Erectile Dysfunction: Causes and Therapy

“Erectile dysfunction is defined as inability to maintain an erection ample for sexual intercourse. This is a dysfunction that impacts hundreds of thousands of males world wide in numerous ways and with varying causes.”

What is it?

Erectile dysfunction is a medical time period used to define the inability to get an erection with adequate inflexibleity for penetration and / or keep it for a period of time adequate to the satisfaction of both partners throughout sex. It is important to understand that it can occur even with desire 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 of their lives, have experienced episodes of erectile dysfunction, usually because of tiredness, stress or alcohol abuse. Occasional failures shouldn’t be overrated. Nonetheless, if the problem persists, a urologist needs to be sought.


The capacity of erection is just one among several aspects of male sexual function. The sexual response cycle has four levels of man main need, erection, orgasm and relaxation. Each can change different.

The causes of ED are divided into natural, psychogenic and combined, can be discovered with combined factors. Natural problems equivalent to diabetes, cancer, arteriosclerosis and neurological accidents can often lead to psychological issues, for example. It will also be secondary, and appear as the first manifestation of varied problems similar to hypertension, diabetes, cardiovascular illness and renal failure.

ED of psychological origin may be manifested in numerous ways, or delayed ejaculation, painful ejaculation and even impotence. There may also be loss of libido (sexual need), lack of orgasm and phobias (fears) sex, all for anxiety, depression or guilt. A person who has an disagreeable experience, such as loss of erection to have sex or ejaculate very early, tends to the following relationship, remember these “failures” and turn out to be anxious. This provides a new fault, making a vicious circle.

Natural causes are subdivided in response to 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, 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 main or secondary (issues of male hormones).

The ED may occur, to be used and abuse of drugs like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.

Issues related

The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular diseases; neurological illnesses, endocrine issues, spinal twine accidents, radical pelvic surgical procedure, radiation remedy, alcoholism, smoking, marijuana use and / or cocaine; use of antihypertensives, tranquilizers and psychotropic substances; relationship problems with partner, stress, nervousness and fear of failure, depression, obsessive-compulsive personality, sexual deviation.


The targets of the initial analysis of the affected person are to determine the probable cause of ED and establish organic or psychological factors that will affect the related therapeutic.

An in depth medical interview is a very powerful factor in evaluating patients with this problem. The history ought to determine the period, progression and severity of ED and associated factors.

After you have identified a problem in the affected person’s sexual efficiency, the subsequent step is to differentiate it from different sexual problems similar to loss of libido and ejaculatory disorders.

Physical examination is to evaluate the patient’s health, with particular consideration to the cardiovascular, neurological and genitourinary, attributable to its contribution to the erection. The neurological evaluation should embody a perception of their patient’s anxiousness or depression. For the reason that evaluation of genital herpes is directed to detection of native abnormalities.

Some are primary laboratory tests to establish issues that may end up in ED.


In cases of psychogenic DE, psychotherapy is indicated. Several factors must be evaluated by the urologist and if doable, by an knowledgeable in psychology or psychiatry. Factors corresponding to 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 had been the main complication, painful erections. Also had the disadvantage of limiting the time limitation of erections and frequency of application (3 times per week). This technique tends to be deserted with the advancement of technology.

With the advance of remedy, some oral medications are available within the market. They’re:

– Viagra (Sildenafil) of Pfizer: acts on the penis by enjoyable muscle mass and increasing blood flow to the region. Effective in cases of partial impotence, erection of providing 40 to 60 minutes after ingestion of the remedy, with stimulation of the penis. Its effect can last as long as six horas.Tem side reactions equivalent to headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, particularly in drug remedy 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, however can be used by coronary 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’t be used for heart illness in using 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, can not be used for heart disease in the usage of nitrates. One of the important advantages is essentially the most affordable value and being sold in single packs.

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