Mental (psychological) Reasons
All sorts of factors, such as stress, anxiety, worry, and fear of failure reduce erectile function. Most of the time, problems in the relationship with the Wife or girlfriend are the cause of psychologically induced impotence. It is not the body that does not work, but the psyche: if you think too much during sex, the erection often fails to materialize. Every man has a phase of psychological impotence in his life. This form of impotence is temporary and actually quite normal.
This is called fear of failure: the man is afraid of not getting an erection or not getting a satisfactory erection and not being able to satisfy the woman: he is afraid of failing. And that is precisely why the erection will not be satisfactory: The psyche is preoccupied with the thought of performing, but not with the feeling, “having great sex”.
Physical (physical or organic) Causes
Many diseases of the human body can result in impotence, including:
Diabetes; Vascular disease, and thus calcification of the veins, high blood pressure and high cholesterol;alcoholism; Nerve disease or nerve injury (e.g., a nerve contusion in lumbago).
Certain medications (such as drugs for high blood pressure or depression) and certain surgeries (especially in the small pelvis) also cause impotence.
Most often, it is a disease of the blood vessels. A high percentage of cardiovascular diseases is typical for our society. And the blood vessels of the penis are affected by the impairment of blood vessels elsewhere in the body. Worse yet, because the blood vessels of the penis are so fine, they get damaged even faster!
Smoking is also proving to be a very big culprit here! It has been proven that smokers suffer from increased damage to the fine blood vessels that supply them. So this certainly applies to the blood vessels in the penis as well.
Besides the deviations of the supplying veins, sometimes the draining veins are also the cause of impotence. When veins are not completely closed, the pressure in the corpora cavernosa can never get high enough to lead to an erection; this is called “venous insufficiency”.
Combined Causes
Often the cause is both physical and mental. One cause may trigger or influence the other: In the case of physical abnormalities, one gets After a certain period of time, one gets a fear of failure, so that the erections become even worse due to the psychological constitution…
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Extensive Clarification
Before any therapy is planned or carried out, it is essential to clarify the cause of the erectile dysfunction. The clarification includes above all a detailed anamnesis (detailed questioning of the patient), a detailed physical general examination as well as the determination of hormonal blood values and the control of the liver and kidney function. liver and kidney function. Erection can be stimulated by injection of vasoactive substances into the corpus cavernosum, and before as well as after this injection are Doppler sonographic measurements of the blood vessels in the penis are informative.
Therapy Options
As far as the therapy of erectile dysfunction is concerned, drugs such as the well-known Viagra are available today. Some precautions must be taken here, such as the simultaneous use of nitrates for certain heart conditions. In these cases, taking Viagra can be dangerous under certain circumstances. Other drugs with similar effects that can be taken are Levitra and Cialis. Important drug for injection into the erectile tissue itself is the Prostaglandin E1, which in certain forms can also be applied directly into the urethra. A self-injection of this vasoactive substance to achieve an erection is possible. Vascular surgery to improve penile blood flow is certainly only useful in younger men (e.g., after pelvic fractures). A general vascular disease such as diabetes etc. must not underlie the erectile dysfunction in these cases.
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