Erectile dysfunction

Erection trouble or erectile dysfunction, also called sexual impotence, is an alteration of the erectile reflex in men that results in a lack of erection.

Erectile dysfunctions are either primary (man has never had an erection) or secondary (man has already had erections). They are either permanent or situational.

The causes can be psychological or physiological. Physiological causes include age, cardiovascular problems and diabetes. Tobacco, which has cardiovascular consequences, is a risk factor for erectile insufficiency. Stress, a psychological phenomenon that translates physiologically, also makes erection difficult because of adrenaline secretion.

The absence or occasional loss of erection is not a sign of impotence. It is only if the phenomenon is recurrent that it can ask questions. It is then necessary to determine whether the cause is physiological, psychological, or both. Taking sildenafil, tadalafil and other phosphodiesterase type 5 inhibitor (PDE-5) pills to ensure a good erection only makes sense when erectile dysfunction is caused by deactivation of cyclic guanosine monophosphate (cGMP) in the smooth muscle of the penis. Cyclic guanosine monophosphate is a transformation of guanosine triphosphate caused by the action of nitric oxide on cyclase guanylate. Nitric oxide is therefore at the beginning of the chemical chain that will lead to erection. Without the release of nitric oxide, there is no erection initiation. However, this nitric oxide is itself released by sexual desire and excitement. Therefore, in the absence of sexual desire or excitement, the pills will have no effect on erection.