Are There Psychological Causes Of Erectile Dysfunction?

Apart from the reproductive tool, sexual relationship is vital for many reasons in a successful relationship.

It is completely about intimacy, happiness and romantic expression. Sex has many different physical and emotional parameters. These benefits will help couples strengthen their relationships and keep intimacy alive. Whether long or short term relationships, sex is a basic thing to determine your overall health, physical as well as mental. But a major set back to this physical relation is the inability of men to perform well. One major and quite a common problem among men is erectile dysfunction. Decreased blood flow is a basic reason for erectile dysfunction that is why the problem is more prevalent in old people. Older men are more susceptible to diseases like increased blood pressure and diabetes, which interfere with the circulation and make erection difficult to achieve.

Another name for erectile dysfunction is impotence. It is an inability to get or maintain an erection of the sex organ i.e. penis until the completion of the sexual act. In such men, the erection is not satisfactory or is not adequate for the pleasure of both. This leads to a low self-esteem of the suffering person.

 

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What is the process of Erection?

To understand the reasons for erectile dysfunction or impotence, the understanding of the process of erection is a must. A series of complex steps take place in the body. Discussed below are the various steps.

• Sexual dysfunction has many things associated with it like libido, erection issue, problems related to orgasm and ejaculation issues. Erectile dysfunction may occur alone or can be a set of different disorders.

• An erection is a complex phenomenon, more likely a neurovascular event. It clearly states that to have a healthy erection, the proper functioning of these two systems is required.

• The central nervous system and peripheral nervous system controls the psychological, hormonal, vascular and local factors involved in the erection of the penis. It is a wrong conception that problem usually lies in the penis. Actually, the penile portion is just a part of a complex process and it is not necessary that problem lies only in this part.

• The stimulus plays a basic role in a sexual intercourse. A proper stimulus from his partner can cause erection in males. A stimulus can be physical like a touch, odour, visual or intimated talk with your partner. It triggers the brain and the information passes from the brain to spinal nerve centres and then finally to the nerve fibres in the penis. This nerve stimulus increases the blood flow in the penis during erection.

• Penis has three cylinders; the corpora cavernosa on the top and corpus spongiosum on the bottom. The process of erection involves only corpora cavernosa. Specific spaces are present in corpus cavernosa which get distended by blood, muscles and blood vessels. The arteries of the penis are dilated after the release of chemicals from the nervous system and increase the blood flow in the penis. When the flow of blood increases in the penis these spaces swell like a sponge. An outer coating, tunica albuginea is present outside the penis. The function of this is to prevent the flow of blood from vessels during erection. This compression of veins keeps the penis filled with blood and strongly erect.

• When the brain stops releasing the muscle relaxing chemicals then the muscles of the penis contract, sinusoidal spaces gets shorter. As a result, the blood drains from the penis and Detumescence occur.

Therefore, the process of erection is a series of physical or psychological steps. If any of the steps is disrupted, it can cause erectile dysfunction.

There are different causes of erectile dysfunction. Many men have more than one cause.

 

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Product Description

How does Viagra and Sildenafil work?

Viagra (Sildenafil) helps men to get and maintain an erection when sexually stimulated and/or excited. The medicine relaxes the blood vessels in the penis which results in more blood flowing to the penis when you are sexually excited.

How do I take it?

You should take Viagra (Sildenafil) approximately 1 hour before planning to have intercourse. Within a window of between 30 minutes and 4 hours after you take the medicine, it will be easier to keep and maintain an erection when you are sexually excited. If you take this medicine after a meal with a high fat content it may take a little longer to start working. This medicine will only work when you are sexually excited. You won’t get an erection just by taking Viagra (Sildenafil).

Dosage

The standard recommended dose for Viagra (Sildenafil) is 50mg and this will be suitable for most people.  If this dose is not effective, you can try 100mg and if 50mg gives you side effects you can also reduce the dose to 25mg tablets.

You must not take more than 100mg daily of Sildenafil/ Viagra. Clinical trials have been conducted in patients taking up to 200mg sildenafil and it was found that ‘doses of 200mg did not result in increased efficacy but did increase the incidence of adverse reactions (headache, flushing, dizziness, dyspepsia, nasal congestion, and altered vision).’

In addition, in patients taking more than 100mg daily, there have been reports of rhabdomyolysis (a breakdown in skeletal muscle tissue the byproducts of which can lead to kidney failure), visual perception changes, vertebral artery dissection (a tear in the artery supplying blood to the brain), heart attacks and aggressive behaviour.

