“Erectile dysfunction is defined as inability to maintain an erection ample for sexual intercourse. This is a dysfunction that impacts millions of males all over the world in numerous ways and with various causes.”
What’s it?
Erectile dysfunction is a medical term 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 both partners throughout sex. You will need 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 20 million Brazilians.
Most men, sooner or later in their lives, have skilled episodes of erectile dysfunction, often attributable to 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 4 stages of man major desire, erection, orgasm and relaxation. Each can change different.
The causes of ED are divided into organic, psychogenic and mixed, might be found with combined factors. Natural problems reminiscent of diabetes, cancer, arteriosclerosis and neurological accidents can usually lead to psychological complications, for example. It will also be secondary, and appear as the first manifestation of various disorders corresponding to hypertension, diabetes, cardiovascular disease and renal failure.
ED of psychological origin can be manifested in various ways, or delayed ejaculation, painful ejaculation and even impotence. There may also be lack of libido (sexual desire), lack of orgasm and phobias (fears) intercourse, all for nervousness, depression or guilt. A person who has an unpleasant expertise, such as loss of erection to have sex or ejaculate very early, tends to the subsequent relationship, keep in mind these “failures” and become anxious. This provides a new fault, creating a vicious circle.
Organic causes are subdivided in keeping with the etiology. The vasculogênicas are more prevalent, particularly the flow changes, arteriosclerosis and trauma (leading to injury to blood vessels).Venous flow irregularities 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 (problems of male hormones).
The ED may additionally occur, to be used and abuse of medication like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
Disorders related
The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular diseases; neurological ailments, endocrine disorders, spinal wire injuries, radical pelvic surgical procedure, radiation remedy, 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.
Diagnosis
The goals of the initial evaluation of the affected person are to determine the probable cause of ED and identify organic or psychological factors that may influence the related therapeutic.
An in depth medical interview is the most important factor in evaluating patients with this problem. The history ought to establish the period, progression and severity of ED and associated factors.
Upon getting recognized a problem in the affected person’s sexual performance, the subsequent step is to distinguish it from different sexual problems reminiscent of loss of libido and ejaculatory disorders.
Physical examination is to evaluate the patient’s health, with particular attention to the cardiovascular, neurological and genitourinary, on account of its contribution to the erection. The neurological analysis should embrace a notion of their patient’s anxiety or depression. Because the assessment of genital herpes is directed to detection of native abnormalities.
Some are basic laboratory tests to identify disorders that may end up in ED.
Therapy
In cases of psychogenic DE, psychotherapy is indicated. Several factors must be evaluated by the urologist and if attainable, by an skilled in psychology or psychiatry. Factors similar 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 efficient and objective, with little or no side effects, with significant improvement of erection, even in extreme OF and organic. They have been the principle complication, painful erections. Additionally had the disadvantage of limiting the time limitation of erections and frequency of application (3 instances per week). This technique tends to be abandoned with the advancement of technology.
With the advance of treatment, some oral medicines are available within the market. They are:
– Viagra (Sildenafil) of Pfizer: acts on the penis by stress-free muscle tissues and growing blood flow to the region. Efficient in cases of partial impotence, erection of providing 40 to 60 minutes after ingestion of the medicine, with stimulation of the penis. Its effect can last up to 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) 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. Might cause headache, nausea, dizziness, fainting and flushing, but 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 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, can not be used for coronary heart illness in the usage 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 nostril). Leads to an erection in 15 minutes, and keeps up to 8 hours. As Viagra and Cialis, can’t be used for coronary heart disease in using nitrates. One of the primary advantages is essentially the most affordable price and being sold in single packs.
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