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Erectile dysfunction

Erectile dysfunction (ED) is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance.
A penile erection is the hydraulic effect of blood entering and being retained in sponge-like bodies within the penis. The process is often initiated as a result of sexual arousal, when signals are transmitted from the brain to nerves in the penis. Erectile dysfunction is indicated when an erection is difficult to produce. If erectile dysfunction is an ongoing problem, it may cause stress, cause relationship problems or affect your self-confidence.

Sign & Symptoms:-
Erectile dysfunction is characterized by the regular or repeated inability to obtain or maintain an erection. There are several ways that erectile dysfunction is analyzed:-
• Trouble getting an erection
• Trouble keeping an erection
• Reduced sexual desire.
• Obtaining full erections at some times, such as when asleep (when the mind and psychological issues, if any, are less present), tends to suggest the physical structures are functionally working.
• Other factors leading to erectile dysfunction are diabetes mellitus (causing neuropathy).


Causes:-
Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health problems can cause or worsen erectile dysfunction. Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical problem that slows your sexual response may cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.



Physical causes of erectile dysfunction
in most cases, erectile dysfunction is caused by something physical. Common causes include:
• Drugs (anti-depressants (SSRIs) and nicotine are most common) Men who use non-steroidal anti-inflammatory drugs (NSAIDs) 3 times a day for more than 3 months are at a 22 percent increased risk of erectile dysfunction.
• Neurogenic disorders (spinal cord and brain injuries, nerve disorders such as Parkinson's disease, Alzheimer's disease, multiple sclerosis, and stroke).
• Cavernosal disorders (Peyronie's disease, development of scar tissue inside the penis.
• Surgery (radiation therapy, surgery of the colon, prostate, bladder, or rectum may damage the nerves and blood vessels involved in erection. Prostate and bladder cancer surgery often require removing tissue and nerves surrounding a tumor, which increases the risk for impotence). Surgeries or injuries that affect the pelvic area or spinal cord.
• Ageing. It is four times higher in men in their 60s than in men in their 40s.
• Kidney failure.
• Diseases such as diabetes and multiple sclerosis (MS).
• Smoking is a key cause of erectile dysfunction. Smoking causes impotence because it promotes arterial narrowing. Alcoholism and other forms of substance abuse.
• Heart disease.
• Clogged blood vessels (atherosclerosis).
• High blood pressure.
• Obesity.
• Metabolic syndrome, a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol.
• Low testosterone.

Psychological causes of erectile dysfunction
the brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:
• Depression, anxiety or other mental health conditions
• Stress
• Fatigue
• Relationship problems due to stress, poor communication or other concerns.
• Lack of sexual knowledge. past sexual problems
• Past sexual abuse.
• Being in a new relationship

Diagnosis:-
Physical examination-
The physical examination can reveal clues for physical causes of erectile dysfunction. For example, if the penis does not respond as expected to touching, a problem in the nervous system may be the cause. Small testicles, lack of facial hair and enlarged breasts (gynecomastia) can point to hormonal problems such as hypogonadism with low testosterone levels. A reduced flow of blood as a result of atherosclerosis can sometimes be diagnosed by finding diminished arterial pulses in the legs or listening with a stethoscope for bruits (the sound of blood flowing through narrowed arteries). Unusual characteristics of the penis itself could suggest the root of the erectile dysfunction, for example, bending of the penis with painful erection could be the result of Peyronie's disease.

Laboratory tests-
The following are common laboratory tests to evaluate erectile dysfunction:
• Complete blood counts
• Urinalysis: An abnormal urinalysis may be a sign of diabetes mellitus and kidney damage.
• Lipid profile: High levels of LDL cholesterol (bad cholesterol) in the blood promote atherosclerosis.
• Blood glucose levels: Abnormally high blood glucose levels may be a sign of diabetes mellitus.
• Serum creatinine: An abnormal serum creatinine may be the result of kidney damage due to diabetes.
• Total testosterone levels: A low total testosterone level suggests hypogonadism.
• Other hormone levels: Measurement of other hormones beside testosterone (luteinizing hormone (LH), prolactin level, and cortisol level) may provide clues to other underlying causes of testosterone deficiency and erectile problems, such as pituitary disease or adrenal gland abnormalities. Thyroid levels may be routinely checked as both hypothyroidism and hyperthyroidism can contribute to erectile dysfunction.
• PSA levels: PSA (prostate specific antigen) blood levels and prostate examination to exclude prostate cancer is important before starting testosterone treatment since testosterone can aggravate prostate cancer.

Complications:-
Complications resulting from erectile dysfunction can include:
• An unsatisfactory sex life
• Stress or anxiety
• Low self-esteem
• Marital or relationship problems
• The inability to get your partner pregnant

Prevention:-
The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health problems you have. Here are some things you can do:
• Work with your doctor to manage diabetes, heart disease or other chronic health problems.
• See your doctor for regular checkups and medical screening tests.
• Stop smoking, limit or avoid alcohol, and don't use street drugs.
• Exercise regularly.
• Take steps to reduce stress.
• Get help for anxiety or depression.

Prognosis:-
In general, the outlook for men with impotence is excellent. Most cases of impotence have medical causes that cannot be cured. Still, many treatment options will help restore sexual function. Several causes of impotence can be cured. These include impotence caused by psychological problems, hormonal disorders and traumatic injury to the penile arteries.


Lifestyle Management:-
• Quit smoking.
• Lose weight. Being overweight can cause — or worsen — erectile dysfunction.
• Get regular exercise. This can help with underlying problems that play a part in erectile dysfunction in a number of ways, including reducing stress, helping you lose weight and increasing blood flow.
• Get treatment for alcohol or drug problems. Drinking too much or taking certain illicit drugs can worsen erectile dysfunction directly or by causing long-term health problems.
• Work through relationship issues. Improve communication with your partner and consider couples or marriage counseling if you're having trouble working through problems on your own.

Homoeopathic remedies :-


Acid Phos: This is corresponds to chronic effects of loss of seminal fluids. In this the whole system is weakened; the legs are weak, burning in the spine worse at night, genitals relaxed, penis has no power of erection, erection imperfect & semen escapes too soon during coitus.


Chinchona: Suitable for the acute effects, such as emission on three or four consecutive nights, weakening the patients greatly.

Nuv vomica: Sudden relaxation of the penis during coitus due to exhaustion rather than to spasmodic action.

Phosphorus: Impotence preceded by over-excitation of the genital organs. It also has a discharge of prostatic juice during a hard stool and frequently involuntary seminal emission.


Picric acid: disturbed sleep from erection and too frequent seminal emission.

Gelsemium: Frequent involuntary emission at night, with relaxation of organs; emission occurs from slightest excitation. No lascivious dreams, case arising from masturbation.

Lycopodium: complete impotency; erection absent or imperfect, genital organs are cold & shriveled. Known as “the Old man’s balm”.


Graphitis: want of sensation during coitus, with no discharge of semen.
Selenium: prostatic juice oozes while sitting, during sleep, when walking and during stool.


Caladium: after masturbation, the penis is as flabby as a rag, nocturnal emission occurs with or without dreams. Emission occurring without any sexual excitement.

Other useful remedies are: Agnus castus, Staphisagria, Conium, zincum, Calc.carb, Nuphar lutea, Eryngium aquaticum, Dioscorea, Digitalis, Sasaparilla etc…

by:
DrKunwar Shatrughan
Dr. Kunwar’s Homoeopathic Clinic
Tohana – Haryana.
dr.kunwarshatrughan@hotmail.com

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