cancer, emphysema and other diseases, smoking can also seriously affect blood circulation. One study showed that men who smoked with high blood pressure or other health risk factors had twice the chance of developing severe erectile dysfunction compared to non-smokers. Alcohol abuse: Alcohol should be consumed in moderation and should not exceed two drinks per day. Alcohol has a sedative effect on the nervous system and therefore may affect the ability to get an erection. Therefore, it is said that “alcohol increases sexual desire but decreases sexual function”. Taking banned substances: Taking banned substances such as marijuana and heroin can not only cause a myriad of health risks, but can also lead to erectile dysfunction. Stress: Stress and anxiety can both affect the erotic response. Try to find ways to help relieve stress, such as exercise, yoga, gardening and dancing. Of course, if you are unable to relieve your stress, you can seek treatment from a psychologist. Effects of Erectile Dysfunction on Partners The negative effects of erectile dysfunction on a man’s mood can have a serious impact on his relationship with his partner. Research studies have shown that erectile dysfunction can be associated with depression, loss of self-esteem and a low self-image. You may think that erectile dysfunction is part of the natural aging process, or that loss of sexual desire is a normal part of life, or that your partner doesn’t find you as attractive as he once did. However, erectile dysfunction is an important part of physical health, not an inevitable part of getting older, and it is treatable. Proper treatment can begin with the patient’s partner. Without the encouragement, support, care and love of a partner, and the determination to seek a solution, many men may not actively seek treatment. It is important for men to understand that erectile dysfunction is a health issue, not a matter of manhood. A harmonious and fulfilling sex life is equally important for both men and women. Once erectile dysfunction occurs, both partners need to work together to find treatment and solve the problem. Put down the baggage and take the initiative to seek help Regardless of the patient’s age, the cause of the erectile dysfunction or how long the condition has been present, most patients with erectile dysfunction are treatable. First, you need to go to a regular hospital and ask your doctor for advice. Remember, this is not something to be embarrassed about. Your doctor will understand and support you, while maintaining your confidentiality. Most erectile dysfunction is related to common chronic conditions. Maintaining communication with your partner can maintain intimacy and make emotional encouragement. Many men find that their partners are willing to participate in the treatment of erectile problems in order to share the intimacy of sex again. Seeking appropriate treatment with your doctor and partner to manage chronic conditions and erectile dysfunction will allow you to enjoy your life again, spend romantic time with your partner, develop sweet feelings, build a stronger relationship and make the most of your life. Sex Index When you go to the hospital for an examination because of erectile problems, your doctor may first ask you to fill out a scale – the Sex Index Test. There are five questions to answer, and you can circle the appropriate answer on the form. The doctor will then add up the scores for the answers you choose and come up with a total score, which is used to initially determine your erectile function. If your score is below 21, you may have erectile dysfunction. Do not ignore it, because it is not only a sexual health problem, but also a precursor to cardiovascular disease. Common tests for erectile dysfunction General examination: Erectile dysfunction may be a sign that you have other medical conditions. Your physician must assess your general condition, possibly examining your penis, scrotum and testicles, and tell your physician about all your medications, both prescription and over-the-counter. You may also need to undergo the following tests: blood tests, lipids, sex hormones, blood sugar, liver and kidney function, prostate, blood flow tests (ultrasound to detect blood flow velocity in the penis), and cavernosography. Rectal testing: to evaluate the presence of other factors that affect your sex life.