of having erectile problems increases. What causes erectile dysfunction? Many factors can affect a man's ability to get and keep an erection. Two or three factors, . Losing weight can help fight erectile dysfunction, so getting to a healthy weight and staying there is another good strategy for avoiding or fixing ED. Obesity. WHAT IS ERECTILE DYSFUNCTION (ED)?. ED, or erectile dysfunction, is when a man finds it hard to get or keep an erection that's firm enough for sex. It affects.
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Subjects were kept in a quiet test room at the beginning of the test after 30 minutes resting time. Before the test, they were restricted from drinking coffee or tea, smoking and taking drugs which can influence ANS. While subjects were breathing normally in a sitting position, electrocardiography was recorded for 5 minutes and then analyzed by SAP Medicore Inc. The digitized electrocardiography signals were analyzed by online database and stored on a hard disk for offline verification simultaneously.
Two main analyses are performed for HRV: time domain and frequency domain analysis [ 14 ]. The unit of the time domain measurement was set as milliseconds. The unit of the frequency domain measurements was set as millisecond square. The parameters of HRV were measured retrospectively.
Comparisons between the two groups were performed with the unpaired t-test. P-value less than 0. There was no significant difference in body mass index BMI , either. BMI of the men with ED was Complete blood count, routine blood chemistry and urinalysis results were normal in both groups. Psychogenic erection is a result of audiovisual stimuli or fantasy. Impulses from the brain modulate the spinal erection centers TL2 and S2-S4 to activate the erectile process.
Reflexogenic erection is produced by tactile stimulation of the genital organs. A stimulation percept from sensory receptors reaches to the spinal erection center, followed by the ascending tract.
Then, messages are sent through the cavernous nerves. Nocturnal erection occurs mostly during rapid-eye-movement REM sleep. During REM sleep, the cholinergic neurons in the lateral pontine tegmentum are activated, and the adrenergic neurons in the locus ceruleus and the serotonergic neurons in the midbrain raphe are silent.
This differential activation may be responsible for nocturnal erection [ 6 ]. From these normal erection processes, it is known that erections are influenced by ANS. HRV depends on the influence of sympathetic and vagal activity on the sinus node, and variability reflects spontaneous changes in autonomic activity [ 13 ]. The clinical significance of HRV was first recognized in by Hon and Lee who noted that fetal distress is preceded by changes in the R-to-R intervals, which was the first indication that HRV indicates body changes or pathology [ 15 ].
Lavie et al. Giuliano and Rampin [ 17 ] suggested that sympathetic pathways play an anti-erectile role while parasympathetic pathways play a pro-erectile role. Dogru et al. These results support the idea that ED patients have excessive sympathetic activity and out study had similar results. Dogru and Basar [ 10 ] also reported that hyperlipidemic patients with ED had diminished nocturnal parasympathetic activities and increased nocturnal sympathetic activity through HRV parameters.
Chen et al. All the HRV parameters of the patients with a satisfactory response after treatment of a two-month oral trazodone 50 to mg, each night have significantly improved. These results including our findings suggest that patients with ED have significant cardiac sympathetic hyperactivity and cardiac vagal impairment and sympathovagal dysfunction in them may not be only confined to the sexual organs, but is likely to be systemic.
RMSSD and HF representing parasympathetic activity were lower in patients than controls and LF representing mainly sympathetic activity was higher in patients than controls although P-values were not statistically significant.
This study has several limitations. First, this study was conducted in the single center. Second, the sample size of both groups was small.
Third, despite exclusion criteria for drugs that affect autonomic activity, we could not control individual emotion, mental state and environmental factors during measurement of HRV. Fourth, electrocardiography recording was measured only for 5 minutes in a sitting position not for 24 hours to simplify the measurement and reduce discomfort of subjects.
Last, we only compared subjects with and without ED not to distinguish between organic and non-organic ED. However, this study is the first report in Korea showing that autonomic variability occurs with ED. Further studies with larger sample size and animal experiments are needed to confirm our results.
Footnotes No potential conflict of interest relevant to this article was reported. References 1. Summary of the recommendations on sexual dysfunctions in men. J Sex Med. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol. Prevalence and risk factors for erectile dysfunction in the US.
