What Is Erectile Dysfunction?

An erection is a state of male sexual arousal where blood flows to and fills up the penis, giving it a rigid, hardened texture.  They usually last several minutes in duration up until ejaculation or climax occurs.  However, if there is difficulty in getting or maintaining one, this is referred to as erectile dysfunction.   Erectile dysfunction is a medical condition where a biological male cannot get or maintain blood flow through the penis during sexual arousal. To note, it is not uncommon to have occasional bouts of erectile dysfunction.  It only becomes problematic when it becomes an ongoing issue and affects the quality of life. 


How Does It Happen?

In order to achieve an erection and maintain it, the body and mind need to be relaxed to stimulate blood flow to the penis.  However, when the relaxation is disrupted, erectile dysfunction can occur.  This disruption is usually caused by a mix of physiological and psychological stress in addition to underlying medical conditions (cardiovascular disease, hypertension, diabetes, thyroid issues, obesity, anxiety disorders, depression, neurological disorders, physical trauma to the groin area).  Additionally, lifestyle choices, such as tobacco, alcohol, drugs, and diet can be a contributing factor.

Temporary Erectile dysfunction is often caused by physiological stress, emotional distress, depression, performance anxiety (and psychological blocks such as insecurities, situational discomfort, and incompatibilities, past traumas), emotional numbing (and emotional disconnect), relationship troubles, loss of attraction, etc.

A common biomechanical cause of erectile dysfunction is injury caused by extensive seated activities (sitting constantly, biking, boating, etc.), high intensity activities which may directly impact the nether regions (contact sports, military, and physically active jobs) and surgery and sexual trauma.  These situations can have direct pressure on the perineum (located between the anus and scrotum).  The perineum is responsible for protecting the pelvic floor muscles, the blood vessels leading to the urinary tract (in extension, the nerves responsible for urination and erections).  When there is restriction, and, more seriously, injury to that nerve, it can cause bladder control and sexual issues. 


How Do You Treat It?

There are several avenues to treat erectile dysfunction such as counseling, physical therapy, and medications and injections.

Counseling – A significant block to getting erections is the mind.  Performance anxiety, stress, relationship issues, self-esteem issues, mood issues, and unrealistic expectations.  So, the first step is to make sure that the cause isn’t psychological/emotional in nature.

Physical therapy – if the erectile dysfunction is physiological in nature, physical therapy can help.  Perineal injury often impacts the pelvic floor muscles needed for proper urination and erections.  So, the right type of exercises can help strengthen the pelvic floor muscles.

Medications and injections – medications such as Viagra, Cialis, Levitra, Staxyn, and Stendra are pills that work to relax the muscles and increase blood flow to the penis.  There are also injectables which can be injected directly into the penis which automatically increases the blood flow to the penis.

Overall, despite the highly personal nature of erectile dysfunction, it is usually just a small sign that a bodily issue needs to be addressed and it is highly treatable.