Erectile Dysfunction (Erection Problems)
How's your love life?
A fulfilled sex life is indispensable for most functioning partnerships. So it is all the more problematic when sexual intercourse no longer satisfies both partners: if it's not satisfying, doesn't lasts long enough – or no longer happens at all – because of erection problems.
Men in particular appreciate the good feeling of being immediately ready whenever love is on the agenda. This requires an erection, the natural response to sexual stimuli.
However, the process does not always proceed as nature intended. There can be many different reasons why a man is unable to have intercourse with his partner. But this is only referred to as erectile dysfunction (ED) if he permanently fails to obtain an erection, and satisfying sex is no longer possible. In general, the term is used if most attempts at sexual intercourse over a period of more than three months are unsuccessful.
Although not everyone talks about it, many men are affected by ED. Back in 1995 the British Journal of Urology counted over 150 million men with the problem worldwide. An estimate by the National Institute of Health in 2002 put the number of men with ED in the United States at 15 to 30 million. The risk of ED generally increases with age.
A question of interaction
An erection is the result of a perfect interaction of nerve signals, neurotransmitters and muscle cells. It all begins with sexual arousal. This usually result from visual, acoustic or tactile stimuli, smells or fantasies. The brain coordinates these stimuli and sends out erection-triggering nerve impulses to the penis through the spinal cord.
The smooth penile muscle then initially goes limp, allowing more blood to flow into the erectile tissues. If stimulation continues, these finally become so filled with blood that the veins in the penis are pressed together, preventing the blood from flowing away. As a result, the penis becomes completely rigid – and the erection persists.
Erection problems usually have organic causes
This sensitive interaction is disturbed when a man has erection problems. As a rule, men who are affected tend to suspect stress or psychological problems as the cause. But these are hardly ever solely or directly responsible when things are not going well in bed. On the other hand, stress can lead to a lifestyle that ultimately furthers the development of erection problems – for example, if smoking and alcohol, high blood pressure and obesity are involved.
The fact is that about 70 percent of all potency problems have organic causes. In other words, the complex interaction of nerve signals, neurotransmitters and muscle cells is disturbed.
Apart from not obtaining an erection and the penis not becoming rigid enough, another early sign of developing ED can be a shortened period of erection. In this case, men initially have a erection, but it doesn't last long enough for satisfactory sexual intercourse. This more discreet sign can also point to a vascular disease and should be seen as a reason to seek professional help.
The influence of other diseases
Circulatory and vascular diseases in particular affect a man's ability to have an erection. For example, insufficient venous occlusion in the erectile tissues can result in the outflow of blood from the penis being too strong at the decisive moment. A weak erection can also be a consequence of high blood pressure – because the associated deposits in the blood vessels impede the circulation in the penis. Unfortunately, a weakening erection can also be a side effect of a drug therapy that has been prescribed to fight high blood pressure.
Another disease that can be accompanied by ED is diabetes, a metabolic disorder that also causes deposits in the blood vessels. This can ultimately disturb the flow of blood to such an extent that not enough flows into the erectile tissue. Furthermore, high levels of blood sugar often damage the nerves, which can in turn disturb the signal flow that triggers an erection.
Prostate disorders are also often linked to erection problems. Surgery, e.g. for carcinoma of the prostate, can damage nerves that are involved in the development of an erection.
Talk about it
If, on one occasion, a man does not have an erection or cannot maintain it, he doesn't need to worry. But if the problem persists over a longer period, talking about it openly is helpful. First, the partners should talk to each other. This is not always easy because most people don't talk much about their sexual thoughts, desires and problems.
Also the other partner should also be attentive – e.g. if he or she feels that their partner is turning away from them and tries to escape the relationship by spending too much time working, for example. Erection problems and a fear of sexual failure can be behind such behavior.
If the man is indeed suffering from erectile dysfunction, a physician should definitely be consulted. Such situations and conversations on erection problems are nothing out of the ordinary for a doctor, and he/she will usually handle the situation very professionally and discuss the matter with the patient in an appropriate manner. Typically, the physician will want to hear about any other diseases, such as diabetes, high blood pressure or Parkinson's disease.
An open and trusting conversation with the physician opens up the best chances of successful treatment. After all, very innovative and effective treatments have become available in recent years.
Innovative therapies
Although the term erectile dysfunction was only coined relatively recently, erection problems have probably always existed. And since time immemorial men have been trying to do something about it, to give their organ greater stability. Rhinoceros powder, extracts from beetles, ginseng root – many different means have been tried out, although the success of such treatments has not been proven by clinical trials.
By contrast, a class of active ingredients known as PDE5 inhibitors that have been extensively and successfully clinically tested has been available to men for several years now. These substances improve the inflow of blood into the penis – and with it the erection.
PDE5 is based on an enzyme (its full name is phosphodiesterase 5). One of this enzyme's normal functions is to ensure that an erection naturally subsides. Drugs that inhibit this enzyme thus stabilize the erection in men with erectile dysfunction.
Since the late 1980s, Bayer Schering Pharma has been involved in research into how enzymes from the phosphodiesterase group can be inhibited. In early years, this research was primarily associated with cardiovascular diseases. Then, as it became increasingly clear that erection problems can also have organic causes, PDE research also became relevant for this indication. Bayer Schering Pharma has since developed a PDE5 inhibitor that is effective and well tolerated, as proven by numerous clinical studies. This successful product has been on the market for several years in many countries.
So today, in many cases, it is no longer a problem to enable men with erection problems to quickly and reliably obtain an erection that also lasts long enough. The physician in conversation with the patient decides on a case-by-case basis which drug is best suited for a man. This enables a return to a fulfilling love life and thus to more satisfaction in the partnership.