“Erectile dysfunction is defined as inability to take care of an erection ample for sexual intercourse. This is a dysfunction that affects hundreds of thousands of men world wide in several ways and with various causes.”
Erectile dysfunction is a medical time period used to define the inability to get an erection with sufficient rigidity for penetration and / or keep it for a time period adequate to the satisfaction of both partners throughout sex. It is important to understand that it can happen even with need and orgasm (ejaculation) present.
Erectile dysfunction (ED) impacts about thirds of men over 50 years of age, representing 10 to twenty million Brazilians.
Most males, at some point in their lives, have skilled episodes of erectile dysfunction, usually due to tiredness, stress or alcohol abuse. Occasional failures shouldn’t be overrated. Nonetheless, if the problem persists, a urologist must be sought.
The capacity of erection is just one of several elements of male sexual function. The sexual response cycle has four levels of man important need, erection, orgasm and relaxation. Every can change different.
The causes of ED are divided into organic, psychogenic and mixed, can be discovered with mixed factors. Organic problems similar to diabetes, cancer, arteriosclerosis and neurological accidents can usually lead to psychological complications, for example. It can be secondary, and seem as the first manifestation of various disorders similar to hypertension, diabetes, cardiovascular illness and renal failure.
ED of psychological origin may be manifested in various 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 anxiety, depression or guilt. A person who has an disagreeable experience, equivalent to lack of erection to have sex or ejaculate very early, tends to the subsequent relationship, remember these “failures” and change into anxious. This provides a new fault, creating a vicious circle.
Organic 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 twine and nerve damage by radical prostatectomy (surgery to remove the prostate). Because the causes are hormonal hipoandrogenismo primary or secondary (problems of male hormones).
The ED may additionally occur, for use and abuse of medication like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
The DE has a number of risk factors as advanced age, diabetes, hypertension, peripheral vascular illnesses; 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, nervousness and concern of failure, depression, obsessive-compulsive personality, sexual deviation.
The objectives of the initial evaluation of the affected person are to find out the probable cause of ED and determine organic or psychological factors which will influence the related therapeutic.
An in depth medical interview is an important factor in evaluating patients with this problem. The history ought to identify the duration, progression and severity of ED and associated factors.
Upon getting identified a problem within the patient’s sexual efficiency, the following step is to differentiate it from other 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, as a result of its contribution to the erection. The neurological analysis ought to embody a notion of their patient’s anxiousness or depression. For the reason that evaluation of genital herpes is directed to detection of native irregularities.
Some are basic laboratory tests to establish issues that can lead to ED.
In cases of psychogenic DE, psychotherapy is indicated. Several factors needs to be evaluated by the urologist and if potential, by an skilled in psychology or psychiatry. Factors such as physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy needs to 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 extreme OF and organic. They had been the principle complication, painful erections. Also had the disadvantage of limiting the time limitation of erections and frequency of application (three times per week). This technique tends to be abandoned with the advancement of technology.
With the advance of therapy, some oral drugs are available within the market. They’re:
– Viagra (Sildenafil) of Pfizer: acts on the penis by relaxing muscle tissues and rising blood flow to the region. Effective in cases of partial impotence, erection of providing 40 to 60 minutes after ingestion of the medication, with stimulation of the penis. Its effect can last as long as six horas.Tem side reactions akin to headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, particularly in drug therapy 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, 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 half-hour, 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 illness 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 nostril). Leads to an erection in quarter-hour, and keeps as much as eight hours. As Viagra and Cialis, cannot be used for heart disease in using nitrates. One of the most important advantages is the most affordable value and being sold in single packs.
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