Am J Med. Some find that traditional treatments, such as surgery or medication, do not work. These men may have success using a penis pump, which draws blood into the penis and induces an erection. These help with achieving or maintaining erections but do not address the underlying cause of ED.
For example, sildenafil Viagra increases blood flow to the penis, which can provide short-term relief from ED. It may help people with conditions such as diabetes and atherosclerosis to get erections.
Primary treatments address the issue that is causing ED. When clogged arteries are responsible, taking medication or exercising more frequently can improve cardiovascular health. This may eliminate ED or reduce the frequency of episodes.
The cause of ED may be psychological, and the condition itself may lead to anxiety. Psychological treatments can reduce anxiety, increase self-confidence, and improve relationships with sexual partners. Some men find that intense anxiety about sex prevents certain treatments from working. Addressing this anxiety can improve overall results. See a doctor to check for any underlying health issues. ED can be the first sign of diabetes-related nerve damage, cardiovascular disease, or a neurological problem.
While the cause of ED may be physical, the condition can still have psychological effects. It may lead to self-consciousness or anxiety, which can make it more difficult to get an erection. A treatment plan may, therefore, include both physical and psychological methods. Adjusting the lifestyle can improve many issues that cause ED, such as diabetes and clogged arteries. Men with underlying health issues should discuss options with their doctors. The pelvic floor muscles help men to urinate and ejaculate.
Strengthening these muscles may also improve erectile function. A comprehensive review found that pelvic floor exercises may help men with diabetes to get and maintain erections.
Discuss pelvic floor physical therapy with a doctor to learn which exercises are most effective. ED can negatively impact self-esteem. It may be difficult to talk about, but the issue is common. It is important to acknowledge and discuss ED, particularly when it causes depression or anxiety. Individual counseling can aid in uncovering the cause of the problem. A psychologist or psychiatrist can help an individual to manage their anxiety and resolve issues, which can eliminate ED and prevent it from returning.
Couples' therapy can help sexual partners to talk through their feelings and find healthful, constructive ways to communicate about ED.
Some men find that alternative and complementary therapies, such as acupuncture , help with ED. Preliminary research suggests that some herbal supplements may also help.
A review found that ginseng preparations significantly improved symptoms of ED in the population studied. Preparations of maritime pine extract, Pinus pinaster , and maca, Lepidium meyenii , also showed promising results, but more research is needed.
Methods of alternative medicine are safest when used under the guidance of a doctor and in conjunction with other treatments. A wide variety of medications can help with ED. The best-known are drugs, such as tadalafil Cialis and Viagra, which increase blood flow to the penis and help to achieve an erection.
These can be effective when that cause of ED is physical, and they also work well when the cause is unknown or related to anxiety. If an underlying condition, such as diabetes, is causing ED, treating it will often reverse ED or prevent it from worsening. Some medications can make ED worse. Blood pressure medication, for example, may lower blood flow to the penis, making it harder to get an erection.
Anyone who suspects that ED is associated with a medication should tell a doctor. Alternative drugs are often available. Penis pumps can draw blood into the penis and induce an erection in most men, including those with severe nerve damage. When there is severe nerve or blood vessel damage, using a ring can help to keep blood in the penis. Even when serious physical health issues are present, a mechanical device can usually help with getting an erection.
If other strategies are ineffective, or when there is an anatomical cause of ED, a doctor may recommend surgery. The procedure involves implanting a device that enables immediate erections. Surgery is effective in most cases, and the rate of complications is less than 5 percent.
Some people feel frustration about ED. It is important to remember that the condition is treatable. ED is very common and can usually be reversed by using natural remedies or medications to treat the underlying cause.
Early intervention can often detect a serious medical condition, and determining the cause of ED early may increase the likelihood of reversing it. Speak with a doctor about the best course of treatment. Article last reviewed by Sun 10 June All references are available in the References tab. Adeniyi, A. Diabetes, sexual dysfunction and therapeutic exercise: A 20 year review. Retrieved from http: Borrelli, F. Herbal dietary supplements for erectile dysfunction: A systematic review and meta-analysis.
Retrieved from https: Hirsch, I. Erectile dysfunction. Martin, S. Predictors of sexual dysfunction incidence and remission in men [Abstract]. Rastrelli, G. Erectile dysfunction in fit and healthy young men: Psychological or pathological? Rew, K. MLA Villines, Zawn.