Erectile Dysfunction: Causes and Treatment

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

What is it?

Erectile dysfunction is a medical time period used to define the inability to get an erection with sufficient rigidity for penetration and / or keep it for a time frame 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) impacts about thirds of men over 50 years of age, representing 10 to 20 million Brazilians.

Most males, in some unspecified time in the future of their lives, have experienced 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 should be sought.


The capacity of erection is just considered one of a number of features of male sexual function. The sexual response cycle has 4 stages of man most important need, erection, orgasm and relaxation. Each can change different.

The causes of ED are divided into natural, psychogenic and blended, can be discovered with mixed factors. Organic problems resembling diabetes, cancer, arteriosclerosis and neurological accidents can typically lead to psychological complications, for example. It can also be secondary, and appear as the primary manifestation of assorted issues such as 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 loss of libido (sexual need), lack of orgasm and phobias (fears) sex, all for anxiety, depression or guilt. An individual who has an disagreeable experience, comparable to 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 keeping with the etiology. The vasculogênicas are more prevalent, particularly the flow adjustments, arteriosclerosis and trauma (leading to injury to blood vessels).Venous flow irregularities are less common. The neurogenic causes are diabetic neuropathy, multiple sclerosis, alcohol abuse, trauma, spinal wire 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 may additionally occur, for use and abuse of medicine 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 wire injuries, radical pelvic surgery, radiation remedy, 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 aims of the initial analysis of the affected person are to determine the probable cause of ED and identify natural or psychological factors that may affect the related therapeutic.

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

Upon getting recognized a problem within the patient’s sexual efficiency, the following step is to differentiate it from different sexual problems akin to lack of libido and ejaculatory disorders.

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

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


In cases of psychogenic DE, psychotherapy is indicated. Several factors needs to be evaluated by the urologist and if possible, by an knowledgeable in psychology or psychiatry. Factors resembling physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy ought to 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 extreme OF and organic. They have been the principle 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 deserted with the advancement of technology.

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

– Viagra (Sildenafil) of Pfizer: acts on the penis by enjoyable muscles and rising blood flow to the region. Effective in cases of partial impotence, erection of providing 40 to 60 minutes after ingestion of the remedy, with stimulation of the penis. Its impact can last up to six horas.Tem side reactions resembling 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, but can be used 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 up to 36 hours. Can cause headache, gastric intolerance, nasal congestion, back pain, muscle pain, dizziness and flushing. As Viagra, cannot be used for 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 8 hours. As Viagra and Cialis, can’t be used for heart disease in the use of nitrates. One of the primary advantages is probably the most affordable worth and being sold in single packs.

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