“Erectile dysfunction is defined as inability to take care of an erection enough for sexual intercourse. This is a disorder that affects tens of millions of males around the world in different ways and with varying causes.”
What is it?
Erectile dysfunction is a medical term used to define the inability to get an erection with sufficient inflexibleity for penetration and / or keep it for a period of time adequate to the satisfaction of each partners during sex. You will need to understand that it can occur even with want and orgasm (ejaculation) present.
Erectile dysfunction (ED) affects about thirds of males over 50 years of age, representing 10 to 20 million Brazilians.
Most men, sooner or later in their lives, have skilled episodes of erectile dysfunction, often on account of tiredness, stress or alcohol abuse. Occasional failures should not be overrated. Nonetheless, if the problem persists, a urologist needs to be sought.
The capacity of erection is just one in all several facets of male sexual function. The sexual response cycle has four stages of man major want, erection, orgasm and relaxation. Each can change different.
The causes of ED are divided into organic, psychogenic and mixed, might be found with combined factors. Natural problems resembling diabetes, cancer, arteriosclerosis and neurological injuries can typically lead to psychological complications, for example. It will also be secondary, and appear as the first manifestation of assorted problems such as hypertension, diabetes, cardiovascular illness and renal failure.
ED of psychological origin could be manifested in varied ways, or delayed ejaculation, painful ejaculation and even impotence. There may additionally be loss of libido (sexual desire), lack of orgasm and phobias (fears) intercourse, all for nervousness, depression or guilt. An individual who has an disagreeable experience, similar to loss of erection to have intercourse or ejaculate very early, tends to the next relationship, keep in mind these “failures” and develop into 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 modifications, arteriosclerosis and trauma (resulting in 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 (surgical procedure to remove the prostate). Since the causes are hormonal hipoandrogenismo major or secondary (problems of male hormones).
The ED might also occur, to be used and abuse of medicine like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular illnesses; neurological ailments, endocrine problems, spinal cord 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, nervousness and concern of failure, depression, obsessive-compulsive personality, sexual deviation.
The aims of the initial analysis of the patient are to determine the probable cause of ED and identify 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 should establish the length, progression and severity of ED and associated factors.
After getting recognized a problem in the affected person’s sexual performance, the subsequent step is to distinguish it from different sexual problems corresponding to lack of libido and ejaculatory disorders.
Physical examination is to evaluate the patient’s health, with particular consideration to the cardiovascular, neurological and genitourinary, resulting from its contribution to the erection. The neurological evaluation ought to include a notion of their affected person’s anxiety or depression. Since the evaluation of genital herpes is directed to detection of native abnormalities.
Some are fundamental laboratory tests to identify issues that may end up in ED.
In cases of psychogenic DE, psychotherapy is indicated. A number of factors should be evaluated by the urologist and if possible, by an knowledgeable in psychology or psychiatry. Factors reminiscent of 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 objective, 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. Also had the disadvantage of limiting the time limitation of erections and frequency of application (3 instances per week). This technique tends to be deserted with the advancement of technology.
With the advance of therapy, some oral drugs are available in the market. They’re:
– Viagra (Sildenafil) of Pfizer: acts on the penis by enjoyable muscle tissues and increasing blood flow to the region. Efficient in cases of partial impotence, erection of providing 40 to 60 minutes after ingestion of the remedy, with stimulation of the penis. Its impact can last up to six horas.Tem side reactions such as headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, particularly in drug therapy 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. Might 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 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 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 nostril). Leads to an erection in 15 minutes, and keeps as much as 8 hours. As Viagra and Cialis, can’t be used for heart disease in the usage of nitrates. One of many main advantages is the most affordable value and being sold in single packs.
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