All About Erectile Dysfunction

All About Erectile Dysfunction


By Dr Poosha Darbha , Sexology

A man is considered to have erectile dysfunction when he has persistent difficulty in getting or maintaining a firm enough erection to be able to achieve sexual intercourse.

To understand what causes erectile dysfunction or ED, it is important to first review how an erection occurs. For a man to have an erection, a complex process takes place within the body.

An erection involves the central nervous system, the peripheral nervous system, the vascular system, intact physiological and communication processes involving hormones, neurotransmitters, biological molecules like nitric oxide and importantly, psychosocial factors. Erection also requires healthy sex organs that include the testes, the accessory glands and most important – the penis. The penile portion of the process leading to an erection represents only a single component of a very complex process.

Forms of Erectile Dysfunction:
Broadly, two forms of erectile dysfunction can affect men’s sexual lives – the main cause is either physical (medical) or psychosocial.

Here, psychosocial refers to the psychological effects which include thoughts, feelings, expectations, reactions, habits, fears, anxieties, demands, disorders etc., and social factors which include but not limited to the effects of social circumstances, interpersonal relationships, religio-social systems etc. – on sexual performance. Medical conditions, such as physical conditions which may or may not be visible outwardly, functional defects, hormone imbalances, illnesses such as diabetes, health conditions such as obesity… and their impact on the psyche and the relationship, can also lead to ED. Often both medical and psychosocial factors coexist.

Erectile dysfunction used to be known more widely as ‘impotence’ before the causes became better understood and successful treatments came into use. Impotence is a term that is still in use, however, although it can be seen as pejorative.


1) Psychological Problems: Erection problems are caused by and can cause significant psychological and emotional reactions in most men. This is often expressed as a pattern of anxiety and tension that can further interfere with normal sexual function. Young men commonly experience “performance anxiety” and face situations where sex is demanded of them either by themselves or partner or circumstances. One episode of failure, regardless of cause, may propagate further psychological distress leading to further erectile failure. These factors need to be recognized and addressed by your doctor. Certain feelings can interfere with normal sexual function, including feeling nervous or self-conscious about sex; feeling stressed either at home or at work; or feeling troubled in your current relationship or feeling low sexual self-esteem. In these cases, psychological counseling helps a lot. The success rate is higher and the benefits last longer if the partner also participates in counseling.

2) Physical Problems: Physical causes for erectile dysfunction are much more common than once thought to be. Their incidence increases with age. In determining a physical (or organic) cause, your doctor will first rule out certain conditions, such as high blood pressure, diabetes, high cholesterol, heart and vascular disease, pituitary and sex hormone levels, other chronic illnesses, use of prescription and recreational drugs, habits like smoking and drinking which are all associated with erectile dysfunction.

In addition to these conditions, certain systemic and respiratory diseases are known to result in erectile dysfunction. A careful sexual case history, including psychosocial factors, physical examination, and any necessary laboratory tests will lead us to identify the root cause of the ED and help resolve it. Therefore, the first step would be to start seeking help from a competent sexual health-care provider.

Statistics reveal that only one in twenty of these men seek treatment. Men are often embarrassed to see a doctor, and prefer to avoid sex rather than seek help. There are many effective treatments available for this difficult condition, and every male facing the ED problem deserves to reclaim his blissful sex life through proper understanding and management of his problem.