“Erectile dysfunction is defined as inability to maintain an erection ample for sexual intercourse. This is a dysfunction that impacts millions of males world wide in several ways and with various causes.”
What’s it?
Erectile dysfunction is a medical time period 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 each partners during sex. It is important to understand that it can happen even with need and orgasm (ejaculation) present.
Erectile dysfunction (ED) impacts about thirds of males over 50 years of age, representing 10 to 20 million Brazilians.
Most males, at some point in their lives, have experienced episodes of erectile dysfunction, usually attributable to tiredness, stress or alcohol abuse. Occasional failures shouldn’t be overrated. Nonetheless, if the problem persists, a urologist ought to be sought.
Causes
The capacity of erection is just one in all a number of elements of male sexual function. The sexual response cycle has 4 levels of man most important want, erection, orgasm and relaxation. Each can change different.
The causes of ED are divided into natural, psychogenic and blended, could be found with combined factors. Organic problems corresponding to diabetes, cancer, arteriosclerosis and neurological injuries can often lead to psychological problems, for example. It will also be secondary, and appear as the primary manifestation of various problems such as hypertension, diabetes, cardiovascular disease and renal failure.
ED of psychological origin may 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) intercourse, all for nervousness, depression or guilt. A person who has an unpleasant expertise, akin to lack of erection to have intercourse or ejaculate very early, tends to the subsequent relationship, keep in mind these “failures” and turn out to be anxious. This provides a new fault, creating a vicious circle.
Natural causes are subdivided according to 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, a number of sclerosis, alcohol abuse, trauma, spinal cord and nerve damage by radical prostatectomy (surgery to remove the prostate). For the reason that causes are hormonal hipoandrogenismo primary or secondary (disorders of male hormones).
The ED may occur, to be used 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 diseases; neurological illnesses, endocrine issues, spinal cord injuries, radical pelvic surgery, radiation remedy, alcoholism, smoking, marijuana use and / or cocaine; use of antihypertensives, tranquilizers and psychotropic substances; relationship problems with partner, stress, anxiousness and concern of failure, depression, obsessive-compulsive personality, sexual deviation.
Analysis
The targets of the initial analysis of the patient are to find out the probable cause of ED and determine organic or psychological factors that may influence the associated therapeutic.
A detailed medical interview is the most important factor in evaluating patients with this problem. The history should determine the duration, progression and severity of ED and related factors.
After you have recognized a problem in the affected person’s sexual performance, the subsequent step is to differentiate it from other sexual problems similar to lack of libido and ejaculatory disorders.
Physical examination is to assess the affected person’s health, with particular consideration to the cardiovascular, neurological and genitourinary, because of its contribution to the erection. The neurological evaluation should embody a notion of their patient’s nervousness or depression. For the reason that evaluation of genital herpes is directed to detection of local irregularities.
Some are basic laboratory tests to establish disorders that can result in ED.
Remedy
In cases of psychogenic DE, psychotherapy is indicated. Several factors must be evaluated by the urologist and if possible, by an skilled in psychology or psychiatry. Factors corresponding 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 goal, with little or no side effects, with significant improvement of erection, even in extreme OF and organic. They have been the main complication, painful erections. Also had the disadvantage of limiting the time limitation of erections and frequency of application (3 instances per week). This methodology tends to be abandoned with the advancement of technology.
With the advance of therapy, some oral medications are available within the market. They are:
– Viagra (Sildenafil) of Pfizer: acts on the penis by relaxing muscles and rising blood flow to the region. Efficient in cases of partial impotence, erection of providing forty to 60 minutes after ingestion of the medicine, with stimulation of the penis. Its effect can last up to six horas.Tem side reactions equivalent 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. May cause headache, nausea, dizziness, fainting and flushing, however 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 up to 36 hours. Can cause headache, gastric intolerance, nasal congestion, back pain, muscle pain, dizziness and flushing. As Viagra, cannot be used for heart illness in the use 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 nose). Leads to an erection in 15 minutes, and keeps up to eight hours. As Viagra and Cialis, cannot be used for coronary heart illness in the usage of nitrates. One of the main advantages is the most affordable value and being sold in single packs.
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