Erectile dysfunction (ED)

Erectile dysfunction (ED)
Dr Samir Chaukkar M.D.(Hom)
Head-Training, Dr Batras® Positive Health Clinics Pvt Ltd, Mumbai
Erectile dysfunction (ED) is the inability of a man to maintain a firm erection long enough to have sex. Although erectile dysfunction is more common in older men, this common problem can occur at any age. Having trouble maintaining an erection from time to time isn't necessarily a cause for concern. But if the problem is ongoing, it can cause stress and relationship problems and affect self-esteem. (1)
Erectile dysfunction or ED is the inability to achieve or sustain an erection suitable for sexual intercourse. Problems with erections may stem from medications, chronic illnesses, poor blood flow to the penis, drinking too much alcohol, or being too tired. Lifestyle changes, medications, and other treatments are often used to treat ED. (2)
According to the National Institutes of Health, approximately 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience ED on a long-term basis.
A much more common problem that affects the majority of men at some point in their life is the occasional failure to achieve an erection, which can occur for a variety of reasons, such as from drinking too much alcohol or from being extremely tired.
Failure to achieve an erection less than 20% of the time is not unusual and treatment is rarely needed. Failure to achieve an erection more than 50% of the time, however, generally indicates there is a problem requiring treatment.(2)

Formerly called impotence, erectile dysfunction was once a taboo subject. It was considered a psychological issue or a natural consequence of growing older. These attitudes have changed in recent years. It's now known that erectile dysfunction is more often caused by physical problems than by psychological ones, and that many men have normal erections into their 80s. (1)
Common causes of erectile dysfunction include: (1)
§ Heart disease
§ Clogged blood vessels (atherosclerosis)
§ High blood pressure
§ Diabetes
§ Obesity
§ Metabolic syndrome
Other causes of erectile dysfunction include:
§ Certain prescription medications
§ Tobacco use
§ Alcoholism and other forms of drug abuse
§ Treatments for prostate cancer
§ Parkinson's disease
§ Multiple sclerosis
§ Hormonal disorders such as low testosterone (hypogonadism)
§ Peyronie's disease
§ Surgeries or injuries that affect the pelvic area or spinal cord
In some cases, erectile dysfunction is one of the first signs of an underlying medical problem.
Psychological causes of erectile dysfunction (1)The brain plays a key role in triggering the series of physical events that cause an erection, beginning with feelings of sexual excitement. A number of things can interfere with sexual feelings and lead to — or worsen — erectile dysfunction. These can include:
§ Depression
§ Anxiety
§ Stress
§ Fatigue
§ Poor communication or conflict with your partner
Erectile dysfunction takes more than a physical toll. The emotional impact the condition can have on a man and his partner can be just as difficult. It is common for men with ED to feel anger, frustration, sadness, or lack confidence. However, the condition can be treated. The first step in addressing your concerns about ED is to be honest with yourself, your partner, and your doctor. Once ED has been brought out into the open, coping with it as you go through treatment will be easier and less stressful. Communication is essential to a successful diagnosis and treatment, as well as, helping your partner understand your feelings.
While you are being treated for ED, it is important to be patient with your progress and keep in mind that everybody is different and that a treatment that might work for one person may not work or be appropriate for you. It is also important to know that the treatment you choose may not work the first time or may not work every time.
For some couples sex therapy may be necessary to help you and your partner cope. It may also help you to hear from some men who have ED and learn about their experiences. Contact your doctor about local support groups in your area .(2)
Feelings that can lead to erectile dysfunction (3)
· Feeling nervous about sex, perhaps because of a bad experience or because of a previous episode of impotence
· Feeling stressed, including stress from work or family situations
· Being troubled by problems in your relationship with your sex partner
· Feeling depressed
· Feeling so self-conscious that you can't enjoy sex
· Thinking that your partner is reacting negatively to you
Treatment
There are a wide range of options that are available for the treatment of erectile dysfunction. Some of the more popular forms of treatment are medications, oral or otherwise, mechanical devices, operations or surgery, and psychological counseling.
Oral medications
The oral medications available for the treatment of ED include:
Viagra(Sildenafil)
Cialis (Tadalafil)
Levitra (Vardenafil)
Prostaglandin E (alprostadil): Alprostadil is a synthetic edition of the prostaglandin E hormone that can aid in the relaxation of the smooth muscle tissue in the penis to improve and attain the blood flow required for erection. Alprostadil are generally used in two ways:
Needle-injection Therapy: in this therapy, alprostadil (Caverject, Edex) is injected to the base or the side of the penis using a needle.
Self-administered Intraurethral Therapy: generally known by the trade name, Medicated Urethral System for Erection (MUSE), this therapy takes the aid of a disposable applicator to slot in a tiny suppository, about half the size of a grain of rice, into the tip of the penis.
Hormone Replacement Therapy
In rare cases, hormone replacement therapy to replace the male hormone testosterone can work in ED patients with deficient testosterone.
Vacuum Devices:
Sometimes, an external vacuum along with one or more tension rings (rubber band) are placed around the male sexual organ. A person undergoing a vacuum device treatment would have an erection that can last enough for a couple to enjoy satisfying sex. The person is required to remove the rings after sexual intercourse.
Vascular Surgery
This treatment is generally adopted for ED patients who have undergone injury to the pelvic region resulting in the blockage of the penile blood flow. Corrective surgeries are employed to allow the flow of blood; however, the success of this surgery in the long run is uncertain.
Penile Implants
Under this treatment, a device is implanted surgically into both the sides of the penis enabling the person to have an erection as often and as long as is required for intercourse. Many experts give the opinion that this treatment should be the last option as it is highly expensive and it may even give rise to risks of complications like infections.
