“Erectile dysfunction is defined as inability to take care of an erection adequate for sexual intercourse. This is a dysfunction that affects tens of millions of men around the globe in several ways and with varying causes.”
What’s it?
Erectile dysfunction is a medical time period used to define the inability to get an erection with adequate inflexibleity for penetration and / or keep it for a period of time adequate to the satisfaction of each partners throughout sex. It is very important understand that it can happen even with need and orgasm (ejaculation) present.
Erectile dysfunction (ED) impacts about thirds of men over 50 years of age, representing 10 to twenty million Brazilians.
Most males, in some unspecified time in the future of their lives, have skilled episodes of erectile dysfunction, often as a consequence of tiredness, stress or alcohol abuse. Occasional failures shouldn’t be overrated. Nevertheless, if the problem persists, a urologist needs to be sought.
Causes
The capacity of erection is just one in all several points of male sexual function. The sexual response cycle has four stages of man fundamental 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. Organic problems corresponding to diabetes, cancer, arteriosclerosis and neurological injuries can often lead to psychological complications, for example. It will also be secondary, and appear as the first manifestation of assorted issues such as hypertension, diabetes, cardiovascular disease and renal failure.
ED of psychological origin might be manifested in various ways, or delayed ejaculation, painful ejaculation and even impotence. There may be lack of libido (sexual desire), lack of orgasm and phobias (fears) sex, all for anxiousness, depression or guilt. A person who has an unpleasant experience, corresponding to loss of erection to have intercourse or ejaculate very early, tends to the subsequent relationship, bear in mind these “failures” and become anxious. This provides a new fault, creating a vicious circle.
Natural causes are subdivided in accordance with 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 primary or secondary (issues of male hormones).
The ED may also occur, to be used and abuse of drugs like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
Issues related
The DE has a number of risk factors as advanced age, diabetes, hypertension, peripheral vascular ailments; neurological diseases, endocrine disorders, spinal cord injuries, 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 worry of failure, depression, obsessive-compulsive personality, sexual deviation.
Analysis
The objectives of the initial analysis of the affected person are to determine the probable cause of ED and determine organic or psychological factors which will influence the associated therapeutic.
A detailed medical interview is an important factor in evaluating patients with this problem. The history ought to establish the length, progression and severity of ED and associated factors.
After getting identified a problem within the patient’s sexual performance, the following step is to differentiate it from other sexual problems resembling loss of libido and ejaculatory disorders.
Physical examination is to evaluate the affected person’s health, with particular consideration to the cardiovascular, neurological and genitourinary, on account of its contribution to the erection. The neurological evaluation should include a perception of their affected person’s anxiety or depression. For the reason that assessment of genital herpes is directed to detection of native abnormalities.
Some are basic laboratory tests to identify problems that can result in ED.
Therapy
In cases of psychogenic DE, psychotherapy is indicated. Several factors must be evaluated by the urologist and if doable, by an expert in psychology or psychiatry. Factors akin to physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy must 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 extreme OF and organic. They had been the primary 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 remedy, some oral medications are available within the market. They’re:
– Viagra (Sildenafil) of Pfizer: acts on the penis by stress-free muscle groups and increasing blood flow to the region. Efficient in cases of partial impotence, erection of providing forty to 60 minutes after ingestion of the remedy, with stimulation of the penis. Its impact can last as long as six horas.Tem side reactions such as headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, especially 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. May cause headache, nausea, dizziness, fainting and flushing, however can be utilized by heart patients.
– Cialis (Tadalafil), manufactured by Eli Lilly, acts directly on the penis by inhibiting the enzyme phosphodiesterase. Leads to an erection in half-hour, and sustained for as much as 36 hours. Can cause headache, gastric intolerance, nasal congestion, back pain, muscle pain, dizziness and flushing. As Viagra, can not be used for heart illness in using 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 nostril). Leads to an erection in quarter-hour, and keeps up to eight hours. As Viagra and Cialis, can not be used for coronary heart illness in using nitrates. One of the principal advantages is the most affordable worth and being sold in single packs.
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