Erectile Dysfunction: Causes and Therapy

“Erectile dysfunction is defined as inability to keep up an erection sufficient for sexual intercourse. This is a disorder that impacts millions of men around the world in different ways and with various 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 time frame adequate to the satisfaction of each partners throughout sex. You will need 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 twenty million Brazilians.

Most men, in some unspecified time in the future of their lives, have skilled episodes of erectile dysfunction, often attributable to tiredness, stress or alcohol abuse. Occasional failures shouldn’t be overrated. Nonetheless, if the problem persists, a urologist needs to be sought.

Causes

The capacity of erection is just one of several aspects of male sexual function. The sexual response cycle has 4 levels of man primary want, erection, orgasm and relaxation. Every can change different.

The causes of ED are divided into natural, psychogenic and mixed, could be found with mixed factors. Natural problems comparable to diabetes, cancer, arteriosclerosis and neurological accidents can usually lead to psychological complications, for example. It will also be secondary, and appear as the first manifestation of varied disorders such as hypertension, diabetes, cardiovascular illness and renal failure.

ED of psychological origin may be manifested in various ways, or delayed ejaculation, painful ejaculation and even impotence. There may be lack of libido (sexual need), lack of orgasm and phobias (fears) intercourse, all for nervousness, depression or guilt. A person who has an disagreeable experience, comparable to loss of erection to have sex or ejaculate very early, tends to the next relationship, remember these “failures” and develop into anxious. This provides a new fault, creating a vicious circle.

Organic causes are subdivided based on the etiology. The vasculogênicas are more prevalent, particularly the flow modifications, 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 cord and nerve damage by radical prostatectomy (surgical procedure to remove the prostate). For the reason that causes are hormonal hipoandrogenismo primary or secondary (issues of male hormones).

The ED may additionally happen, to be used and abuse of medication like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.

Disorders associated

The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular ailments; neurological diseases, endocrine disorders, 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, anxiousness and fear of failure, depression, obsessive-compulsive personality, sexual deviation.

Analysis

The targets of the initial analysis of the affected person are to find out the probable cause of ED and determine natural or psychological factors that will influence the related therapeutic.

A detailed medical interview is crucial factor in evaluating patients with this problem. The history should identify the length, progression and severity of ED and associated factors.

After you have identified a problem in the patient’s sexual efficiency, the next step is to differentiate it from other sexual problems reminiscent of lack of libido and ejaculatory disorders.

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

Some are basic laboratory tests to determine disorders that can result in ED.

Therapy

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

Penile injections have been the first efficient and goal, with little or no side effects, with significant improvement of erection, even in severe OF and organic. They were the principle complication, painful erections. Additionally 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 treatment, some oral drugs are available in the market. They are:

– Viagra (Sildenafil) of Pfizer: acts on the penis by stress-free muscle mass and growing blood flow to the region. Efficient in cases of partial impotence, erection of providing forty to 60 minutes after ingestion of the remedy, with stimulation of the penis. Its impact can last up to six horas.Tem side reactions comparable 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) 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 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 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 coronary heart illness in using nitrates.

– Levitra (Vardenafil) of Bayer and Glaxo, additionally 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 quarter-hour, and keeps as much as 8 hours. As Viagra and Cialis, cannot be used for coronary heart disease in the use of nitrates. One of the primary advantages is the most affordable price and being sold in single packs.

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