Male Erectile Dysfunction

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) defines Sexual Dysfunctions as characterized by a disturbance in the sexual response cycle or by pain associated with sexual intercourse. The sexual response cycle is defined by four (4) phases: desire, excitement, orgasm, and resolution. The desire phase consists of fantasies about and the desire of sexual activity. Excitement is a subjective sense of sexual pleasure and the accompanying physiological changes, penile tumescence and erection in men. Orgasm is the peaking sexual pleasure, with release of sexual tension; in men, there is the sensation of ejaculatory inevitability, which is followed by ejaculation of semen. Resolution is the sense of muscular relaxation and general well being following orgasm.

Erectile Dysfunction is defined by the DSM-IV-TR as first, a persistent or recurrent inability to attain, or to maintain an adequate erection. Secondly, this inability causes interpersonal difficulty for the patient. Finally, this inability is not better accounted for by another disorder, is not due exclusively to the direct physiological effects of a substance (medication or drug of abuse), or to a general medical condition.

Usually, when people think of Erectile Dysfunction, they think of one type of issue (the inability to obtain an erection), but in fact, there are four (4) varieties of Erectile Dysfunction as defined by the DSM-IV-TR. Perhaps the most commonly known issue, as previously noted, is the inability to obtain any erection from the onset of a sexual experience. However, some men report first experiencing an adequate erection and then losing tumescence when attempting penetration; while others report having an erection that is sufficiently firm for penetration but then lose tumescence before or during intercourse; still others report being able to experience an erection only during masturbation or upon awakening.

Very often, Erectile Dysfunction has more than one cause. The causes may be psychological, physical, or a combination of both. Psychologically, Erectile Dysfunction is frequently associated with sexual anxiety, fear of failure, concerns about sexual performance, and a decreased subjective sense of sexual excitement and please. Physically, vascular diseases often contribute to Erectile Dysfunction. Interestingly enough, smoking is one of the most common causes of vascular diseases.

Recent advances in medical and psychological treatment offer hope to many men facing Erectile Dysfunction and other sexual problems.

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