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Sexual health is a key component of wellness. Erectile dysfunction (ED) is a disorder affecting male sexual health. Historically known as impotence, ED affects the ability to obtain or sustain a penile erection leading to poor sexual performance (Rew & Heidelbaugh, 2016). Erectile dysfunction has been underappreciated due to patients' reluctance to discuss the condition and because health professionals have been remiss in asking the right questions (Marchese, 2017). According to the Urology Care Foundation (2018), approximately 30 million men in the United States have this condition. Penile anatomy and erectile physiology will be reviewed in this article. The pathophysiology of ED is addressed, including primary causes, treatment options, and nursing considerations. Specific medications used in the treatment of this condition are identified; however, a detailed discussion of medications is beyond the scope of this article.
Penile Anatomy and Erectile Physiology
The penis is an innervated and vascular organ with three tissue-filled columns that run lengthwise, two on the dorsal side (corpora cavernosa) and one on the ventral side (corpus spongiosum) (Urology Care Foundation, 2018). In a relaxed state and with normal blood flow, the penis is flaccid (Kim, 2018). The body responds to sexual stimulation with numerous chemical and neurosensory changes. The two dorsal compartments of spongy tissue in the penis relax and expand in reaction to the release of nitric oxide and other chemicals, allowing increased arterial blood flow into the penis. The spongy tissue on the ventral side surrounds and prevents closure of the urethra, allowing a track for semen during ejaculation. The corpora cavernosa expand larger than the corpus spongiosum (Hinkle & Cheever, 2018). When penile tumescence (engorgement) occurs, the tissue expansion compresses the veins at the base of the penis and prevents the outflow of blood from the penis. Blood pressure in the penis increases as a result of the blocked blood flow, producing a penile erection. When an orgasm is achieved, penile arteries contract, releasing the pressure on the penile veins, and the blood-filled compartments drain. The outflow of blood returns the penis to a flaccid state, and normal blood flow resumes (Kim, 2018; Urology Care Foundation, 2018).
Causes of Erectile Dysfunction
A breakdown of any part in the chain of vascular, chemical, sensory, and psychological responses during sexual...