Erections are mysterious things that seem to have a mind of their own. Most men have problems with erections from time to time. But some men have erectile dysfunction or ED. This is when it is hard to get or keep an erection firm enough for sexual intercourse.
Decreased blood flow, typically because vessels that supply blood to the penis have narrowed, is often the cause of erectile dysfunction (ED) in older men. Emotional issues are more commonly at the root of it for younger men. Regardless of the reasons, it’s essential to look for answers.
What is the erection deficit?
Erection deficit is defined as partial or total difficulty maintaining an erection until sexual activity is completed. The causes of this sexual problem can be physical and psychic, related to personal history and the couple’s relationship. Often factors of both types combine to cause and maintain erection difficulties.
Causes and diagnosis for ED
An erection deficit is a problem that generates fear and anxiety, and the first consultation is critical in determining a relationship of trust between the doctor and the patient. A frank and precise description of the disorder is required. It is necessary to know if this is accompanied by a decrease in desire, by ejaculatory dysfunctions or by orgasmic difficulties.
A few years ago, it was thought that about 90% of erectile deficits were of psychological origin. Still, recent studies and numerous andrological research have shown the presence of a predominantly organic cause in more than 50% of cases.
An erection disorder can have an endocrine cause, both due to a testosterone deficiency and an excess of inhibitory hormones, particularly prolactin. However, the overall incidence of hormonal erectile deficits does not seem to exceed 5% of cases. In some cases, however, general blood chemistry, testosterone, and prolactin evaluation may be useful.
When an older man experiences erectile dysfunction, there is often a physical problem to be solved. Still, in boys between 20 and 30 years of age, the cause is usually attributed to a psychological problem.
The feelings of sexual arousal that lead to an erection start from the brain. But conditions like depression and anxiety can significantly interfere with this process. A meaningful sign of depression is withdrawal from things that once brought pleasure.
Workplace stress, money, and other concerns contribute to the development of erectile dysfunction. Alcohol and drugs are common causes of erectile dysfunction among young people. Also, a couple of problems and poor communication with a partner can cause sexual dysfunction in men and women.
Then, for some young people, the desire to perform well in the sexual sphere can be so important as to lead to a very high level of anxiety, which causes the absence of an erection. “When a young boy experiences erectile dysfunction, it is often associated with significant performance anxiety, which can increase the problem, turning a temporary situation into a permanent problem,” says Jerome Hoeksema, professor of urology at the Rush University Medical center of Chicago. The more you worry about it, the worse it. Young people need to recognize this cycle and reduce stress linked to sex.
Boys are often under high stress in occasional relationships or on a first date. In certain situations, it is easy for the penis not to become hard or lose the erection suddenly due to high tension.
Also, in younger boys, performance anxiety is often caused by the fear that having sex can cause pregnancy. Often, then, young people do not use a condom because the time used to put it causes sexual excitement to pass. But this increases anxiety about pregnancy risk even more.
What are the physical causes of erection difficulties?
From a physical point of view, the erection deficit can be the indicator of more critical diseases, for example, cardiovascular type. The difficulty in maintaining an erection can anticipate a myocardial infarction or an attack of angina by about three years.
The erection deficit can be a sign of hypertension that has not yet given other indications of itself.
Even the excess cholesterol is the enemy of erection. In this case, the vascular damage that underlies the erection deficit is due to the accumulation of “clods” of cholesterol along the vessels’ walls. This causes atherosclerosis, which then causes the loss of elasticity of the blood vessels due to the progressive hardening of their wall: an alteration known as arteriosclerosis. It reduces the vessel’s lumen and, therefore, the blood flow, while the increased rigidity correlates with the increase in diastolic pressure, i.e., the minimum pressure.
Diabetes can damage erection in different ways:
a) vascular (“diabetic microangiopathy”) for the damage that high (or poorly controlled) blood sugar causes on the vessel wall;
b) neurological (“diabetic neuropathy”), for the suffering of the nerve endings, especially of the “autonomous” system, which coordinates involuntary functions, including an erection;
c) hormonal: poorly controlled diabetes, primarily type 2, is associated with overweight, which leads to hormonal changes in the levels of testosterone, the male hormone. A lower level of this hormone reduces desire and makes the erection more problematic;
d) neuropsychic: depression is often associated with diabetes and erection problems.
In other cases, neurological diseases, such as multiple sclerosis, damage the nerve mechanisms that coordinate erection. Spinal cord trauma, when they cause paraplegia, i.e., paralysis of the lower limbs, can also cause erection problems.
Hormone problems of any kind, such as low testosterone, can also be responsible for erectile dysfunction. Another hormonal cause is the increase in the production of prolactin, a hormone produced by the pituitary gland. Too high or low thyroid hormone values can also cause erectile dysfunction. Young people who use steroids to gain muscle mass are at risk of facing this problem.
For some young people with erectile dysfunction, healthier nutrition, exercise, and weight loss can help minimize the problem. Quitting smoking cigarettes and consuming alcoholic beverages can also lead to better results.
Smoking is a risk factor for erectile dysfunction, according to the 2014 US Surgeon General Report. Excess weight can also be a cause of this problem. Young people who use or abuse drugs and alcohol are more likely to develop erectile dysfunction. Abuse of substances that can damage blood vessels, including those that feed the penis, can make an erection more difficult.
Performance anxiety can aggravate other causes, such as communication problems with your partner. A therapist or other mental health professional may be able to help young people who face this problem. Treatment of depression, for example, can help erection problems disappear.