“Erectile dysfunction is defined as inability to keep up an erection sufficient for sexual intercourse. This is a disorder that impacts millions of males around the globe in several ways and with varying causes.”
What is it?
Erectile dysfunction is a medical term used to define the inability to get an erection with adequate rigidity for penetration and / or keep it for a time frame adequate to the satisfaction of both partners during sex. It is important to understand that it can occur even with need and orgasm (ejaculation) present.
Erectile dysfunction (ED) affects 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, normally on account of tiredness, stress or alcohol abuse. Occasional failures shouldn’t be overrated. Nevertheless, if the problem persists, a urologist must be sought.
Causes
The capacity of erection is just one of several elements of male sexual function. The sexual response cycle has four phases of man primary want, erection, orgasm and relaxation. Every can change different.
The causes of ED are divided into natural, psychogenic and blended, can be discovered with combined factors. Natural problems reminiscent of diabetes, cancer, arteriosclerosis and neurological accidents can often lead to psychological complications, for example. It can be secondary, and appear as the first manifestation of varied issues equivalent to hypertension, diabetes, cardiovascular illness and renal failure.
ED of psychological origin could be manifested in various ways, or delayed ejaculation, painful ejaculation and even impotence. There may also be lack of libido (sexual want), lack of orgasm and phobias (fears) sex, all for anxiety, depression or guilt. A person who has an disagreeable expertise, comparable to loss of erection to have intercourse or ejaculate very early, tends to the next relationship, bear in mind these “failures” and turn out to be anxious. This provides a new fault, making a vicious circle.
Natural causes are subdivided in line with the etiology. The vasculogênicas are more prevalent, particularly the flow adjustments, arteriosclerosis and trauma (resulting in 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). For the reason that causes are hormonal hipoandrogenismo main or secondary (problems of male hormones).
The ED can also happen, for use and abuse of medicine like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
Problems related
The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular ailments; neurological ailments, endocrine problems, 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, anxiety and concern of failure, depression, obsessive-compulsive personality, sexual deviation.
Prognosis
The aims of the initial analysis of the patient are to find out the probable cause of ED and establish organic or psychological factors which will affect the associated therapeutic.
An in depth medical interview is an important factor in evaluating patients with this problem. The history ought to determine the period, progression and severity of ED and related factors.
After getting identified a problem within the patient’s sexual performance, the following step is to differentiate it from other 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 evaluation should include a perception of their patient’s anxiety or depression. For the reason that assessment of genital herpes is directed to detection of local irregularities.
Some are primary laboratory tests to identify problems 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 potential, by an expert in psychology or psychiatry. Factors equivalent 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 extreme 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 (3 occasions per week). This methodology tends to be abandoned with the advancement of technology.
With the advance of therapy, some oral medicines are available in the market. They are:
– Viagra (Sildenafil) of Pfizer: acts on the penis by enjoyable muscle groups and increasing blood flow to the region. Effective in cases of partial impotence, erection of providing forty 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 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’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. 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 as much as 36 hours. Can cause headache, gastric intolerance, nasal congestion, back pain, muscle pain, dizziness and flushing. As Viagra, can’t be used for heart disease 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 nose). Leads to an erection in quarter-hour, and keeps up to 8 hours. As Viagra and Cialis, cannot be used for heart illness in the use of nitrates. One of many principal advantages is probably the most affordable value and being sold in single packs.
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