Erectile Dysfunction: Causes and Treatment

“Erectile dysfunction is defined as inability to maintain an erection sufficient for sexual intercourse. This is a disorder that affects hundreds of thousands of men all over the world in several ways and with varying causes.”

What is it?

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

Most men, sooner or later in their lives, have skilled episodes of erectile dysfunction, normally as a consequence of tiredness, stress or alcohol abuse. Occasional failures shouldn’t be overrated. However, if the problem persists, a urologist should be sought.


The capacity of erection is just one in every of a number of features of male sexual function. The sexual response cycle has four levels of man foremost desire, erection, orgasm and relaxation. Every can change different.

The causes of ED are divided into natural, psychogenic and blended, may be found with mixed factors. Natural problems such as diabetes, cancer, arteriosclerosis and neurological accidents can typically lead to psychological issues, for example. It may also be secondary, and seem as the primary manifestation of varied problems reminiscent of hypertension, diabetes, cardiovascular disease and renal failure.

ED of psychological origin will be manifested in numerous ways, or delayed ejaculation, painful ejaculation and even impotence. There might also be loss of libido (sexual desire), lack of orgasm and phobias (fears) sex, all for anxiousness, depression or guilt. A person who has an disagreeable expertise, corresponding to loss of erection to have sex or ejaculate very early, tends to the next relationship, remember these “failures” and develop into anxious. This provides a new fault, creating a vicious circle.

Natural causes are subdivided according to the etiology. The vasculogênicas are more prevalent, particularly the flow adjustments, arteriosclerosis and trauma (resulting in injury to blood vessels).Venous flow irregularities are less common. The neurogenic causes are diabetic neuropathy, multiple sclerosis, alcohol abuse, trauma, spinal twine and nerve damage by radical prostatectomy (surgery to remove the prostate). Since the causes are hormonal hipoandrogenismo primary or secondary (problems of male hormones).

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

Issues related

The DE has a number of risk factors as advanced age, diabetes, hypertension, peripheral vascular diseases; neurological diseases, endocrine issues, spinal cord injuries, radical pelvic surgical procedure, radiation therapy, alcoholism, smoking, marijuana use and / or cocaine; use of antihypertensives, tranquilizers and psychotropic substances; relationship problems with partner, stress, nervousness and fear of failure, depression, obsessive-compulsive personality, sexual deviation.


The targets of the initial evaluation of the affected person are to determine the probable cause of ED and determine organic 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 determine the duration, progression and severity of ED and related factors.

Once you have identified a problem within the affected person’s sexual efficiency, the following step is to distinguish it from different sexual problems akin 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 result of its contribution to the erection. The neurological analysis should embody a perception of their patient’s anxiousness or depression. Since the assessment of genital herpes is directed to detection of native abnormalities.

Some are primary laboratory tests to determine problems that may end up in ED.


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

Penile injections have been the first efficient and goal, with little or no side effects, with significant improvement of erection, even in severe OF and organic. They had been the principle complication, painful erections. Also had the disadvantage of limiting the time limitation of erections and frequency of application (3 times per week). This method tends to be abandoned with the advancement of technology.

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

– Viagra (Sildenafil) of Pfizer: acts on the penis by relaxing muscle tissues 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 such as 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. Could cause headache, nausea, dizziness, fainting and flushing, but can be utilized 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, can’t be used for coronary heart disease in the use 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 as much as eight hours. As Viagra and Cialis, can not be used for coronary heart illness in the usage of nitrates. One of the essential advantages is the most affordable worth and being sold in single packs.

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