What is Impotence means?
Erectile dysfunction, or ED, is the most common sexual problem men report to their doctor. It affects approximately 30 million men.

ED is defined as difficulty achieving or maintaining an erection strong enough for sexual intercourse.

While it is not uncommon for a man to occasionally experience erectile problems, progressive or frequent ED during sexual intercourse is not normal and should be treated.

ED can occur:

• Most often when blood flow to the penis is restricted or nerves are damaged
• Due to stress or emotional factors
• As an early sign of a more serious condition, such as atherosclerosis (hardening or blockage of the arteries), heart disease, high blood pressure, or high blood sugar levels due to diabetes

Identifying the cause(s) of ED will help treat the problem and improve overall well-being. As a general rule, what is good for heart health is also good for sexual health.

How Erections Work
During sexual arousal, nerves release chemicals that increase blood flow to the penis. Blood flows into the two erectile chambers of the penis, which are composed of spongy muscle tissue. The chambers of the corpus cavernosum are not hollow.

During an erection, the spongy tissues relax and retain blood. The blood pressure in the chambers stiffens the penis, causing an erection. When a man orgasms, a second set of nerve signals reaches the penis and causes the penile muscle tissues to contract, releasing blood into the circulation and causing an erection.

In the absence of sexual arousal, the penis is soft and flaccid. Men may notice that penis size varies with heat, cold, or anxiety; this is normal and reflects the balance of blood entering and leaving the penis.

Symptoms
With erectile dysfunction (ED), it is difficult to achieve or maintain an erection strong enough for sexual intercourse. When ED becomes a recurring and bothersome problem, your primary care physician or urologist can help.

Erectile dysfunction can be a significant warning sign of cardiovascular disease, indicating the formation of blockages in the male vascular system. Some studies have shown that men with ED are at significant risk of heart attack, stroke, or circulatory problems in the legs. ED also causes:

• Low self-esteem
• Depression
• Distress for the man and his partner

If ED is affecting a man's well-being or relationships, it needs to be treated. Treatment aims to correct or improve erectile function, promote circulatory health, and improve the man's quality of life.

Causes of Erectile Dysfunction
Most men occasionally experience difficulty achieving or maintaining an erection.

This is usually due to stress, fatigue, or excessive alcohol consumption and is nothing to worry about.

It can also be a side effect of certain medications.

If erectile dysfunction occurs frequently, it may be due to a condition such as:

• High blood pressure or cholesterol
• Diabetes
• Depression or anxiety
• Hormonal problems

Effective treatments for erectile dysfunction
Treatment can usually help improve erectile dysfunction.

Erectile Dysfunction Medications
The main treatments are medications that increase blood flow to the penis, called PDE-5 inhibitors.

These include:

• Sildenafil (Viagra)
• Tadalafil (Cialis)
• Vardenafil (Levitra)
• Avanafil (Spedra)

Sildenafil can be obtained with a prescription or purchased at a pharmacy. Other types of erectile dysfunction require a doctor's prescription.

Vacuum Pumps
Vacuum pumps stimulate blood flow to the penis, causing an erection.

They work for most men and can be used if medications are unsuitable or fail.

They are not always available through the National Health Service. Consult a doctor to find out where to purchase a vacuum pump.

Treating the Cause of Erectile Dysfunction
There are also treatments for some of the causes of erectile dysfunction.

For example:
Your doctor may adjust your medication if it is the cause of your erectile dysfunction.

High blood pressure, high cholesterol, and hormonal problems can be treated with medication.

Counseling and therapy can help if erectile problems are related to emotional or mental health issues, but the wait for these services through the National Health Service can be long.

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