Written by MOTUNRAYO JOEL - Nigeria
When a man finds it hard to get or keep an erection that is firm enough for sex, he is suffering from a medical condition known as erectile dysfunction.
Otherwise referred to as ED, studies have it that it affects as many as 30 million men and the condition has become highly visible in recent years.
On the causes of ED, many medical experts, who also referred to it as impotence, listed the most common as reduced blood flow to the penis due to chronic health challenges such as high blood pressure, high cholesterol, and hardening of the arteries.
Also psychological challenges such as depression, anxiety, and relationship issues are also possible causes of ED. Multiple sclerosis, spinal cord injuries, chronic back pain, and other neurological conditions, can trigger ED too.
A consultant urologist, Dr. Gabriel Ogah, opined that about one half of men between the ages of 40 and 70 experience ED.
On the severity, Ogah explained that, this also varies. According to him, some men have a total inability to achieve an erection, others have an inconsistent ability to achieve an erection, and still, others can sustain only brief erections.
"The variations in the severity of erectile dysfunction make estimating its frequency difficult. Many men also are reluctant to discuss erectile dysfunction with their doctors due to embarrassment, and thus the condition is under-diagnosed. Nevertheless, experts have estimated that erectile dysfunction affects 18-30 million men in the United States," he said.
Another consultant urologist, National Hospital, Abuja, Dr Atim Teraka, said sufferers of ED, who are middle aged risk cardiac arrest if care is not taken.
Stating that the same cholesterol plaques that can build up in the arteries surrounding the heart can also affect arteries that go through penile tissue, he said, "Once doctors rule psychological causes, they need to do a cardiac workup to make sure that the man is not on the verge of getting a heart attack.
"Since sexual arousal is a complex process involving hormones, emotions, nerves, muscles, blood vessels and the brain, a malfunction in any of these can lead to ED."
Tereka noted that anxiety over maintaining an erection can actually make it harder to attain. "Any condition that inhibits blood flow to the penis can lead to ED."
Ogah, still on the blood flow to the penis, maintained that, "When you are not sexually aroused, the penis is soft and limp. But with a sexual arousal, nerve messages release chemicals that increase blood flow into the penis. The blood flows into two erectile chambers made of spongy tissue in the penis. The 'smooth muscle' in the erection chambers relaxes, which allows blood to enter and stay in the chambers. The pressure of the blood in the chambers makes the penis firm, giving one an erection. After orgasm, the blood flows out of the chambers and the penis goes limp again."
With ageing as one of the factors listed for ED, Tereka listed other causes as, diabetes, obesity, low testosterone, peyronie's disease (scar tissue inside the penis), certain prescription drugs, such as antidepressants and high blood pressure medication, smoking, alcoholism or drug addiction and many others.