It is the inability to consistently or regeneratively achieve an adequate erection or to maintain an erection until the end of sexual activity.
Erectional problems in men can occur in many different ways. It can occur in different manifestations, such as not being able to achieve an erection under any circumstances for intercourse at one end, and at the other end, not being able to perform sexual function with a certain partner even though it had previously functioned well.
Erection problem in men is life-long, acquired and It manifests itself in three ways: situationally. In the lifelong type, the person has not been able to achieve sufficient erection for intercourse under any circumstances. In the acquired type, the person has a history of previously having adequate functioning. However, he later started having erection problems. In the situational type, the person can achieve the erection necessary for sexual activity with a certain situation and partner, but cannot achieve sufficient erection with another partner. The way erectile dysfunction begins varies from person to person. In some men, erectile dysfunction may begin gradually, while in others it may occur suddenly after a trauma. While some people cannot achieve an erection in the presence of a partner, they can achieve an erection during masturbation and function well. Others can only achieve an erection when they are with their partner. Others may lose their erection during penis-vagina intercourse before orgasm. Separating all of these different patterns from each other is important for healing.
In our culture, as in almost all cultures, men attach great importance to sexual performance. In fact, they have a very strong desire for sexual performance. For this reason, in our culture, sexual function is perceived as synonymous with erection. This being the case, erection represents a very critical point in a man's sexual function. When this is the perception, men tend to react with very strong negative emotions towards erectile dysfunction.
Those suffering from erectile dysfunction Men generally experience feelings and thoughts of anger, depression, anxiety, shame, humiliation, worthlessness, failure, and loss of self-confidence very strongly. After this, anxiety focused on failure and sexual performance becomes permanent. These strong emotional reactions further complicate the problem and serve to perpetuate the difficulty.
CAUSES OF ERECTION DISORDER
Psychological factors: many psychosocial factors contribute to the erection problem. why could it be. For example, anger towards the spouse, stress, extreme fatigue, important life events, financial loss, work-related problems, marital problems, etc. Erectile dysfunction, which develops due to these problems, may gradually increase over time and become persistent and recurrent.
Failure experiences that occur from time to time lead to a general loss of confidence in the man's performance, which immediately leads to the expectation of failure in the man. Once this series begins, the person falls into a vicious cycle from which he finds it difficult to get out. In other words, the feeling caused by not being able to achieve an erection during sexual activity is so strong that these strong emotions lead to persistent performance anxiety in many men. This persistent anxiety deepens the vicious cycle by repeatedly inhibiting effective erection. Performance anxiety is one of the leading causes of psychologically induced erectile dysfunction.
Relationship problems, whether the couple's expectations from sexuality match, and the couple's communication style are among the interpersonal causes of erectile dysfunction. In addition, traumas experienced during childhood or a trauma experienced later may cause the onset of erection problems or the formation of a predisposition in the person.
The repressive approach to sexuality towards the child at an early age is another important psychosocial reason. A person who is raised in the context of shame, sin, bad, dirty and crime regarding sexuality naturally becomes alienated from his own body first. A person who is alienated from his own body loses connection with his emotions. Therefore, sexual activity He/she encounters difficulty focusing on his/her emotions and sensations during e.g. This difficulty prevents or makes it difficult for the person to become aroused and therefore to have an erection.
Medical causes: Many organic causes can cause erection problems. The most important of these are endocrine diseases, neurological diseases, vascular diseases and diabetes.
Causes related to drug and substance use: There are many substances and medications that affect erection in men. Both acute and persistent substance use negatively affects erection. Although initially users report that alcohol positively affects the level of arousal, this is misleading. In fact, alcohol use negatively affects a man's erectile function. Likewise, smoking also affects it negatively.
Drug addiction also negatively affects erectile function. Although substance addiction seems to function like a sexual stimulant at first, it is accepted that it causes erection problems as the dose taken increases. Likewise, it is accepted that some psychoactive drugs have a negative effect on sexual function. There is a conception that erection problems increase with age. However, this is thought to be due to the simultaneous increase in systemic medical diseases and psychosocial factors affecting erectile functions rather than the result of normal aging. A significant proportion of men may experience significant erectile dysfunction, which may be temporary or persistent, at some important stage in their lives. However, erectile dysfunction that occurs later is more common in applications.
TREATMENT
In the treatment, is the erectile dysfunction caused primarily by a medical condition, psychological reasons, or drug use? This distinction must be made. Because such a distinction affects the planning and course of treatment. It would not make sense to apply more invasive methods to a person whose erection problem is found to be of psychological origin.
Treatment should primarily include psycho-sexual, relational and detailed medical advice. Taking the blood sample gives us the necessary information about the type of problem, its causes and therefore the treatment plan. Therefore, taking a good history is essential. In cases where the history is not sufficient, laboratory findings and other medical investigations should be activated and evaluated by experts in the field. If the cause of the disorder is due to psychological reasons, sexual therapy by an experienced sexual therapist who is well-trained in the treatment of sexual dysfunctions is very valuable in these cases. In mixed type cases where both organic and psychological factors appear simultaneously, applying sexual therapy simultaneously with medical treatment provides optimal success.
The presence of medication or substance use or medical or physiological reasons for erectile dysfunction does not exclude the application of sexual therapy. In such cases, sexual therapy is an effective method in addition to medical treatment. Whatever the reason, erectile dysfunction will negatively affect the man's emotional and social life, so these areas of the client should be addressed in the treatment. Because, regardless of the reason, it is almost inevitable that a man who has erectile dysfunction will not experience performance anxiety. The excellent response of erectile dysfunction caused by performance anxiety to sexual therapy is extremely rewarding for both the client and the therapist.
The support and participation of the partner in the treatment is very important. Unlike others, perhaps most of all, there is a need for the participation of partners, cooperation and support for each other in the sexual therapy process. Once the couple enters the process of giving this support to each other during the therapy process, their relationship deepens and, most importantly, they have the opportunity to capture sincerity and enthusiasm in their relationship.
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