Erectile Dysfunction: Causes and Therapy

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

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

Most males, in some unspecified time in the future in their lives, have skilled episodes of erectile dysfunction, usually because 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 considered one of several elements of male sexual function. The sexual response cycle has 4 stages of man foremost want, erection, orgasm and relaxation. Each can change different.

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

ED of psychological origin could be manifested in varied ways, or delayed ejaculation, painful ejaculation and even impotence. There may additionally be lack of libido (sexual desire), lack of orgasm and phobias (fears) sex, all for nervousness, depression or guilt. An individual who has an disagreeable expertise, such as loss of erection to have sex or ejaculate very early, tends to the following 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 based on the etiology. The vasculogênicas are more prevalent, particularly the flow adjustments, 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 cord and nerve damage by radical prostatectomy (surgery to remove the prostate). Since the causes are hormonal hipoandrogenismo main or secondary (disorders of male hormones).

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

Disorders related

The DE has a number of risk factors as advanced age, diabetes, hypertension, peripheral vascular ailments; neurological diseases, endocrine disorders, spinal wire accidents, radical pelvic surgical procedure, 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 objectives of the initial evaluation of the affected person are to determine the probable cause of ED and determine organic or psychological factors that will affect the related therapeutic.

An in depth medical interview is crucial factor in evaluating patients with this problem. The history ought to determine the duration, progression and severity of ED and related factors.

Once you have identified a problem within the patient’s sexual efficiency, the next step is to differentiate it from different sexual problems corresponding to loss of libido and ejaculatory disorders.

Physical examination is to evaluate the patient’s health, with particular attention to the cardiovascular, neurological and genitourinary, on account of its contribution to the erection. The neurological evaluation should embody a perception of their affected person’s anxiety or depression. Because the assessment of genital herpes is directed to detection of local abnormalities.

Some are primary laboratory tests to identify disorders that may end up in ED.


In cases of psychogenic DE, psychotherapy is indicated. Several factors needs to be evaluated by the urologist and if potential, by an professional 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 extreme OF and organic. They have been the primary complication, painful erections. Additionally had the disadvantage of limiting the time limitation of erections and frequency of application (3 times per week). This method tends to be abandoned with the advancement of technology.

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

– 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 forty to 60 minutes after ingestion of the medicine, with stimulation of the penis. Its effect can last as long as six horas.Tem side reactions similar to headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, particularly in drug therapy 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 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, cannot be used for coronary heart illness in the usage of 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 nose). Leads to an erection in 15 minutes, and keeps up to 8 hours. As Viagra and Cialis, cannot be used for heart disease in the use of nitrates. One of the foremost advantages is the most affordable worth and being sold in single packs.

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