MALE HEALTH
ERECTILE By Gareth McCabe I
f we are honest most men occasionally fail to get or keep an erection which usually results from
stress, tiredness, anxiety or excessive alcohol consumption and is nothing to worry about. However, once it does become a common occurrence then it would be an indicator for referral to a GP.
Before we look at the main causes of ED, it is beneficial to get an understanding of how an erection occurs. The penis is an organ with paired erection chambers (corpora cavernosa). Erection is caused primarily by the flow and storage of blood into the penis and therefore into the erection chambers. This flow of blood is regulated by hormones
36 - PHARMACY IN FOCUS
and nerves to build up pressure within the penis and create rigidity. This all begins by stimulation either directly on the genitalia or through stimulation from the brain.
Upon stimulation, chemicals are released in the brain that cause signals to pass down the spinal cord and outward through special nerves into the penis. These nerves release another chemical (Nitric Oxide) that causes the aforementioned smooth muscle to relax and blood rushes into corpora cavernosa, causing erection2
.
Therefore in order for a man to successfully achieve and maintain an erection, a good blood supply, connecting nerves, the desire to be intimate and stimulation are required. If one or more of these aren’t working
DYSFUNCTION
ERECTILE DYSFUNCTION (ED) IS A CONDITION WHERE THERE IS AN INABILITY TO GET AND MAINTAIN AN ERECTION LONG ENOUGH TO HAVE SEXUAL INTERCOURSE. IT IS A VERY COMMON CONDITION AFFECTING HALF OF MEN BETWEEN THE AGES OF 40 AND 70 YEARS TO SOME DEGREE1
properly, a man may not be able to get or keep an erection long enough for sexual intercourse (3)
CAUSES OF ED:
This leads us into the causes of ED. The causes can be classed as either physical or psychological. The main cause in 40-70 year olds can be attributed to an underlying medical condition. See below the list of physical conditions that can lead to ED4
:
• Vasculogenic conditions: cardiovascular disease (CVD), hypertension, hyperlipidaemia/ arthrosclerosis and diabetes.
• Neurogenic conditions: multiple sclerosis, Parkinson’s disease, stroke, diabetes and spinal injury
or disorder
• Hormonal conditions: Hypo- and hyperthyroidism, hypogonadism (low testosterone level), Cushing’s syndrome (high cortisol level),
• Surgery and radiation therapy for bladder, prostate or rectal cancer
• Injury to the penis • Side effect of prescribed drugs • Recreational drug use • Excessive alcohol consumption
POSSIBLE PSYCHOLOGICAL CAUSES OF ED INCLUDE (5):
• stress, • anxiety • depression, and • relationship problems.
Not surprisingly erectile dysfunction is more common and has a greater likelihood of happening to those who are overweight, smoke and are not active enough.
It is worth noting that ED can be the first sign of future heart problems, especially if the diagnosis is that of atherosclerosis. The narrowing associated with atherosclerosis, that
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