“Erectile dysfunction is defined as inability to keep up an erection ample for sexual intercourse. This is a dysfunction that impacts millions of men around the globe in several ways and with various causes.”
What is it?
Erectile dysfunction is a medical term used to define the inability to get an erection with enough inflexibleity 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 want and orgasm (ejaculation) present.
Erectile dysfunction (ED) affects about thirds of men over 50 years of age, representing 10 to twenty million Brazilians.
Most men, at some point in their lives, have skilled episodes of erectile dysfunction, usually as a consequence of tiredness, stress or alcohol abuse. Occasional failures should not be overrated. Nevertheless, if the problem persists, a urologist should be sought.
Causes
The capacity of erection is just certainly one of a number of elements of male sexual function. The sexual response cycle has 4 phases of man main want, erection, orgasm and relaxation. Every can change different.
The causes of ED are divided into natural, psychogenic and blended, may be found with mixed factors. Organic problems akin to diabetes, cancer, arteriosclerosis and neurological accidents can typically lead to psychological complications, for example. It will also be secondary, and seem as the primary manifestation of assorted issues comparable to hypertension, diabetes, cardiovascular illness and renal failure.
ED of psychological origin can be manifested in numerous ways, or delayed ejaculation, painful ejaculation and even impotence. There may additionally be lack of libido (sexual need), lack of orgasm and phobias (fears) sex, all for anxiousness, depression or guilt. An individual who has an disagreeable expertise, similar to lack of erection to have sex 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.
Organic causes are subdivided based on 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 twine and nerve damage by radical prostatectomy (surgical procedure to remove the prostate). For the reason that causes are hormonal hipoandrogenismo primary or secondary (disorders of male hormones).
The ED might also occur, for use and abuse of medicine like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
Disorders related
The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular illnesses; neurological diseases, endocrine issues, spinal twine 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 fear of failure, depression, obsessive-compulsive personality, sexual deviation.
Prognosis
The targets of the initial evaluation of the patient are to find out the probable cause of ED and establish organic or psychological factors which will influence the related therapeutic.
A detailed medical interview is an important factor in evaluating patients with this problem. The history ought to determine the length, progression and severity of ED and associated factors.
After you have recognized a problem in the affected person’s sexual efficiency, the following step is to distinguish it from different sexual problems comparable to lack of libido and ejaculatory disorders.
Physical examination is to evaluate the patient’s health, with particular attention to the cardiovascular, neurological and genitourinary, resulting from its contribution to the erection. The neurological analysis should include a perception of their affected person’s anxiety or depression. For the reason that evaluation of genital herpes is directed to detection of native abnormalities.
Some are basic laboratory tests to identify problems that can lead to ED.
Treatment
In cases of psychogenic DE, psychotherapy is indicated. Several factors must be evaluated by the urologist and if attainable, by an knowledgeable in psychology or psychiatry. Factors comparable to physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy should be addressed to the couple.
Penile injections have been the primary environment friendly and objective, with little or no side effects, with significant improvement of erection, even in extreme OF and organic. They have been the primary complication, painful erections. Also had the disadvantage of limiting the time limitation of erections and frequency of application (three instances per week). This method tends to be abandoned with the advancement of technology.
With the advance of treatment, some oral medications are available in the market. They’re:
– Viagra (Sildenafil) of Pfizer: acts on the penis by relaxing muscle tissue and rising blood flow to the region. Effective in cases of partial impotence, erection of providing 40 to 60 minutes after ingestion of the medicine, with stimulation of the penis. Its impact can last as long as six horas.Tem side reactions resembling 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, 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 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, cannot be used for coronary heart illness in using 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 nostril). Leads to an erection in 15 minutes, and keeps up to eight hours. As Viagra and Cialis, can’t be used for heart illness in using nitrates. One of many predominant advantages is essentially the most affordable price and being sold in single packs.
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