If the 100mg strength doesn’t work for you, there may be alternatives you can try and we recommend that you call us for a free consultation with our pharmacist or doctor to discuss any underlying conditions you may have. We recommend that all men taking medicine for erectile dysfunction have regular tests for blood pressure, cholesterol, diabetes and hormone imbalances. For instance, it may be that by fixing a hormone imbalance such as testosterone, your Viagra medication will be even more effective.

In addition, drug manufacturers do not advise patients to split tablets in half to get the correct dosage as they cannot guarantee that the active ingredient will be distributed evenly throughout the tablet.  For instance, if you cut a 100mg tablet in two, you may find that you get 80mg in one half of the tablet and 20mg in the other half leading to either an overdose (increased risk of side effects) or a suboptimal dose (the medication may not work).

It is important that you choose the correct dose for you. If you wish to talk to our pharmacist or doctor about this, please contact us in the pharmacy on 01625 460621 or email [email protected]

Side Effects

Viagra (Sildenafil) is normally well tolerated, however, side effects can include:

  • Headache
  • Dizziness
  • Nausea

Side effects normally subside after a few hours, however, if you experience a prolonged or painful erection (longer than 4 hours), then you must contact your doctor immediately.

Drug interactions

There are a number of medicines which interact with Sildenafil/ Viagra. For an exhaustive list please see the patient information leaflet (see section below) or call us in the pharmacy to discuss your specific situation. The main drug interactions are listed here:

Recreational drugs such as ‘poppers’ or amyl nitrate
Alpha blockers used for urinary retention or blood pressure problems (eg Flomax or Cardura)
Anti- arrhythmic drugs such as disopyramide
Antibiotics such as erythromycin
Antifungals such as itraconazole
Antivirals such as drugs used to treat HIV
Bosentan
Cobicistat
Calcium channel blockers to treat blood pressure and angina such as amlodipine
Dapoxetine (Priligy – used to treat premature ejaculation)
Grapefruit juice**
Nicorandil
Nitrates
Riociguat
Cimetidine (to treat stomach ulcers)

Please do not take Sildenafil/Viagra if you have taken any of the above drugs within the last 60 days without first consulting with either us in the Pharmacy ([email protected] / 01625 460621) or via email with our doctor [email protected]

**We advise not to take Sildenafil/Viagra with grapefruit juice as the blood concentration of Sildenafil will possibly be increased resulting in side effects.

Patient Information Leaflets

Please click here for the patient information leaflet for Viagra.

For Actavis Sildenafil please see the following leaflets: 100mg, 50mg, 25mg.

Storing Medicines Safely

Please keep your medicine out of the reach of children and store at room temperature.  Unwanted medicine can be disposed of by returning it to any local pharmacy or indeed to us here for us to dispose of it for you.

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Erectile dysfunction and age:

Erectile dysfunction usually occurs in old age but many young people are also suffering from this problem.

As erection basically depends on the relaxation of blood vessels, therefore it’s not a wonder that erectile dysfunction occurs more in old age. Due to atherosclerosis elasticity of vessels decreases and lessens the flow of blood. Another cause may be a vein which does not function properly and drains the blood from the penis very quickly. Erections basically involve the functioning of blood vessels, so it is quite obvious that it is more common in old age due to conditions such as atherosclerosis or diabetes. Other underlying causes may involve a surgery or a hormonal imbalance.

The blood vessels that produce an erection function under the effect of nervous system via nerve signals and these signals can be interfered by side effects of certain prescription medications. Antihistamines, diuretics, sedatives, medications for cancer and high blood pressure are examples of such medicines.

Erectile dysfunction is also associated with young men. In younger men, the problems are mostly of the psychological nature. Tension and anxiety can be a basic problem in younger. Sexual difficulty in young men is linked to

• Body fatigue

• Stress and anxiety

• Fear of performance

• History of sexual abuse

• Relationship problems

 

Causes of Erectile Dysfunction:

Erectile dysfunction has many underlying causes. It is true that erectile dysfunction mostly depends on physical causes but it is important to consider the psychological causes of erectile dysfunction.

There are four major physical categories of erectile dysfunction. They include

• Vasculogenic disorders – problems in blood flow

• Hormonal disorders – imbalance in normal body hormones

• Anatomical problems – structural deformity in the penis

• Neurogenic disorders – affects the function of nerves, brain and spinal cord.

Do psychological causes play a role in erectile dysfunction?

As determined by a study psychological factors are largely the underlying cause of the erectile dysfunction in many men. These problems are wide-ranging, and even the couples are unaware of them. Below are few psychological problems which need to be discussed.

