“Erectile dysfunction is defined as inability to take care of an erection adequate for sexual intercourse. This is a disorder that affects tens of millions of males around the world in different 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 sufficient rigidity for penetration and / or keep it for a period of time adequate to the satisfaction of each partners throughout sex. It is important to understand that it can happen even with need and orgasm (ejaculation) present.
Erectile dysfunction (ED) impacts about two thirds of males over 50 years of age, representing 10 to 20 million Brazilians.
Most men, in some unspecified time in the future of their lives, have experienced episodes of erectile dysfunction, usually because of tiredness, stress or alcohol abuse. Occasional failures should not be overrated. However, if the problem persists, a urologist needs to be sought.
Causes
The capacity of erection is just certainly one of several elements of male sexual function. The sexual response cycle has four stages of man foremost want, erection, orgasm and relaxation. Each can change different.
The causes of ED are divided into organic, psychogenic and blended, may be found with mixed factors. Natural problems resembling diabetes, cancer, arteriosclerosis and neurological injuries can often lead to psychological problems, for example. It may also be secondary, and seem as the primary manifestation of various disorders comparable to hypertension, diabetes, cardiovascular illness and renal failure.
ED of psychological origin might be manifested in numerous ways, or delayed ejaculation, painful ejaculation and even impotence. There may additionally be loss of libido (sexual desire), lack of orgasm and phobias (fears) intercourse, all for anxiousness, depression or guilt. A person who has an unpleasant expertise, akin to lack of erection to have intercourse or ejaculate very early, tends to the next relationship, remember these “failures” and turn into anxious. This provides a new fault, making a vicious circle.
Natural causes are subdivided according to the etiology. The vasculogênicas are more prevalent, particularly the flow modifications, arteriosclerosis and trauma (leading to injury to blood vessels).Venous flow irregularities are less common. The neurogenic causes are diabetic neuropathy, multiple sclerosis, alcohol abuse, trauma, spinal wire and nerve damage by radical prostatectomy (surgical procedure to remove the prostate). Since the causes are hormonal hipoandrogenismo primary or secondary (disorders of male hormones).
The ED may happen, for use and abuse of medication like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
Issues related
The DE has a number of risk factors as advanced age, diabetes, hypertension, peripheral vascular illnesses; neurological ailments, endocrine issues, spinal cord accidents, radical pelvic surgery, radiation therapy, alcoholism, smoking, marijuana use and / or cocaine; use of antihypertensives, tranquilizers and psychotropic substances; relationship problems with partner, stress, anxiousness and concern of failure, depression, obsessive-compulsive personality, sexual deviation.
Analysis
The aims of the initial analysis of the patient are to determine the probable cause of ED and establish organic or psychological factors which will affect the related therapeutic.
An in depth medical interview is crucial factor in evaluating patients with this problem. The history ought to determine the duration, progression and severity of ED and related factors.
Upon getting identified a problem in the affected person’s sexual efficiency, the following step is to differentiate it from different sexual problems reminiscent of loss of libido and ejaculatory disorders.
Physical examination is to assess the patient’s health, with particular consideration to the cardiovascular, neurological and genitourinary, because of its contribution to the erection. The neurological analysis ought to embody a perception of their affected person’s anxiousness or depression. Because the assessment of genital herpes is directed to detection of native irregularities.
Some are fundamental laboratory tests to determine disorders that can lead to ED.
Therapy
In cases of psychogenic DE, psychotherapy is indicated. A number of factors ought to be evaluated by the urologist and if potential, by an professional in psychology or psychiatry. Factors resembling physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy should be addressed to the couple.
Penile injections have been the first efficient and goal, with little or no side effects, with significant improvement of erection, even in severe OF and organic. They had been the main 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 drugs are available in the market. They are:
– Viagra (Sildenafil) of Pfizer: acts on the penis by stress-free muscle tissues and growing 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 effect can last as long as six horas.Tem side reactions such as headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, especially in drug therapy of nitrate (Sustrate, Monocordil, Isordil, Nitradisc, Nitroderm TTS, Isocord, Isosorbide, nitroglycerin) can not 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, but can be used by 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 up to 36 hours. Can cause headache, gastric intolerance, nasal congestion, back pain, muscle pain, dizziness and flushing. As Viagra, can’t be used for coronary heart disease in the use of nitrates.
– Levitra (Vardenafil) of Bayer and Glaxo, additionally 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 quarter-hour, and keeps up to 8 hours. As Viagra and Cialis, can’t be used for heart disease in the use of nitrates. One of many essential advantages is essentially the most affordable worth and being sold in single packs.
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