“Erectile dysfunction is defined as inability to maintain an erection adequate for sexual intercourse. This is a disorder that impacts millions of males around the globe in several ways and with various causes.”
What’s it?
Erectile dysfunction is a medical term used to define the inability to get an erection with enough rigidity 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 want and orgasm (ejaculation) present.
Erectile dysfunction (ED) affects about thirds of males 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 shouldn’t be overrated. However, if the problem persists, a urologist should be sought.
Causes
The capacity of erection is just considered one of several elements of male sexual function. The sexual response cycle has 4 phases of man predominant want, erection, orgasm and relaxation. Every can change different.
The causes of ED are divided into organic, psychogenic and mixed, can be found with combined factors. Organic problems akin to diabetes, cancer, arteriosclerosis and neurological injuries can usually lead to psychological complications, for example. It may also be secondary, and seem as the primary manifestation of varied problems akin 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 might also be lack of libido (sexual need), lack of orgasm and phobias (fears) intercourse, all for anxiety, depression or guilt. A person who has an unpleasant experience, akin to lack of erection to have sex or ejaculate very early, tends to the next relationship, bear in mind these “failures” and change into 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 adjustments, arteriosclerosis and trauma (resulting in injury to blood vessels).Venous flow abnormalities are less common. The neurogenic causes are diabetic neuropathy, multiple sclerosis, alcohol abuse, trauma, spinal wire and nerve damage by radical prostatectomy (surgery to remove the prostate). Because the causes are hormonal hipoandrogenismo main 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.
Issues associated
The DE has a number of risk factors as advanced age, diabetes, hypertension, peripheral vascular diseases; neurological diseases, endocrine issues, spinal wire accidents, radical pelvic surgery, radiation therapy, 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.
Diagnosis
The aims of the initial evaluation of the patient are to determine the probable cause of ED and determine organic or psychological factors which will influence the associated 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 associated factors.
Upon getting identified a problem in the affected person’s sexual efficiency, the next step is to distinguish it from different sexual problems reminiscent of lack of libido and ejaculatory disorders.
Physical examination is to assess the affected person’s health, with particular attention to the cardiovascular, neurological and genitourinary, due to its contribution to the erection. The neurological analysis ought to include a notion of their patient’s anxiety or depression. Because the assessment of genital herpes is directed to detection of native abnormalities.
Some are primary laboratory tests to establish issues that may end up in ED.
Treatment
In cases of psychogenic DE, psychotherapy is indicated. Several factors should be evaluated by the urologist and if attainable, by an skilled in psychology or psychiatry. Factors such as physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy ought 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 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 (three times per week). This methodology tends to be abandoned with the advancement of technology.
With the advance of treatment, some oral medicines are available in the market. They’re:
– Viagra (Sildenafil) of Pfizer: acts on the penis by enjoyable muscles 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 impact 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) 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. Could 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’t be used for coronary 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 as much as 8 hours. As Viagra and Cialis, cannot be used for heart illness in the use of nitrates. One of the main advantages is essentially the most affordable worth and being sold in single packs.
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