Erectile Dysfunction: Causes and Treatment

“Erectile dysfunction is defined as inability to take care of an erection sufficient for sexual intercourse. This is a disorder that impacts thousands and thousands of men around the globe in several 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 period of time adequate to the satisfaction of each partners during sex. You will need to understand that it can occur even with desire and orgasm (ejaculation) present.

Erectile dysfunction (ED) impacts about thirds of males over 50 years of age, representing 10 to 20 million Brazilians.

Most men, at some point of their lives, have experienced episodes of erectile dysfunction, normally as a result of tiredness, stress or alcohol abuse. Occasional failures should not be overrated. However, if the problem persists, a urologist should be sought.


The capacity of erection is just certainly one of a number of elements of male sexual function. The sexual response cycle has four levels of man essential need, erection, orgasm and relaxation. Every can change different.

The causes of ED are divided into organic, psychogenic and combined, might be discovered with mixed factors. Organic problems such as diabetes, cancer, arteriosclerosis and neurological injuries can typically lead to psychological complications, for example. It can be secondary, and appear as the primary manifestation of assorted problems equivalent to hypertension, diabetes, cardiovascular illness 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 want), lack of orgasm and phobias (fears) intercourse, all for nervousness, depression or guilt. An individual who has an unpleasant experience, comparable to loss of erection to have sex or ejaculate very early, tends to the subsequent relationship, keep in mind these “failures” and develop into anxious. This provides a new fault, creating a vicious circle.

Organic causes are subdivided in line with the etiology. The vasculogênicas are more prevalent, particularly the flow modifications, arteriosclerosis and trauma (leading to injury to blood vessels).Venous flow abnormalities are less common. The neurogenic causes are diabetic neuropathy, a number of sclerosis, alcohol abuse, trauma, spinal wire and nerve damage by radical prostatectomy (surgical procedure to remove the prostate). Since the causes are hormonal hipoandrogenismo primary or secondary (disorders of male hormones).

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

Issues related

The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular illnesses; neurological illnesses, endocrine disorders, spinal twine 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 determine the probable cause of ED and establish natural or psychological factors which will affect the associated therapeutic.

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

After getting identified a problem in the affected person’s sexual performance, the subsequent step is to differentiate it from different sexual problems corresponding to lack of libido and ejaculatory disorders.

Physical examination is to evaluate the affected person’s health, with particular consideration to the cardiovascular, neurological and genitourinary, attributable to its contribution to the erection. The neurological evaluation should include 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 establish issues that can lead to ED.


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

Penile injections have been the primary 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. Also had the disadvantage of limiting the time limitation of erections and frequency of application (3 occasions per week). This technique tends to be abandoned with the advancement of technology.

With the advance of remedy, some oral drugs are available in the market. They are:

– Viagra (Sildenafil) of Pfizer: acts on the penis by stress-free muscle tissue and rising blood flow to the region. Efficient 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 up to six horas.Tem side reactions equivalent to headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, especially in drug treatment 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. Might cause headache, nausea, dizziness, fainting and flushing, but 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 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, can’t be used for coronary heart disease 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 nostril). Leads to an erection in quarter-hour, and keeps as much as eight hours. As Viagra and Cialis, can not be used for heart disease in the usage of nitrates. One of the most important advantages is essentially the most affordable value and being sold in single packs.

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