“Erectile dysfunction is defined as inability to take care of an erection enough for sexual intercourse. This is a dysfunction that impacts hundreds of thousands of males all over the world in numerous ways and with varying causes.”
What is 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 during sex. It is very important understand that it can happen even with desire and orgasm (ejaculation) present.
Erectile dysfunction (ED) impacts about thirds of males over 50 years of age, representing 10 to 20 million Brazilians.
Most males, at some point of their lives, have skilled episodes of erectile dysfunction, normally because of tiredness, stress or alcohol abuse. Occasional failures should not be overrated. However, if the problem persists, a urologist should be sought.
The capacity of erection is just one of a number of points of male sexual function. The sexual response cycle has 4 levels of man foremost desire, erection, orgasm and relaxation. Each can change different.
The causes of ED are divided into organic, psychogenic and mixed, will be discovered with mixed factors. Organic problems such as diabetes, cancer, arteriosclerosis and neurological accidents can typically lead to psychological problems, for example. It can 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 varied ways, or delayed ejaculation, painful ejaculation and even impotence. There may be lack of libido (sexual need), lack of orgasm and phobias (fears) sex, all for nervousness, depression or guilt. An individual who has an disagreeable expertise, equivalent to loss of erection to have sex or ejaculate very early, tends to the subsequent relationship, keep in mind these “failures” and become anxious. This provides a new fault, creating a vicious circle.
Natural 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, multiple 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 (issues of male hormones).
The ED can also happen, for use and abuse of drugs like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
The DE has a number of risk factors as advanced age, diabetes, hypertension, peripheral vascular ailments; neurological diseases, endocrine disorders, 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, anxiety and concern of failure, depression, obsessive-compulsive personality, sexual deviation.
The goals of the initial evaluation of the patient are to find out the probable cause of ED and identify organic or psychological factors that may influence the related therapeutic.
An in depth medical interview is the most important factor in evaluating patients with this problem. The history should identify the period, progression and severity of ED and related factors.
Once you have recognized a problem in the patient’s sexual efficiency, the subsequent step is to differentiate it from other sexual problems such as lack of libido and ejaculatory disorders.
Physical examination is to assess the patient’s health, with particular consideration to the cardiovascular, neurological and genitourinary, attributable to its contribution to the erection. The neurological analysis ought to embrace a notion of their patient’s anxiousness or depression. For the reason that assessment of genital herpes is directed to detection of native abnormalities.
Some are primary laboratory tests to identify issues that can result in ED.
In cases of psychogenic DE, psychotherapy is indicated. A number of factors must be evaluated by the urologist and if attainable, by an skilled in psychology or psychiatry. Factors resembling physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy needs to be addressed to the couple.
Penile injections have been the first efficient and objective, with little or no side effects, with significant improvement of erection, even in severe OF and organic. They were the principle complication, painful erections. Also 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 remedy, some oral drugs are available in the market. They are:
– Viagra (Sildenafil) of Pfizer: acts on the penis by stress-free muscle tissue 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 impact can last as long as six horas.Tem side reactions such as 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. May 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, can’t be used for heart illness 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 8 hours. As Viagra and Cialis, can’t be used for heart illness in the use of nitrates. One of many predominant advantages is probably the most affordable worth and being sold in single packs.
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