“Erectile dysfunction is defined as inability to take care of an erection enough for sexual intercourse. This is a dysfunction that affects thousands and thousands of men around the world in numerous ways and with various 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 period adequate to the satisfaction of both partners during sex. It is very important understand that it can happen 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 men, sooner or later in their lives, have skilled episodes of erectile dysfunction, often because of tiredness, stress or alcohol abuse. Occasional failures should not be overrated. However, if the problem persists, a urologist needs to be sought.
Causes
The capacity of erection is just one among several elements of male sexual function. The sexual response cycle has 4 levels of man foremost desire, erection, orgasm and relaxation. Every can change different.
The causes of ED are divided into natural, psychogenic and combined, might be found with combined factors. Natural problems equivalent to diabetes, cancer, arteriosclerosis and neurological accidents can usually lead to psychological problems, for example. It can be secondary, and appear as the primary manifestation of assorted problems akin to hypertension, diabetes, cardiovascular disease and renal failure.
ED of psychological origin might be manifested in varied ways, or delayed ejaculation, painful ejaculation and even impotence. There may be lack of libido (sexual want), lack of orgasm and phobias (fears) intercourse, all for nervousness, depression or guilt. An individual who has an unpleasant experience, corresponding to loss of erection to have sex or ejaculate very early, tends to the next relationship, keep in mind these “failures” and turn out to be 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 abnormalities are less common. The neurogenic causes are diabetic neuropathy, a number of sclerosis, alcohol abuse, trauma, spinal wire and nerve damage by radical prostatectomy (surgical procedure to remove the prostate). Because the causes are hormonal hipoandrogenismo main or secondary (problems of male hormones).
The ED can also occur, for use and abuse of medicine like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
Issues related
The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular diseases; neurological diseases, endocrine issues, spinal twine accidents, radical pelvic surgery, 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.
Diagnosis
The goals of the initial analysis of the patient are to determine the probable cause of ED and determine organic or psychological factors that may influence the related therapeutic.
A detailed medical interview is a very powerful factor in evaluating patients with this problem. The history ought to establish the length, progression and severity of ED and related factors.
After getting recognized a problem within the patient’s sexual efficiency, the next 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, resulting from its contribution to the erection. The neurological analysis ought to embody a perception of their patient’s nervousness or depression. Since the evaluation of genital herpes is directed to detection of local abnormalities.
Some are basic laboratory tests to establish problems that may end up in ED.
Treatment
In cases of psychogenic DE, psychotherapy is indicated. A number of factors needs to be evaluated by the urologist and if potential, by an knowledgeable in psychology or psychiatry. Factors equivalent to physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy needs to be addressed to the couple.
Penile injections have been the primary environment friendly and goal, with little or no side effects, with significant improvement of erection, even in severe OF and organic. They have been the primary complication, painful erections. Additionally had the disadvantage of limiting the time limitation of erections and frequency of application (three occasions per week). This methodology tends to be abandoned with the advancement of technology.
With the advance of remedy, some oral medicines are available within the market. They’re:
– Viagra (Sildenafil) of Pfizer: acts on the penis by enjoyable muscle mass and increasing blood flow to the region. Efficient in cases of partial impotence, erection of providing forty to 60 minutes after ingestion of the medication, with stimulation of the penis. Its effect can last up to six horas.Tem side reactions reminiscent of 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 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. May cause headache, nausea, dizziness, fainting and flushing, but can be utilized by coronary 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 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 15 minutes, and keeps as much as 8 hours. As Viagra and Cialis, can not be used for heart illness in the use of nitrates. One of many essential advantages is probably the most affordable price and being sold in single packs.
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