Erectile Dysfunction: Causes and Therapy

“Erectile dysfunction is defined as inability to take care of an erection adequate for sexual intercourse. This is a dysfunction that affects hundreds of thousands of men all over the world in different 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 rigidity for penetration and / or keep it for a time period adequate to the satisfaction of each partners during sex. It is important to understand that it can occur even with want and orgasm (ejaculation) present.

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

Most males, in some unspecified time in the future of their lives, have skilled episodes of erectile dysfunction, normally resulting from 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 considered one of a number of aspects of male sexual function. The sexual response cycle has 4 stages of man major desire, erection, orgasm and relaxation. Every can change different.

The causes of ED are divided into organic, psychogenic and blended, could be discovered with combined factors. Organic problems such as diabetes, cancer, arteriosclerosis and neurological accidents can often lead to psychological problems, for example. It can also be secondary, and appear as the primary manifestation of varied disorders equivalent to hypertension, diabetes, cardiovascular illness and renal failure.

ED of psychological origin might be manifested in numerous ways, or delayed ejaculation, painful ejaculation and even impotence. There may additionally be lack of libido (sexual want), lack of orgasm and phobias (fears) intercourse, all for anxiety, depression or guilt. An individual who has an disagreeable experience, resembling lack of erection to have sex or ejaculate very early, tends to the next relationship, keep in mind these “failures” and turn out to be anxious. This provides a new fault, making a vicious circle.

Natural causes are subdivided in line 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, multiple sclerosis, alcohol abuse, trauma, spinal twine and nerve damage by radical prostatectomy (surgery to remove the prostate). Since the causes are hormonal hipoandrogenismo primary or secondary (disorders of male hormones).

The ED can also happen, for use and abuse of medication like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.

Disorders related

The DE has a number of risk factors as advanced age, diabetes, hypertension, peripheral vascular diseases; neurological illnesses, endocrine issues, spinal cord 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, anxiousness and concern of failure, depression, obsessive-compulsive personality, sexual deviation.


The targets of the initial evaluation of the affected person are to find out the probable cause of ED and establish organic or psychological factors which will affect the related therapeutic.

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

Upon getting recognized a problem in the affected person’s sexual performance, the following step is to distinguish it from different sexual problems akin to lack of libido and ejaculatory disorders.

Physical examination is to assess the patient’s health, with particular attention to the cardiovascular, neurological and genitourinary, attributable to its contribution to the erection. The neurological evaluation ought to include a perception of their patient’s anxiety or depression. Because the assessment of genital herpes is directed to detection of local irregularities.

Some are fundamental laboratory tests to identify issues that can lead to ED.


In cases of psychogenic DE, psychotherapy is indicated. A number of factors must be evaluated by the urologist and if possible, by an skilled in psychology or psychiatry. Factors equivalent to physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy must 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 extreme OF and organic. They were the primary complication, painful erections. Also had the disadvantage of limiting the time limitation of erections and frequency of application (three times per week). This technique tends to be abandoned with the advancement of technology.

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

– Viagra (Sildenafil) of Pfizer: acts on the penis by enjoyable muscle tissue and increasing blood flow to the region. Efficient in cases of partial impotence, erection of providing forty 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 corresponding to headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, especially in drug remedy of nitrate (Sustrate, Monocordil, Isordil, Nitradisc, Nitroderm TTS, Isocord, Isosorbide, nitroglycerin) can’t 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 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 coronary 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 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 the use of nitrates. One of many major advantages is essentially the most affordable price and being sold in single packs.

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