In both conditions, an intact neural system is required for a successful and complete erection. Stimulation of penile shaft by the nervous system leads to the secretion of nitric oxide (NO), which causes the relaxation of smooth muscles of corpora cavernosa (the main erectile tissue of penis), and subsequently penile erection. Additionally, adequate levels of testosterone (produced by the testes) and an intact pituitary gland are required for the development of a healthy erectile system. Based on the mechanism of a normal erection, impotence may develop due to hormonal deficiency, disorders of the neural system, lack of adequate penile blood supply or psychological problems. Restriction of blood flow can arise from impaired endothelial function due to the usual causes associated with coronary artery disease. Source: National Institute of Diabetes and Digestive and Kidney Diseases Structural Changes of the Penis before and after Erection: Insufficient rigidity / erectile dysfunction is caused by physiological or psychological factors, or both.
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Testosterone replacement therapy: Available in gel, injection, patch, or pellet forms. To make your visit easier, you can use the Chat on WhatsApp, Book Appointment feature, or download the Care Dokter app from Google Play or the App Store to check queue numbers, schedule visits, and access more information. Penile erection is managed by two different mechanisms: The first one is reflex erection, which is achieved by directly touching the penile shaft. The second is psychogenic erection, which is achieved by erotic or emotional stimuli. The former uses the peripheral nerves and the lower parts of the spinal cord, whereas the latter uses the limbic system of the brain. About 80-90% of cases of insufficient rigidity / ED are caused by physiological origin, which are further classified into vascular (related to blood flow) and non-vascular factors. It is estimated that 70% of insufficient rigidity / ED cases may be attributable to vascular diseases alone. A penis requires a healthy blood supply in order to erect. Even only a minor obstruction will lead to a serious erection problem. This is described as the lack of adequate penile blood supply, which is a result from the following factors: Source: The National Institute of Diabetes and Digestive and Kidney Diseases Type 2 Diabetes mellitus occurs when the pancreas does not make enough insulin, or when body tissues cannot utilize insulin effciently, resulting in an abnormally high blood glucose level. Advancing thirst, tiredness, weight loss, blurred vision and others are symptoms of diabetes. The condition will also lead to insufficient rigidity / erectile dysfunction by inducing damages of blood vessels and nerves involved in erection. Hypertension is a condition in which the blood pressure is persistently higher than normal (140/90 mmHg), even when you are resting or relaxing. Smoking, physical inactivity, obesity, stress, excess alcohol intake and a family history of hypertension are risk factors of hypertension. Most people with hypertension do not have any symptoms. According to the Population Health Survey of the Department of Health, 60% of males with hypertension do not know they have the disease. Hypertension is usually diagnosed unexpectedly in a routine health check-up. When severe, hypertension will cause headache, dizziness, and visual problems. Impotence is also one of the symptoms of hypertension. It is because penile arteries are damaged by excessive blood pressure.
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Direct stimulation of the penis might also be necessary. However, erectile dysfunction is not an inevitable part of aging. Risk factors that can increase the likelihood of ED include: Certain health conditions, such as diabetes or heart disease Smoking, which affects blood flow and can cause long-term health issues linked to ED Medical treatments such as prostate surgery or radiation therapy for cancer Injuries, especially those affecting the nerves or blood vessels involved in erections Use of certain medications, including antidepressants, antihistamines, and drugs for high blood pressure, pain, or prostate conditions Mental health issues such as stress, anxiety, and depression Long-term or excessive use of alcohol or recreational drugs The best way to prevent erectile dysfunction is by maintaining a healthy lifestyle and managing any chronic medical conditions. Work with a doctor to manage diabetes, heart disease, or other chronic health conditions Quit smoking, limit or avoid alcohol, and avoid illegal drugs Seek medical help for anxiety, depression, or other mental health issues The first step in treating erectile dysfunction is identifying the underlying cause. A doctor will help determine the most appropriate treatment method. Normally, these arteries dilate in response to sexual stimulation, allowing more blood to flow into the spongy tissue of the penis to produce an erection. The excessive pressure in these arteries may cause tiny tears, which are subsequently repaired by the body. The healed arteries have thicker walls to better resist the elevated blood pressure. These thicker blood vessel walls, though, will impose extra resistance to blood flow into the erectile tissues of the penis. Cardiac Disease is one of the main killer diseases among men in Hong Kong, causing 3,442 deaths in 2008. Coronary heart disease accounted for approximately two thirds of all heart-disease-related deaths in men. Coronary heart disease (CHD) is a type of heart disease due to the occlusion of the coronary arteries. The coronary arteries serve to supply oxygen and nutrients to the heart muscles. When the arteries become narrow and stiff because of fatty plaques, blood supply to the heart will be reduced and the heart muscles will be damaged. A number of risk factors, including smoking, high-fat diet, physical inactivity, high blood pressure, high cholesterol levels, obesity, diabetes mellitus, stress and family history of coronary heart disease, which may work independently or in combinations, can lead to coronary heart disease. Smoking is associated with insufficient rigidity / erectile dysfunction by damaging the blood circulation system in the penis.
