Erectile Dysfunction: Causes and Treatment

“Erectile dysfunction is defined as inability to keep up an erection sufficient for sexual intercourse. This is a disorder that impacts tens of millions of men 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 frame adequate to the satisfaction of each partners during sex. It is very important understand that it can happen even with desire and orgasm (ejaculation) present.

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

Most men, sooner or later in their lives, have skilled episodes of erectile dysfunction, usually due to tiredness, stress or alcohol abuse. Occasional failures should not be overrated. Nonetheless, if the problem persists, a urologist should be sought.


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

The causes of ED are divided into natural, psychogenic and mixed, might be discovered with combined factors. Natural problems corresponding to diabetes, cancer, arteriosclerosis and neurological injuries can usually lead to psychological issues, for example. It may also be secondary, and seem as the primary manifestation of assorted problems such as hypertension, diabetes, cardiovascular disease and renal failure.

ED of psychological origin might be manifested in various ways, or delayed ejaculation, painful ejaculation and even impotence. There can also be loss of libido (sexual need), lack of orgasm and phobias (fears) intercourse, all for anxiousness, depression or guilt. An individual who has an unpleasant expertise, similar to lack of erection to have intercourse or ejaculate very early, tends to the subsequent relationship, bear in mind these “failures” and grow to be anxious. This provides a new fault, making a vicious circle.

Organic causes are subdivided in accordance with the etiology. The vasculogênicas are more prevalent, particularly the flow changes, arteriosclerosis and trauma (resulting in injury to blood vessels).Venous flow irregularities are less common. The neurogenic causes are diabetic neuropathy, a number of sclerosis, alcohol abuse, trauma, spinal twine and nerve damage by radical prostatectomy (surgical procedure to remove the prostate). Since the causes are hormonal hipoandrogenismo major or secondary (problems of male hormones).

The ED can also occur, 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 ailments, endocrine disorders, spinal twine accidents, 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 aims of the initial analysis of the patient are to determine the probable cause of ED and determine natural or psychological factors that may affect the related therapeutic.

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

Upon getting identified a problem within the affected person’s sexual performance, the following step is to distinguish it from other sexual problems similar to loss 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 patient’s anxiety or depression. For the reason that assessment of genital herpes is directed to detection of local irregularities.

Some are basic laboratory tests to determine issues that can lead to ED.


In cases of psychogenic DE, psychotherapy is indicated. A number of factors must be evaluated by the urologist and if attainable, by an knowledgeable in psychology or psychiatry. Factors resembling physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy must 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 had been the primary complication, painful erections. Additionally had the disadvantage of limiting the time limitation of erections and frequency of application (three instances per week). This method tends to be abandoned with the advancement of technology.

With the advance of therapy, some oral medications are available within the market. They’re:

– Viagra (Sildenafil) of Pfizer: acts on the penis by enjoyable muscle mass and rising blood flow to the region. Efficient 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 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 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. 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 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 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 quarter-hour, and keeps as much as 8 hours. As Viagra and Cialis, cannot be used for coronary heart illness in using nitrates. One of the major advantages is essentially the most affordable price and being sold in single packs.

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