Erectile Dysfunction
Erectile Dysfunction (ED) has been an interesting topic for the last 15 years because of the development of an effective and simple drug therapy. Not always good information was given about the problem and the treatment. On average a man waits 1,5 years from the first symptoms before seeing his GP.
Usually there are multiple factors in the onset of ED.
- Psychological factors: stress, grief, relationship problems, ...
- Sexuality factors: competitive spirit, unrealistic expectations, …
- Somatic factors: aging, medication (antidepressants, hormones, beta-blockers), cardiovascular disease, ...
- Lifestyle factors: smoking, obesity, physical inactivity, ...
These factors contributing to ED are often related to one another. For example, a man with diabetes can also have heart-vascular problems or a depression and uses medication with possible erectile inhibition as a side effect. This can give him a sense of uncertainty so he will avoid sexual situations. This may lead to questions or comments from his partner which may increase the pressure on him to perform. Thereby avoiding sexual situations so his erection ability goes down even further.
Because of this avoidance behaviour he can end up in a vicious circle:
Inability to obtain or maintain an erection
↓
Uncertainty and anxiety
↓
Avoiding sexual situations
↓
Negative reaction partner
↓
Increasing pressure to perform
Psychological and relational factors may enhance or reduce existing physical causes. It is up to the physician or psychologist (sexologist) to weigh those factors against each other. The doctor can diagnose ED and identify the major causative factors in most cases. Sometimes referral to a specialist is needed.