The inability to maintain an erection while having sex haunts men more than anything else and half the questions we receive on our Q&A section ask for tips to deal with this condition. Technically speaking, an erection is caused due to the hydraulic effect of blood entering and being retained in spongy bodies within the penis. In most males, this happens when they’re sexually aroused thanks to signals transmitted from the brain to nerves in the penis. Both the brain (to send a signal) and the heart (to pump blood to the penis) must work properly to get and maintain an erection. ED occurs whenever any of the proceedings are disrupted.

Impotence and infertility are not the same

Sometimes, perhaps due to similar vernacular words, people tend to use the terms impotence and infertility synonymously. It’s important to understand the difference. Impotence is the inability to get an erection whereas infertility (or sterility) is the inability to father children. They are not related or synonymous in anyway.

So what causes ED?

The various causes of ED but they can be broadly categorized under two categories: Physiological  or physical (pertaining to the body) and psychological (pertaining to the mind)

Physiological Causes of ED

There are various things that we do to our body that can cause impotence:

Alcohol-consumption, smoking and drugs: The cliché sex, drugs and rock ’n’ roll is actually very wrong. Substance abuse makes it hard for your heart to pump blood and it also robs your off your libido. Drinking and drugs can cause temporary and permanent ED. While temporary ED goes away when we aren’t under influence, research has shown that as many as 60-70% heavy alcohol consumers suffer from permanent erectile dysfunction. Smoking too is a big culprit; it’s the biggest cause of ED among men under 40. In the long term, all these activities constrict your blood vessels and prevent adequate blood flow to the penis.

Diabetes:  Around 50% men with diabetes suffer from ED. In fact ED is one of the most common symptoms of diabetes. The elevated blood glucose level and nerve damage leads to inadequate blood flow and nerve damage to the penis.

Obesity: Another big reason is your extra girth (not in the right places) and not just because of low self-esteem. Most fat men tend to have high cholesterol which causes clogged arteries and prevents efficient blood flow. They also tend to have heart disease, hypertension, diabetes, higher stress levels and other obesity related issues which don’t bode well for your penis.

Medicinal Side-effect: ED can be a side effect of many common medicines such as blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants.

Other diseases and conditions that might cause ED: Diseases like high blood pressure, nerve disease or nerve damage, multiple sclerosis, atherosclerosis, and heart disease-account for the majority of ED cases. Spinal cord and brain injuries, nerve disorders such as Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, and stroke. Sometimes surgery, especially radical prostate and bladder surgery for cancer causes ED.

Besides the aforementioned physical causes of ED there might be some psychological causes as well. Men who are suffering from depression, anxiety-related conditions and other mental health problems tend to suffer from the disease. Drugs used to treat these conditions like anti-depressants can also cause problems.

While sex is a great stress-buster, the opposite is also true – stress can lower your libido and cause ED. Actually, stress is often synonymous with physical conditions like obesity, heart disease, hypertension, etc. Some simple lifestyle changes, exercising regularly, getting enough sleep, taking some time off and seeking professional help in extreme cases can help you get over stress-related ED.

Sometimes the problem can lie in your mind. Scores of porn viewings and urban myths give guys the idea that sex is supposed to be a certain way and when it doesn’t happen exactly like they saw onscreen it can affect them. It can lead to performance anxiety and snowball into a major self-esteem issue. The most important thing to remember is that sex is supposed to be simple and fun. Just be comfortable with what you’re doing, you don’t need to strut like a porn star.

Treatment for impotency

Prescription medications such as Viagra, Cialis, and Levitra all treat the condition. All three of these medications work the same way, by helping increase blood flow to the penis. The medications are taken a half hour before sex and the effects can last from 4 to 5 hours. However these drugs all have serious side-effects and it is important to talk to your doctor and discuss your entire medical history before taking any of these drugs. As a last resort there is a surgical procedure which involves the implantation of a prosthetic device in the penis. A similar method is used in female-to-male sex change operations.

ED due to psychological reasons can be overcome by visiting a psychiatrist who can help us get to the root of the problem. We usually find the notion outrageous, that we discuss our sex life with strangers, but professional help is the best way to deal with the condition. And lastly the best solution is the simplest – talk to your partner about it.

Read: Revealed – the average size of the Indian penis!

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