Attractive man feeling disappointed and depressed because of erectile dysfunction, looking at his penis under white cover, doesn't know what's the problem, angry wife lying next to him and waiting

Performance anxiety:

This is basically defined as pressure regarding performance during intercourse. It is quite common in newly developed relationships, where the male partner is usually nervous about his impression on his partner.

This problem does not persist for a long time and may vanish as partners become more comfortable with each other.

Performance anxiety is considered to be the most common cause of impotence in males. Its self-perpetuating nature makes it the major part in persistent psychogenic. In simple words the more you feel anxious about performance the lesser will you perform. If this anxious nature persists for long, it may lead to spinal deterioration.

In such case, the only option is to talk with your partner about your problem. In many cases, this has proven to be very beneficial but if this is left unaddressed, the situation may worsen.

But if the solution is not solved, it is necessary to visit your GP. Sometimes a proper treatment is required to alleviate the symptoms.

Stress and General Anxiety:

Sex is not only the cause of anxiety every time. Psychological causes of erectile dysfunction may be related to basic routine life.

Sometimes issues related to your office work, long working hours, financial problems and others can have a significant effect on your sex life.

• According to experts, when you are going under shear stress, the brain cells involved in the process of sexual arousal starts decreasing.

• Another cause is distraction due to stress, which does not allow the mind to focus on intercourse.

• Hormones have a pivotal role in the normal sexual procedure. If the hormonal balance is disturbed, it reduces the erection in males. Cortisol is a hormone which is released response to stress interferes with the level of testosterone in the body. A drop in levels of testosterone disturbs sexual activity.

It is advised to solve your financial issues and try to make yourself comfortable at workplace thus alleviating stress.

women hands holding distorted and normal cucumber on white

Depression:

Lack of self-esteem, fatigue and eating or sleeping disorders are basic signs of depression. But another common sign of depression is erectile dysfunction. These two problems when coming together, aggravate each other making the other one worse.

But the symptoms of erectile dysfunction can be improved by taking Viagra. It lessens the depression and alleviates the symptoms of erectile dysfunction in men. But it is important to consult your physician before taking the medication because the correct dose is the basic need for erectile dysfunction therapy.

Relationship problems:

A usual pattern among psychological causes of erectile dysfunction is their self-perpetuating nature. Examples of relationship problems are a loss of interest in the partner, low libido or decreased sexual desire. Men are more subjected to erection problems and are more prone to decreased libido if they are undergoing erectile dysfunction.

Psychological dependence on medicines:

Many men use erectile dysfunction medication such as Viagra, Cialis, Levitra, Spedra etc. These are the most common short-term treatments of erectile dysfunction used by men. The ED medications restore the erection during sexual intercourse and help to overcome the loss of confidence regarding sex relation.

But a major drawback of this treatment is dependent on these medications. A psychological feeling starts developing in the user that an erection can only be caused by taking the pill. If this feeling persists for a long time it can be a setback in getting a normal erection. The differences and side effects are mentioned here.

Anger:

Anger causes the increased blood flow in the body but it is not useful for the erection of the penis. In fact, if you are raging at your partner or even someone else, you are not able to perform well in bed. Unexpressed anger can lead to a problematic life in the bedroom.

Low self esteem/Locking into mirror and see an ugly version of self

Self-image:

A consistently low feeling about yourself while looking into the mirror can take away the romance from your life. When you do not feel good about your looks then, you will continue to imagine about disking of your partner towards you. This low self-esteem strongly disturbs your performance in bed leading to a self-created impotence.

People who are the victim of psychological problems should talk openly with their partners about their relationship issues. In many cases, just discussion has improved the conditions tremendously. Even then if the problem is not solved than move towards the next step.

Now it is a must to talk to your doctor if you are suffering from erectile dysfunction problems. As the causes are so wide-ranging that only a health professional is able to diagnose the actual problem and prescribe the medication according to body need.

 

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References:

  1. https://www.accessrx.com/blog/erectile-dysfunction/7-cool-facts-about-viagra/#
  2. https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776
  3. https://www.healthline.com/health/erectile-dysfunction/common-causes-impotence
  4. https://www.webmd.com/men/ss/slideshow-causes-of-ed
  5. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
  6. https://www.urologicalcare.com/erectile-dysfunction/ed-common-causes/

 

Assured Pharmacy is not liable for the currency or accuracy of the information contained in this blog post. For specific information about your personal medical condition, please contact our doctors or pharmacists for advice on [email protected]