“Erectile dysfunction is defined as inability to take care of an erection sufficient for sexual intercourse. This is a disorder that impacts tens of millions of males around the globe in different ways and with various causes.”
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 time period adequate to the satisfaction of each partners during sex. You will need to understand that it can occur even with need and orgasm (ejaculation) present.
Erectile dysfunction (ED) affects about two thirds of men over 50 years of age, representing 10 to twenty million Brazilians.
Most males, at some point in their lives, have experienced episodes of erectile dysfunction, usually as a consequence of tiredness, stress or alcohol abuse. Occasional failures should not be overrated. However, if the problem persists, a urologist needs to be sought.
The capacity of erection is just certainly one of a number of features of male sexual function. The sexual response cycle has four phases of man predominant need, erection, orgasm and relaxation. Each can change different.
The causes of ED are divided into organic, psychogenic and blended, will 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 various issues comparable to hypertension, diabetes, cardiovascular disease and renal failure.
ED of psychological origin will be manifested in numerous ways, or delayed ejaculation, painful ejaculation and even impotence. There can also be lack of libido (sexual desire), lack of orgasm and phobias (fears) sex, all for anxiety, depression or guilt. An individual who has an unpleasant experience, resembling loss of erection to have sex or ejaculate very early, tends to the next relationship, keep in mind these “failures” and become anxious. This provides a new fault, making a vicious circle.
Organic causes are subdivided in accordance with the etiology. The vasculogênicas are more prevalent, particularly the flow changes, 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 cord and nerve damage by radical prostatectomy (surgery to remove the prostate). For the reason that causes are hormonal hipoandrogenismo major or secondary (problems of male hormones).
The ED might also happen, for use and abuse of medication like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular ailments; neurological ailments, endocrine disorders, 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, anxiety and concern of failure, depression, obsessive-compulsive personality, sexual deviation.
The objectives 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.
An in depth medical interview is an important factor in evaluating patients with this problem. The history ought to determine the period, progression and severity of ED and related factors.
After you have recognized a problem in the affected person’s sexual efficiency, the next step is to distinguish it from different sexual problems such as 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 consequence of its contribution to the erection. The neurological evaluation ought to include a notion of their patient’s anxiety or depression. Since the evaluation of genital herpes is directed to detection of local irregularities.
Some are fundamental laboratory tests to identify problems that may end up in ED.
In cases of psychogenic DE, psychotherapy is indicated. A number of factors ought to be evaluated by the urologist and if potential, by an expert in psychology or psychiatry. Factors comparable to physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy must be addressed to the couple.
Penile injections have been the first environment friendly 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 (3 instances per week). This method tends to be abandoned with the advancement of technology.
With the advance of therapy, some oral medicines are available in the market. They are:
– Viagra (Sildenafil) of Pfizer: acts on the penis by stress-free muscle groups and increasing 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 effect can last up to six horas.Tem side reactions similar 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 not 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, however 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, cannot be used for heart disease 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 nostril). Leads to an erection in 15 minutes, and keeps up to eight hours. As Viagra and Cialis, cannot be used for heart disease in using nitrates. One of the essential advantages is the most affordable value and being sold in single packs.
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