“Erectile dysfunction is defined as inability to keep up an erection ample for sexual intercourse. This is a dysfunction that impacts millions of males around the globe in several ways and with varying causes.”
What is it?
Erectile dysfunction is a medical time period used to define the inability to get an erection with enough rigidity for penetration and / or keep it for a time frame adequate to the satisfaction of both partners during sex. It is very important understand that it can occur even with need and orgasm (ejaculation) present.
Erectile dysfunction (ED) affects about two thirds of males over 50 years of age, representing 10 to 20 million Brazilians.
Most males, sooner or later of 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 must be sought.
Causes
The capacity of erection is just certainly one of a number of aspects of male sexual function. The sexual response cycle has 4 phases of man main want, erection, orgasm and relaxation. Each can change different.
The causes of ED are divided into natural, psychogenic and mixed, may be discovered with combined factors. Organic problems such as diabetes, cancer, arteriosclerosis and neurological injuries can often lead to psychological problems, for example. It can be secondary, and appear as the first manifestation of varied issues similar 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 also be lack of libido (sexual need), lack of orgasm and phobias (fears) intercourse, all for anxiousness, depression or guilt. An individual who has an disagreeable expertise, equivalent to lack of erection to have intercourse or ejaculate very early, tends to the next relationship, remember these “failures” and turn out to be anxious. This provides a new fault, creating a vicious circle.
Organic causes are subdivided in line with 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 twine and nerve damage by radical prostatectomy (surgical procedure to remove the prostate). Since the causes are hormonal hipoandrogenismo major or secondary (problems of male hormones).
The ED may additionally occur, to be used and abuse of drugs 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 problems, spinal twine injuries, radical pelvic surgical procedure, radiation therapy, alcoholism, smoking, marijuana use and / or cocaine; use of antihypertensives, tranquilizers and psychotropic substances; relationship problems with partner, stress, nervousness and worry of failure, depression, obsessive-compulsive personality, sexual deviation.
Analysis
The aims of the initial analysis of the patient are to determine the probable cause of ED and establish organic or psychological factors which will 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 associated factors.
After you have identified a problem within the affected person’s sexual performance, 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 affected person’s health, with particular consideration to the cardiovascular, neurological and genitourinary, resulting from its contribution to the erection. The neurological analysis ought to embody a notion of their patient’s anxiousness or depression. Since the evaluation of genital herpes is directed to detection of native irregularities.
Some are basic laboratory tests to identify issues that can lead to ED.
Remedy
In cases of psychogenic DE, psychotherapy is indicated. A number of factors must be evaluated by the urologist and if potential, by an expert in psychology or psychiatry. Factors such as physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy should 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 were the principle complication, painful erections. Additionally had the disadvantage of limiting the time limitation of erections and frequency of application (three instances per week). This methodology tends to be abandoned with the advancement of technology.
With the advance of treatment, some oral drugs are available in the market. They’re:
– Viagra (Sildenafil) of Pfizer: acts on the penis by relaxing muscle tissue and growing blood flow to the region. Effective in cases of partial impotence, erection of providing 40 to 60 minutes after ingestion of the remedy, with stimulation of the penis. Its effect can last up to six horas.Tem side reactions akin to headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, particularly in drug remedy of nitrate (Sustrate, Monocordil, Isordil, Nitradisc, Nitroderm TTS, Isocord, Isosorbide, nitroglycerin) cannot 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 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 up to 36 hours. Can cause headache, gastric intolerance, nasal congestion, back pain, muscle pain, dizziness and flushing. As Viagra, can not be used for heart disease 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 nose). Leads to an erection in quarter-hour, and keeps up to eight hours. As Viagra and Cialis, can not be used for heart disease in using nitrates. One of many fundamental advantages is the most affordable price and being sold in single packs.
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