Psychological Counseling
When the doctor diagnoses stress, anxiety or depression as the cause of erectile dysfunction, he suggests the suffering couple to visit a psychologist or psychiatrist with experience in treating sexual problems.
Homeopathy
It offers some very good medicines to treat this condition. But for proper treatment a homeopath must probe into the psychological reasons behind the condition. A detailed case history is necessary, including not only the sexual history, but also his general medical history, physical and mental characteristics etc. It is not easy give long term results if a homeopath is unable to make a judgment as to 'What went wrong?'. Also the 'when', 'where' and 'how' need to be answered too. long with the medicine such patients often need psychological counseling, especially so, if there are marked depressive traits present. This counseling can be done by an experienced homeopath or by a trained psychologist.
Some of the medicines commonly indicated in such conditions are agnus-castus, argentum-nit, china, conium, lycopodium, acid-phos, picric-acid, sabal-serr., selenium, strychninum, yohibinum, kali-brom, arnica, baryta-carb, nux-vomica etc. The selection of medicine varies from cae to case, and so do the results. But the food thing about homeopathic treatment is that you don't need to pop-a-pil every time you desire some action. Once you regain your ability to attain an erection, you usually get it for good.(4)
These are some among the many homeopathic remedies which cater to relieve ED specificallyAgnus castus: This remedy may be helpful if problems with impotence develop after a man has led a life of intense and frequent sexual activity for many years. A cold sensation felt in the genitals is a strong indication for Agnus castus. People who need this remedy are often very anxious about their health and loss of abilities, and may have problems with memory and concentration.Argentum nitricum: This remedy may be helpful if a man's erection fails when sexual intercourse is attempted, especially if thinking about the problem makes it worse. People who need this remedy are often nervous and imaginative. A person who needs Argentum nitricum is usually warm-blooded, with cravings for both sweets and salt.Caladium: This remedy may be helpful to a man whose genitals are completely limp, despite having sexual interest. Nocturnal emissions can occur without an erection, even if dreams are not sex-related. A person who needs this remedy often craves tobacco.Causticum: This remedy may be indicated if physical pleasure during sex has diminished and sexual urges are reduced. The person feels tired and weak, and may experience memory loss, with a compulsive need to check things (to see that doors are locked, etc.) Prostate problems may be associated with impotence, and urine may be lost when the person coughs or sneezes.Lycopodium: commonly called club moss, is a wonderful homeopathic remedy.People who need this remedy may have problems with erections because of worry, and can also be troubled by memory loss. They often lack self-confidence (though some may overcompensate by acting egoistically). People who need this remedy often have digestive problems with gas and bloating, and an energy slump in the late afternoon and evening.Selenium metallicum: Selenium is a nutrient needed by humans in micro amounts. It is widely distributed in nature. Brazilian nuts, sea-foods, yeast, whole grains are all excellent sources of selenium. Homeopathic remedy is highly potent and has a wide curative spectrum for disorders like impotency, chronic fatigue syndrome, sterility, depression etc.This remedy is often helpful to men who have diminished sexual ability, especially if the problem starts after a fever or exhausting illness. The person feels weak and exhausted, but interest is usually still present. Erection is slow, insufficient, weak and has involuntary seminal emissions.Unusual hair-loss (body hair or eyebrows) can also suggest a need for Selenium.Staphysagria: Staphysagria is a homeopathic remedy made from the seeds of the Delphinium Staphisagria, which has lovely purple-blue flowers, and in its raw form is highly poisonous, historically used to kill vermin. The homeopathic remedy, through its preparation, is no longer toxic yet remains extremely powerful.Staphyagria is often an indicated remedy when there is a history of abuse. This can either be physical, sexual or emotional misuse of power and the sufferer generally does not have the ability to fight back for whatever reason.Gentle-natured, quiet men with deep emotions may respond to this remedy. Problems with impotence often occur from embarrassment or shyness. People who need this remedy often have a history of emotional suppression and very sensitive feelings.Other remedies to be considered in treating erectile dysfunction are: china, conium, acid-phos, picric-acid, sabal-serr., strychninum, yohibinum, kali-brom, arnica, baryta-carb, nux-vomica etc. (5)
• Argentum nitricum treats ED occurring after intercourse is initiated. Men who need this remedy usually have cravings for sweets and salt, and may be described as volatile or artistic.
• Caladium remedies the complete absence of erection despite sexual excitement. Men who benefit from this remedy may have nocturnal emissions without dreams. •
• Causticum treats ED occurring with incontinence, especially loss of urine when coughing, laughing, or sneezing, or prostate problems. Homeopathic theory associates this remedy with the need to check things, such as returning home in the middle of a trip to make sure the appliances are turned off, checking bank balances several times a day, and so on.
• Lycopodium treats ED in men who are sexually inexperienced or lacking in self-confidence. Homeopathy teaches that this remedy is appropriate for men who have problems with bloating and flatulence or who have the need for rest or sleep late in the day.
• Selenium metallicum is given to men who develop ED after a serious illness. Loss of body hair or eyebrows is a sign that homeopathic selenium is an appropriate remedy.
• Staphysagria treats ED in men who suffer embarrassment in a sexual context. Homeopathic doctors typically offer this remedy to men from religious backgrounds with strong prohibitions on sexual activity.(6)

References

1) http://www.mayoclinic.com/health/erectile-dysfunction/ds00162
2) http://www.webmd.com/erectile-dysfunction/guide/erectile-dysfunction-basics
3) http://familydoctor.org/online/famdocen/home/men/reproductive/109.html
4) http://www.hpathy.com/diseases/impotence-symptoms-treatment-cure.asp
5) http://www.e-homoeopathy.com/app/erectile-dysfunction-medicines.asp

6) http://ezinearticles.com/?Homeopathy-For-Erectile-Dysfunction&id=1837412