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Erectile Dysfunction: Causes and Therapy
"Erectile dysfunction is defined as inability to maintain an erection enough for sexual intercourse. This is a dysfunction that impacts millions of men around the globe in numerous 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 rigidity for penetration and / or keep it for a time period adequate to the satisfaction of each partners during sex. It is important to understand that it can happen even with need and orgasm (ejaculation) present.
Erectile dysfunction (ED) impacts about two thirds of men over 50 years of age, representing 10 to twenty million Brazilians.
Most men, sooner or later of their lives, have experienced episodes of erectile dysfunction, often attributable 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 a number of elements of male sexual function. The sexual response cycle has 4 levels of man essential need, erection, orgasm and relaxation. Every can change different.
The causes of ED are divided into natural, psychogenic and mixed, might be discovered with mixed factors. Natural problems similar to diabetes, cancer, arteriosclerosis and neurological accidents can often lead to psychological problems, for example. It will also be secondary, and seem as the first manifestation of various disorders such as hypertension, diabetes, cardiovascular disease and renal failure.
ED of psychological origin will be manifested in varied ways, or delayed ejaculation, painful ejaculation and even impotence. There might also be loss of libido (sexual want), lack of orgasm and phobias (fears) intercourse, all for anxiety, depression or guilt. A person who has an unpleasant expertise, resembling lack of erection to have sex or ejaculate very early, tends to the subsequent relationship, remember these "failures" and change into anxious. This provides a new fault, creating a vicious circle.
Natural causes are subdivided in keeping with the etiology. The vasculogênicas are more prevalent, particularly the flow modifications, arteriosclerosis and trauma (leading to 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 main or secondary (problems of male hormones).
The ED may happen, for use and abuse of medication like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular illnesses; neurological ailments, endocrine disorders, spinal wire accidents, 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 fear of failure, depression, obsessive-compulsive personality, sexual deviation.
The goals of the initial evaluation of the affected person are to determine the probable cause of ED and establish natural or psychological factors that will affect the related therapeutic.
A detailed medical interview is crucial factor in evaluating patients with this problem. The history ought to establish the length, progression and severity of ED and associated factors.
Once you have identified a problem in the affected person's sexual efficiency, the following step is to distinguish it from other sexual problems corresponding to lack of libido and ejaculatory disorders.
Physical examination is to assess the affected person's health, with particular attention to the cardiovascular, neurological and genitourinary, as a result of its contribution to the erection. The neurological evaluation ought to embody a notion of their affected person's anxiousness or depression. Since the assessment of genital herpes is directed to detection of native abnormalities.
Some are basic laboratory tests to establish problems that may end up in ED.
In cases of psychogenic DE, psychotherapy is indicated. Several factors ought to be evaluated by the urologist and if doable, by an skilled in psychology or psychiatry. Factors such as 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 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 occasions per week). This method tends to be deserted with the advancement of technology.
With the advance of remedy, some oral drugs are available within the market. They are:
- Viagra (Sildenafil) of Pfizer: acts on the penis by stress-free muscle mass and increasing 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 up to six horas.Tem side reactions corresponding to headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, particularly in drug remedy of nitrate (Sustrate, Monocordil, Isordil, Nitradisc, Nitroderm TTS, Isocord, Isosorbide, nitroglycerin) cannot 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. Might 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 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 15 minutes, and keeps up to eight hours. As Viagra and Cialis, cannot be used for coronary heart illness in the use of nitrates. One of the essential advantages is the most affordable price and being sold in single packs.
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