Erectile Dysfunction: Causes and Therapy

“Erectile dysfunction is defined as inability to take care of an erection sufficient for sexual intercourse. This is a disorder that impacts hundreds of thousands of men around the world in different ways and with varying causes.”

What’s it?

Erectile dysfunction is a medical term used to define the inability to get an erection with ample rigidity for penetration and / or keep it for a time frame 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 men 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 as a consequence of tiredness, stress or alcohol abuse. Occasional failures should not be overrated. Nevertheless, if the problem persists, a urologist ought to be sought.


The capacity of erection is just one in all several aspects of male sexual function. The sexual response cycle has 4 levels of man essential desire, erection, orgasm and relaxation. Each can change different.

The causes of ED are divided into natural, psychogenic and combined, might be found with mixed factors. Natural problems comparable to diabetes, cancer, arteriosclerosis and neurological accidents can typically lead to psychological problems, for example. It will also be secondary, and seem as the first manifestation of assorted issues akin to hypertension, diabetes, cardiovascular illness and renal failure.

ED of psychological origin can be manifested in varied ways, or delayed ejaculation, painful ejaculation and even impotence. There can also be lack of libido (sexual want), lack of orgasm and phobias (fears) sex, all for anxiousness, depression or guilt. A person who has an unpleasant experience, comparable to lack of erection to have intercourse or ejaculate very early, tends to the subsequent relationship, bear in mind these “failures” and change into anxious. This provides a new fault, creating a vicious circle.

Organic causes are subdivided in keeping with the etiology. The vasculogênicas are more prevalent, particularly the flow adjustments, 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 twine and nerve damage by radical prostatectomy (surgical procedure to remove the prostate). For the reason that causes are hormonal hipoandrogenismo major or secondary (disorders of male hormones).

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

Issues associated

The DE has a number of risk factors as advanced age, diabetes, hypertension, peripheral vascular diseases; neurological diseases, endocrine disorders, spinal cord injuries, radical pelvic surgery, radiation therapy, alcoholism, smoking, marijuana use and / or cocaine; use of antihypertensives, tranquilizers and psychotropic substances; relationship problems with partner, stress, anxiousness and worry of failure, depression, obsessive-compulsive personality, sexual deviation.


The aims of the initial analysis of the affected person are to determine the probable cause of ED and establish organic or psychological factors that may influence the related therapeutic.

An in depth medical interview is an important factor in evaluating patients with this problem. The history should determine the period, progression and severity of ED and associated factors.

Upon getting recognized a problem within the patient’s sexual efficiency, the following step is to distinguish it from other sexual problems reminiscent of loss of libido and ejaculatory disorders.

Physical examination is to evaluate the patient’s health, with particular attention to the cardiovascular, neurological and genitourinary, due to its contribution to the erection. The neurological analysis ought to embody a perception of their affected person’s nervousness or depression. For the reason that assessment of genital herpes is directed to detection of native irregularities.

Some are primary laboratory tests to determine issues that can result in ED.


In cases of psychogenic DE, psychotherapy is indicated. Several factors ought to be evaluated by the urologist and if possible, by an skilled in psychology or psychiatry. Factors akin to physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy ought to be addressed to the couple.

Penile injections have been the primary environment friendly and goal, with little or no side effects, with significant improvement of erection, even in severe OF and organic. They were the main complication, painful erections. Additionally had the disadvantage of limiting the time limitation of erections and frequency of application (3 occasions per week). This method tends to be deserted with the advancement of technology.

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

– Viagra (Sildenafil) of Pfizer: acts on the penis by enjoyable muscles 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 similar to headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, particularly 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. Could cause headache, nausea, dizziness, fainting and flushing, however can be utilized 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 30 minutes, and sustained for up to 36 hours. Can cause headache, gastric intolerance, nasal congestion, back pain, muscle pain, dizziness and flushing. As Viagra, cannot be used for coronary 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 nose). Leads to an erection in 15 minutes, and keeps as much as 8 hours. As Viagra and Cialis, can not be used for coronary heart illness in the use of nitrates. One of many primary advantages is the most affordable worth and being sold in single packs.

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