RELATIOHSHIP BETWEEN SMOKING AND ERECTILE DYSFUNCTION

INTRODUCTION
The use of tobacco is a major public health problem worldwide, and its effect on sexual life is an often-used fact in anti-smoking campaigns. Association between smoking and ED has been assessed mainly in prevalence studies, which have considerable weaknesses for elucidating the etiology of ED. two longitudinal studies have evaluated the effect of smoking on erectile function. One has clearly shown that smoking does not have an effect on the incidence of ED.and the other has also found no effect in whole sample.while doubling of risk in a subgroup of men free from vascular diseases

SMOKING
DEFINITION Smoking is a practice in which a substance, most commonly tobacco or cannabis, is burned and the smoke is tasted or inhaled. This is primarily practised as a route of administration for recreational drug use, as combustion releases the active substances in drugs such as nicotine and makes them available for absorption through the lungs.

HEALTH EFFECTS
Tobacco-related diseases are some of the biggest killers in the world today and are cited as one of the biggest causes of premature death in industrialized countries. In the United States about 500,000 deaths per year are attributed to smoking-related diseases. At least half of all lifelong smokers die earlier as a result of smoking. The risk of dying from lung cancer before age 85 is 22.1% for a male smoker and 11.9% for a female current smoker, in the absence of competing causes of death

PHYSIOLOGY
Inhaling the vaporized gas form of substances into the lungs is a quick and very effective way of delivering drugs into the bloodstream (as the gas diffuses directly into the pulmonary vein, then into the heart and from there to the brain) and affects the user within less than a second of the first inhalation. The lungs consist of several million tiny bulbs called alveoli that altogether have an area of over 70 m (about the area of a tennis court).

 The inhaled substances trigger chemical reactions in nerve endings in the brain due to being similar to naturally occurring substances such as endorphins and dopamines, which are associated with sensations of pleasure

ERECTILE DYSFUNCTION
DEFINITION Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex. Having erection trouble from time to time isn't necessarily a cause for concern. But if erectile dysfunction is an ongoing problem, it may cause stress, cause relationship problems or affect your selfconfidence.

Erection physiology
When a man becomes aroused, his central nervous system stimulates the release of a number of chemicals that relax the smooth muscles in the penis, allowing blood to flow into the tiny pool-like sinuses and flood the penis. The spongy chambers almost double in diameter due to the increase in blood flow. The veins surrounding the corpa cavernosum and corpus spongiosum are squeezed almost completely shut by the pressure of the erectile tissue; they are unable to drain blood out of the penis, causing it to become rigid.

SYMPTOMS
Erectile dysfunction is the inability to maintain an erection firm enough for sex, on an ongoing basis. Symptoms related to erectile dysfunction may include: o Trouble getting an erection o Trouble keeping an erection o Reduced sexual desire

 A family doctor is a good place to start when you have erectile problems. See your doctor if: Erectile or other sexual problems are an issue for you or your partner You have diabetes, heart disease or another known health problem that may be linked to erectile dysfunction You have other symptoms along with erectile dysfunction that may not seem related.

DIAGNOSIS

Physical exam. This may include careful examination of your penis and testicles and checking your nerves for feeling. Blood tests. A sample of your blood may be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health problems. Urine tests (urinalysis). Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions. Ultrasound. This test can check blood flow to your penis. It involves using a wandlike device (transducer) held over the blood vessels that supply the penis. It creates a video image to let your doctor see if you have blood flow problems. This test is sometimes done in combination with an injection of medications into the penis to determine if blood flow increases normally. Overnight erection test. Most men have erections during sleep without remembering them. This simple test involves wrapping special tape around your penis before you go to bed. If the tape is separated in the morning, your penis was erect at some time during the night. This indicates the cause is of your erectile dysfunction is most likely psychological and not physical.

