“Erectile dysfunction is defined as inability to keep up an erection enough for sexual intercourse. This is a dysfunction that affects hundreds of thousands of men 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 adequate inflexibleity for penetration and / or keep it for a period of time adequate to the satisfaction of both partners during sex. You will need to understand that it can occur even with desire and orgasm (ejaculation) present.
Erectile dysfunction (ED) affects about two thirds of men over 50 years of age, representing 10 to twenty million Brazilians.
Most men, sooner or later in their lives, have experienced episodes of erectile dysfunction, usually as a consequence of tiredness, stress or alcohol abuse. Occasional failures shouldn’t be overrated. Nonetheless, if the problem persists, a urologist must be sought.
The capacity of erection is just one among a number of facets of male sexual function. The sexual response cycle has four levels of man fundamental need, 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. Natural problems corresponding to diabetes, cancer, arteriosclerosis and neurological accidents can usually lead to psychological problems, for example. It will also be secondary, and seem as the first manifestation of varied issues such as hypertension, diabetes, cardiovascular illness and renal failure.
ED of psychological origin might be manifested in varied ways, or delayed ejaculation, painful ejaculation and even impotence. There may be loss of libido (sexual want), lack of orgasm and phobias (fears) intercourse, all for anxiousness, depression or guilt. A person who has an disagreeable expertise, comparable to loss of erection to have sex or ejaculate very early, tends to the following relationship, bear in mind these “failures” and turn into anxious. This provides a new fault, creating a vicious circle.
Organic causes are subdivided in accordance 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 main or secondary (disorders of male hormones).
The ED may additionally occur, to be used and abuse of medication like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular diseases; neurological ailments, endocrine problems, spinal wire injuries, radical pelvic surgery, 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 targets of the initial evaluation of the patient are to determine the probable cause of ED and establish 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 should establish the duration, progression and severity of ED and related factors.
After you have identified a problem within the patient’s sexual performance, the subsequent step is to distinguish it from different sexual problems equivalent to lack of libido and ejaculatory disorders.
Physical examination is to assess the affected person’s health, with particular consideration to the cardiovascular, neurological and genitourinary, as a consequence of its contribution to the erection. The neurological analysis ought to embody a perception of their patient’s nervousness or depression. Since the evaluation of genital herpes is directed to detection of native abnormalities.
Some are basic laboratory tests to determine issues that can result in 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 skilled in psychology or psychiatry. Factors such as physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy needs to be addressed to the couple.
Penile injections have been the primary environment friendly and objective, with little or no side effects, with significant improvement of erection, even in severe OF and organic. They were the main complication, painful erections. Also had the disadvantage of limiting the time limitation of erections and frequency of application (three times per week). This methodology tends to be abandoned with the advancement of technology.
With the advance of treatment, some oral medications are available within the market. They are:
– Viagra (Sildenafil) of Pfizer: acts on the penis by relaxing muscle tissues and increasing blood flow to the region. Efficient in cases of partial impotence, erection of providing 40 to 60 minutes after ingestion of the treatment, 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 therapy 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, however 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 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 using 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 nose). Leads to an erection in 15 minutes, and keeps up to 8 hours. As Viagra and Cialis, cannot be used for coronary heart illness in using nitrates. One of the fundamental advantages is essentially the most affordable value and being sold in single packs.