Erectile Dysfunction: Causes and Therapy

“Erectile dysfunction is defined as inability to keep up an erection adequate for sexual intercourse. This is a disorder that impacts tens of millions of males world wide in several ways and with various causes.”

What is it?

Erectile dysfunction is a medical time period 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 both partners throughout sex. You will need to understand that it can occur even with desire and orgasm (ejaculation) present.

Erectile dysfunction (ED) impacts about two thirds of males over 50 years of age, representing 10 to twenty million Brazilians.

Most males, sooner or later in their lives, have skilled episodes of erectile dysfunction, normally as a result of tiredness, stress or alcohol abuse. Occasional failures should not be overrated. Nonetheless, if the problem persists, a urologist must be sought.


The capacity of erection is just one in all a number of points of male sexual function. The sexual response cycle has 4 stages of man foremost need, erection, orgasm and relaxation. Each can change different.

The causes of ED are divided into organic, psychogenic and blended, may be found with combined factors. Natural problems resembling diabetes, cancer, arteriosclerosis and neurological injuries can typically lead to psychological issues, for example. It will also be secondary, and seem as the primary manifestation of varied problems comparable to hypertension, diabetes, cardiovascular disease 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 desire), lack of orgasm and phobias (fears) sex, all for nervousness, depression or guilt. A person who has an disagreeable experience, comparable to lack of erection to have sex or ejaculate very early, tends to the subsequent relationship, remember these “failures” and grow to be anxious. This provides a new fault, creating a vicious circle.

Natural causes are subdivided in response to the etiology. The vasculogênicas are more prevalent, particularly the flow changes, arteriosclerosis and trauma (resulting in 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). For the reason that causes are hormonal hipoandrogenismo main or secondary (issues of male hormones).

The ED may happen, for use and abuse of drugs like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.

Problems associated

The DE has a number of risk factors as advanced age, diabetes, hypertension, peripheral vascular illnesses; neurological diseases, endocrine problems, spinal wire accidents, radical pelvic surgery, radiation remedy, 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 analysis 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 crucial factor in evaluating patients with this problem. The history should identify the period, progression and severity of ED and related factors.

After you have recognized a problem in the patient’s sexual efficiency, the following step is to distinguish it from different sexual problems similar to lack of libido and ejaculatory disorders.

Physical examination is to assess the affected person’s health, with particular attention to the cardiovascular, neurological and genitourinary, as a consequence of its contribution to the erection. The neurological analysis ought to include a notion of their affected person’s anxiety or depression. Because the assessment of genital herpes is directed to detection of native abnormalities.

Some are primary laboratory tests to establish problems that can result in ED.


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

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

With the advance of treatment, some oral medicines are available in the market. They are:

– Viagra (Sildenafil) of Pfizer: acts on the penis by relaxing muscle mass and rising blood flow to the region. Effective in cases of partial impotence, erection of providing forty 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 such as 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. Might cause headache, nausea, dizziness, fainting and flushing, however can be used 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 as much as 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 the usage 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 nose). Leads to an erection in quarter-hour, and keeps up to 8 hours. As Viagra and Cialis, can not be used for coronary heart disease in using nitrates. One of the most important advantages is essentially the most affordable worth and being sold in single packs.

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