THE CORRELATION BETWEEN SMOKING AND ERECTILE DYSFUNCTION

Blood is a vehicle for delivering oxygen and nutrients to our body's tissues and organs. Without it they die. Our blood vessels (circulatory system) are the piping highways in which our blood flows. The inside of each healthy blood vessel is coated with a thin Teflon like layer of cells that ensure smooth blood flow. Carbon monoxide from smoking or second-hand smoke damages this important layer of cells, allowing fats and plaque to stick to vessel walls. Nicotine then performs a double whammy of sorts

 First, each time new nicotine arrives in our brain it causes the body to activate its fight or flight stress defenses. This in turn causes the immediate release of stored fats into the bloodstream, fats intended to be used to provide the instant energy needed to either fight or flee the saber tooth tiger. But there is no tiger The extra food we consumed during our big meals each day was converted to fat and stored. It was then pumped back into our bloodstream with each new puff of nicotine. It's how we were able to skip meals and what causes many of us to experience wild blood sugar swings when trying to quit. In fact, many of the symptoms of withdrawal - like an inability to concentrate - are due to nicotine no longer feeding us while we continue to skip meals.

 The heavy blasts of stored fats released by nicotine stick to vessel walls damaged by toxic carbon monoxide. We've recently learned that nicotine itself, inside our vessels, somehow causes the growth of new blood vessels (vascularization) that then provides a rich supply of oxygen and nutrients to the fats and plaques that have stuck to damaged vessel walls. This internal nicotine vascularization (vessels within vessels) hardens a smoker's arteries and veins and further accelerates their narrowing and clogging. The damage being done isn't just to the vessels supplying blood to our heart and brain. It's occurring, to one degree or another, inside every vessel in a smoker's body. It affects everything from blood vessels associated with hearing, to the skin's blood supply that shows itself in wrinkles, early aging, hair loss and tooth loss. Below are links to images showing varying degrees of artery clogging, followed by links that aid in understanding our body's circulatory system.

 Since erection is linked with blood flow, every erectile problem is known to be influenced by it. This is why, when something interferes in the process when blood rushes to the penis, a dysfunction takes place and sometimes smoking has something to do with it. It is known that smoking does not affect only the respiratory system but it also damages the body's circulation. Because the cigarettes contain carbon monoxide, the haemoglobin in the blood binds with it and the oxygen carrying capacity is reduced, along with the count of red blood cells. All this factors combined can cause cardiovascular problems, arteriosclerosis and reduced blood flow to the penis. In this way, smoking can be responsible also for low sperm count, sperm mortality and lack of libido

Treatment
So, if your erectile dysfunction has to do with smoking, you should know that it can't be treated only with chemical based medicines like Viagra. Before trying to treat your problem with erectile dysfunction pills, you should know that the only remedy is to simply quit smoking, especially if you suffer from diabetes or heart troubles. You can find help with the Internet programs or with the de-addiction centres in order to manage quit smoking. Most of all, you should always remember that quitting smoking will not only improve your sexual problems, but it will also have benefices on your general health.

CONCLUSION
Based on data and information obtained Smoking can cause erectile dysfunction directly or indirectly. The first step of the treatment is to quit smoking and to practice a healthy life style. Erectile dysfunction is not the only side effect or health effect you might get. A variety of options exist for treating erectile dysfunction. The cause and severity of condition, and underlying health problems, are important factors in recommending the best treatment. To choose the best treatment we need to understand the risks and benefits of each treatment. Partner's preferences also may play a role in treatment choices.

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Sherwood L . Human Physiology From Cell to System . 6th ed . United State of America ; Thomson Brooks/Cole ; 2007, p 444-445, 749-750 Kasper D, Braunwald E, Fauchi A. Harrisons Principles of Internal Medicine. 16th ed, New York : McGraw Hill, 2005 Erectile dysfunction and quit smoking Available at : http://www.mayoclinic.com/health/erectiledysfunction/DS00162 Relationship between smoking and erectile dysfunction Available at : http://www.nature.com/ijir/journal/v17/n2/full/3901280a.html Erectile Dysfunction Linked To Smoking Available at : http://www.sciencedaily.com/releases/2007/07/070727153458.htm