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These typically begin to work within an hour. Low-intensity shockwave therapy (LiSWT): A non-invasive treatment using sound waves to improve blood flow. Results are usually seen within two months. Penile injections: Medications like alprostadil, papaverine, phentolamine, or a combination of drugs can be injected directly into the penis, producing an erection within 10 minutes. Vacuum erection devices (penis pumps): These work almost immediately to help achieve an erection. As insufficient rigidity / ED is shown to be highly prevalent among smokers in clinical studies, it is hypothesized that quitting smoking can help prevent insufficient rigidity / ED, and improve the condition in insufficient rigidity / ED patients. Prostatitis is an inflammation of the prostate gland. It can be sudden and acute, or reoccurring and chronic. This disease is often accompanied by a strong and frequent urge to urinate, difficulty in urinating (hesitant urination often results in only small amount of urine), and / or pain in the lower back or abdomen. Prostatitis can also cause insufficient rigidity / erectile dysfunction due to reduced blood flow.
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Cardio exercise: Engaging in moderate to intense cardio activity for at least 45 minutes, three times a week, can help improve mild ED. This can include brisk walking, jogging, swimming, cycling, or jumping rope. Quitting smoking: Men with mild ED often see improvement within a few months of quitting smoking. Sex therapy or counseling: Useful for addressing psychological causes of ED. Oral medications: Such as sildenafil, vardenafil, tadalafil, or avanafil, which help improve blood flow to the penis. Other associated physical conditions or causes are less common. Since insufficient rigidity / erectile dysfunction can be an early symptom of such underlying medical conditions, it is essential for patients to seek prompt diagnosis and treatment.
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Additionally, stress and mental health issues can either cause or worsen ED. Sometimes, erectile dysfunction results from both physical and psychological causes. For example, a mild physical condition that slows sexual response may trigger anxiety about maintaining an erection, which then aggravates the ED. Metabolic syndrome (a combination of high blood pressure, high insulin levels, excess body fat around the waist, and high cholesterol) Peyronie’s disease (curved or painful erection, shortened penis during erection, or noticeable lumps) Prostate cancer treatment or prostate enlargement procedures Pelvic or spinal cord injuries or surgeries The brain plays a vital role in initiating the physical events that lead to an erection. Psychological conditions that can affect sexual arousal include: Depression, anxiety, or other mental health disorders As men age, erections may take longer to develop and may not be as firm. It is however, not uncommon to see insufficient rigidity / ED in an otherwise completely healthy person, both physically and psychologically. It is postulated that the penile circulation is intrinsically precarious, being an end-artery it may not be surprising that blood flow to the penis be partially occluded as men age. Although this may not cause major health problems, erection problems may arise due to the hindered penile blood flow. Psychological factors are responsible for about 10%-20% of all cases of insufficient rigidity / ED. It is often secondary to an underlying physical cause. In some cases, the psychological effects of insufficient rigidity / ED may stem from childhood abuse or sexual trauma. However, the most common psychological causes of insufficient rigidity / ED include: The Characteristics of Psychological Insufficient Rigidity / Erectile Dysfunction Include: Being able to achieve or maintain an erection with one partner but not with another.