“Erectile dysfunction is defined as inability to keep up an erection enough for sexual intercourse. This is a dysfunction that impacts millions of males all over the world in several ways and with varying causes.”
What’s it?
Erectile dysfunction is a medical term used to define the inability to get an erection with ample rigidity for penetration and / or keep it for a period of time adequate to the satisfaction of each partners during sex. It is important to understand that it can occur even with desire 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, often due to tiredness, stress or alcohol abuse. Occasional failures should not be overrated. Nevertheless, if the problem persists, a urologist must be sought.
Causes
The capacity of erection is just considered one of a number of aspects of male sexual function. The sexual response cycle has four stages of man foremost desire, erection, orgasm and relaxation. Every can change different.
The causes of ED are divided into natural, psychogenic and blended, may be discovered with mixed factors. Natural problems comparable to diabetes, cancer, arteriosclerosis and neurological accidents can often lead to psychological problems, for example. It will also be secondary, and seem as the primary manifestation of assorted disorders resembling hypertension, diabetes, cardiovascular illness and renal failure.
ED of psychological origin could be manifested in varied ways, or delayed ejaculation, painful ejaculation and even impotence. There might also be loss of libido (sexual desire), lack of orgasm and phobias (fears) intercourse, all for anxiety, depression or guilt. A person who has an unpleasant experience, comparable to lack of erection to have sex or ejaculate very early, tends to the subsequent relationship, bear in mind these “failures” and grow to be anxious. This provides a new fault, making a vicious circle.
Organic causes are subdivided in accordance with the etiology. The vasculogênicas are more prevalent, particularly the flow changes, arteriosclerosis and trauma (resulting in 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). Since the causes are hormonal hipoandrogenismo major or secondary (problems of male hormones).
The ED can also happen, to be used and abuse of drugs like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
Issues related
The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular ailments; neurological ailments, endocrine disorders, spinal wire injuries, radical pelvic surgical procedure, radiation therapy, 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 objectives of the initial analysis of the patient are to determine the probable cause of ED and determine natural or psychological factors which will affect the associated therapeutic.
An in depth medical interview is a very powerful factor in evaluating patients with this problem. The history should identify the period, progression and severity of ED and associated factors.
Once you have identified a problem within the affected person’s sexual efficiency, the subsequent step is to differentiate it from different sexual problems similar to lack 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 ought to embrace a perception of their patient’s anxiousness or depression. For the reason that evaluation of genital herpes is directed to detection of local irregularities.
Some are basic laboratory tests to determine disorders that can result in ED.
Remedy
In cases of psychogenic DE, psychotherapy is indicated. A number of factors ought to be evaluated by the urologist and if attainable, 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 primary efficient and objective, with little or no side effects, with significant improvement of erection, even in severe OF and organic. They had been the principle complication, painful erections. Additionally had the disadvantage of limiting the time limitation of erections and frequency of application (three times per week). This method tends to be abandoned with the advancement of technology.
With the advance of remedy, some oral medications are available in the market. They’re:
– Viagra (Sildenafil) of Pfizer: acts on the penis by enjoyable muscle mass and growing blood flow to the region. Effective in cases of partial impotence, erection of providing forty to 60 minutes after ingestion of the treatment, with stimulation of the penis. Its effect can last as long as six horas.Tem side reactions corresponding to headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, especially in drug treatment of nitrate (Sustrate, Monocordil, Isordil, Nitradisc, Nitroderm TTS, Isocord, Isosorbide, nitroglycerin) cannot 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 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 heart illness in the usage 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 15 minutes, and keeps as much as 8 hours. As Viagra and Cialis, can not be used for coronary heart disease in the usage of nitrates. One of many principal advantages is probably the most affordable worth and being sold in single packs.
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