Erectile Dysfunction: Causes and Treatment

“Erectile dysfunction is defined as inability to maintain an erection enough for sexual intercourse. This is a disorder that affects hundreds of thousands of males around the world in several ways and with various causes.”

What’s it?

Erectile dysfunction is a medical term used to define the inability to get an erection with ample inflexibleity for penetration and / or keep it for a time period adequate to the satisfaction of each partners during sex. You will need to understand that it can happen even with need and orgasm (ejaculation) present.

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

Most males, sooner or later of their lives, have experienced episodes of erectile dysfunction, normally on account of tiredness, stress or alcohol abuse. Occasional failures should not be overrated. However, if the problem persists, a urologist ought to be sought.

Causes

The capacity of erection is just one of several facets of male sexual function. The sexual response cycle has 4 stages of man most important desire, erection, orgasm and relaxation. Each can change different.

The causes of ED are divided into organic, psychogenic and mixed, might be discovered with combined factors. Organic problems resembling diabetes, cancer, arteriosclerosis and neurological injuries can usually lead to psychological issues, for example. It may also be secondary, and appear as the first manifestation of various issues similar to hypertension, diabetes, cardiovascular disease and renal failure.

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

Organic causes are subdivided in response to 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, a number of sclerosis, alcohol abuse, trauma, spinal cord and nerve damage by radical prostatectomy (surgery to remove the prostate). For the reason that 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.

Problems associated

The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular diseases; neurological ailments, endocrine problems, spinal cord injuries, 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, nervousness and worry of failure, depression, obsessive-compulsive personality, sexual deviation.

Prognosis

The aims of the initial analysis of the affected person are to find out the probable cause of ED and identify natural or psychological factors that may influence the associated therapeutic.

A detailed medical interview is the most important factor in evaluating patients with this problem. The history should establish the length, progression and severity of ED and related factors.

Upon getting recognized a problem within the patient’s sexual performance, the subsequent step is to differentiate it from different sexual problems comparable to loss of libido and ejaculatory disorders.

Physical examination is to assess the affected person’s health, with particular consideration to the cardiovascular, neurological and genitourinary, attributable to its contribution to the erection. The neurological analysis ought to include a perception of their patient’s anxiety or depression. Since the assessment of genital herpes is directed to detection of native irregularities.

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

Treatment

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

Penile injections have been the primary efficient 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 occasions per week). This method tends to be deserted 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 relaxing muscular tissues and growing 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 impact can last as long as six horas.Tem side reactions reminiscent of headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, particularly 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. May 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 half-hour, and sustained for up to 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 use 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 coronary heart disease in the use of nitrates. One of the main advantages is the most affordable worth and being sold in single packs.

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