“Erectile dysfunction is defined as inability to keep up an erection adequate for sexual intercourse. This is a dysfunction that affects millions of males around the world in numerous ways and with varying causes.”
What is it?
Erectile dysfunction is a medical time period used to define the inability to get an erection with enough inflexibleity for penetration and / or keep it for a time frame adequate to the satisfaction of both partners during sex. It is important to understand that it can happen even with need and orgasm (ejaculation) present.
Erectile dysfunction (ED) affects about thirds of males over 50 years of age, representing 10 to twenty million Brazilians.
Most men, at some point of their lives, have experienced episodes of erectile dysfunction, normally on account of tiredness, stress or alcohol abuse. Occasional failures should not be overrated. Nonetheless, if the problem persists, a urologist should be sought.
Causes
The capacity of erection is just one of a number of features of male sexual function. The sexual response cycle has four levels of man predominant want, erection, orgasm and relaxation. Each can change different.
The causes of ED are divided into organic, psychogenic and combined, can be found with mixed factors. Natural problems such as diabetes, cancer, arteriosclerosis and neurological accidents can often lead to psychological issues, for example. It will also be secondary, and appear as the primary manifestation of varied problems comparable to hypertension, diabetes, cardiovascular illness and renal failure.
ED of psychological origin might be manifested in various ways, or delayed ejaculation, painful ejaculation and even impotence. There may additionally be lack of libido (sexual need), lack of orgasm and phobias (fears) intercourse, all for anxiety, depression or guilt. An individual who has an unpleasant experience, such as lack of erection to have sex or ejaculate very early, tends to the subsequent relationship, remember these “failures” and become anxious. This provides a new fault, making a vicious circle.
Organic causes are subdivided in response to the etiology. The vasculogênicas are more prevalent, particularly the flow changes, arteriosclerosis and trauma (leading to injury to blood vessels).Venous flow abnormalities are less common. The neurogenic causes are diabetic neuropathy, a number of sclerosis, alcohol abuse, trauma, spinal cord and nerve damage by radical prostatectomy (surgical procedure to remove the prostate). For the reason that causes are hormonal hipoandrogenismo main or secondary (issues of male hormones).
The ED can also occur, to be used and abuse of medication like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
Issues related
The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular illnesses; neurological ailments, endocrine disorders, spinal twine injuries, radical pelvic surgery, radiation remedy, alcoholism, smoking, marijuana use and / or cocaine; use of antihypertensives, tranquilizers and psychotropic substances; relationship problems with partner, stress, nervousness and worry of failure, depression, obsessive-compulsive personality, sexual deviation.
Diagnosis
The targets of the initial analysis of the patient are to determine the probable cause of ED and identify natural or psychological factors which will influence the associated therapeutic.
A detailed medical interview is a very powerful factor in evaluating patients with this problem. The history should determine the duration, progression and severity of ED and associated factors.
Once you have identified a problem within the affected person’s sexual efficiency, the next step is to distinguish it from different sexual problems equivalent to lack of libido and ejaculatory disorders.
Physical examination is to evaluate the patient’s health, with particular consideration to the cardiovascular, neurological and genitourinary, attributable to its contribution to the erection. The neurological analysis ought to include a notion of their affected person’s anxiousness or depression. For the reason that assessment of genital herpes is directed to detection of local irregularities.
Some are fundamental laboratory tests to establish disorders that may end up in ED.
Treatment
In cases of psychogenic DE, psychotherapy is indicated. Several factors should be evaluated by the urologist and if possible, by an professional in psychology or psychiatry. Factors comparable to physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy ought to be addressed to the couple.
Penile injections have been the first environment friendly and goal, with little or no side effects, with significant improvement of erection, even in severe OF and organic. They were the principle complication, painful erections. Additionally had the disadvantage of limiting the time limitation of erections and frequency of application (3 occasions per week). This method tends to be deserted with the advancement of technology.
With the advance of treatment, some oral medications are available within the market. They’re:
– Viagra (Sildenafil) of Pfizer: acts on the penis by stress-free muscle mass and rising blood flow to the region. Effective in cases of partial impotence, erection of providing forty to 60 minutes after ingestion of the medication, with stimulation of the penis. Its impact can last up to six horas.Tem side reactions equivalent to headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, particularly in drug treatment of nitrate (Sustrate, Monocordil, Isordil, Nitradisc, Nitroderm TTS, Isocord, Isosorbide, nitroglycerin) can’t take this medicine.
– Uprima (apomorphine), from Abbott Laboratories, acts on the central nervous system, facilitating the conduct of sexual stimulation of the brain to the penis. Generates erection 10-20 minutes after oral administration sublingually. Could cause headache, nausea, dizziness, fainting and flushing, however can be used by coronary heart patients.
– Cialis (Tadalafil), manufactured by Eli Lilly, acts directly on the penis by inhibiting the enzyme phosphodiesterase. Leads to an erection in 30 minutes, and sustained for as much as 36 hours. Can cause headache, gastric intolerance, nasal congestion, back pain, muscle pain, dizziness and flushing. As Viagra, cannot be used for heart illness in the use of nitrates.
– Levitra (Vardenafil) of Bayer and Glaxo, also acts directly and selectively on the penis by inhibiting the enzyme phosphodiesterase, with fewer side effects (headache, flushing and runny nose). Leads to an erection in 15 minutes, and keeps as much as 8 hours. As Viagra and Cialis, can not be used for heart disease in the usage of nitrates. One of many essential advantages is the most affordable value and being sold in single packs.
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