Erectile dysfunction, while not life-threatening, is a significant concern in any man that can affect his psychological well-being in many ways, but mainly because of the sensation of masculinity loss.

Misnamed impotence, erectile dysfunction is the inability to get an erection firm enough to have pleasurable sex.

It is mistakenly considered an ''old men problem'', but surprisingly some young man has trouble getting an erection at least once in their life. In fact, new evidence suggests a growing incidence of ED in men younger than 40 years.

Fortunately, treatment has proven to be successful in a large proportion of patients, and better drugs and treatments are being developed every day.

Erectile dysfunction is the inability to achieve a firm, long-lasting erection to have sex. Once called impotence because of the worry in men, now is considered a symptom rather than a second name.

Erectile dysfunction may not show itself as its definition, but through minor signs during sex that are later recognized, such as:

• You have erections only occasionally, but not every time you want to have sex.

• Because of the above, you are constantly afraid of failing during sex, so you avoid sexual intercourse.

• Erections achieved do not last as long as you expect them to, and you find it tough to have sex because of this.

The process of getting an erection depends on so many things that if one fails, the full erection fails. Blood vessels, nerves, nerve signals and hormones participate in it, and if, for example, one nerve is damaged, there will be no nerve impulse for penis stimulation and thus no erection.

In order for the penis to be enlarged, it needs 1) sexual desire and emotions, 2) nerves transmitting information to the penis and 3) blood to flow inside it for muscle dilation. 

Desire is a fundamental part of executing the sexual encounter, but it is often influenced by external factors, mainly psychological.

If sexual desire is affected, the nerve signals that tell the penis to enlarge will also be affected, thus the blood inflow.

Suppose there is flowing sexual desire and stimulation for arousal. In that case, the brain will tell the penis to release chemicals to dilate the penile blood vessels and ultimately allow an erection by increased blood inflow. This is how an erection works in a nutshell.

Now that you know the steps of an erection, the causes of ED mainly compromise any of them. 

The organic causes include physical problems of a man's reproductive system, such as vascular or nerve injury, medications, hormones, and others.

Among them are mentioned:

1. Heart disease

2. Obesity

3. Blocked blood vessels (atherosclerosis)

4. High cholesterol

5. High blood pressure

6. Metabolic syndrome

7. Diabetes

8. Multiple sclerosis

9. Parkinson's disease

10. Some prescribed medication

11. Tobacco use

12. Peyronie's disease

13. Spina bifida

14. Alcohol or any other abuse

As the body computer, the brain plays a crucial role in erection, enabling sexual arousal and desire. However, many situations or mental disturbances can interfere with sexual thinking.

Many past or current situations can cause problems getting an erection, such as:

1. Performance anxiety

2. Conflicts in the couple's relationship

3. Social and work problems 

4. Affective problems

5. Stress and little sleep

6. Low self-esteem

7. Depression

8. Sexual inhibition

9. Consequences of sexual abuse during childhood

10. Religious or cultural taboos

11. Result of sexual preferences

Young men often go through changes and new experiences that make them nervous, stressed, or worried. Fear of having sex due to inexperience, childhood trauma, fear of getting pregnant, and wrong beliefs about sex can interfere with erection.

Performance anxiety in sex described by Masters and Johnson is the fear of having sex due to past erection failure. Faced with the experience, fear and a complete loss of confidence regarding the subsequent intercourse arise. Men with performance anxiety self-observe their penis and focus all their attention on it with the consequent loss of sexual stimulation and attention to the partner.

In these situations, the brain releases typical stress chemicals that compress the penile arteries and hinder the typical rigidity of an erection.

Getting older is already a risk factor for erectile dysfunction. Damage to the heart, hardening of the blood vessels, kidney and neurological problems are some of the issues that lead to it. According to studies, men have a 50% risk of developing ED in their 40s, increasing every year.

High blood pressure and diabetes are some of the chronic diseases closely related to aging, both due to involved organs failure and as a result of years of bad habits.

Lipid imbalance such as dyslipidemia and diseases that impair muscle function such as multiple sclerosis also gradually weaken male erection.

Thanks to scientific advances, there are currently many therapeutic options ranging from emotional control to medications or surgeries in specific cases.

If you are a young man with problems getting an erection, it is likely that the source is psychological and even more likely that the best treatment for you is to look inside your thoughts with psychotherapy.

If psychotherapy does not work, drugs that stimulate sexual function, such as sildenafil or tadalafil, may be included depending on what your doctor suggests.

These medications are usually very effective in promoting erection, allowing you to have sex whenever you want. Although there are still cases where they work little or do not at all.

If you think you have erectile dysfunction, seek help as soon as possible. You are not alone. There are many men like you who want to talk about it. Don't wait for the perfect moment to seek help because there isn't one. Schedule your appointment now and start improving your sex life.

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