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Erectile Dysfunction: Causes and Treatment

 

"Erectile dysfunction is defined as inability to maintain an erection ample for sexual intercourse. This is a dysfunction that affects tens of millions of males all over the world in numerous ways and with varying causes."

 

 

What's 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 occur even with need and orgasm (ejaculation) present.

 

 

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

 

 

Most males, at some point of their lives, have experienced episodes of erectile dysfunction, normally attributable to tiredness, stress or alcohol abuse. Occasional failures should not be overrated. However, if the problem persists, a urologist must be sought.

 

 

Causes

 

 

The capacity of erection is just one among a number of elements of male sexual function. The sexual response cycle has 4 stages of man major desire, erection, orgasm and relaxation. Every can change different.

 

 

The causes of ED are divided into organic, psychogenic and mixed, may be found with combined factors. Natural problems akin to diabetes, cancer, arteriosclerosis and neurological accidents can often lead to psychological complications, for example. It may also be secondary, and seem as the first manifestation of assorted issues reminiscent of hypertension, diabetes, cardiovascular illness and renal failure.

 

 

ED of psychological origin could be manifested in varied ways, or delayed ejaculation, painful ejaculation and even impotence. There may be lack of libido (sexual need), lack of orgasm and phobias (fears) intercourse, all for anxiousness, depression or guilt. An individual who has an unpleasant expertise, corresponding to loss of erection to have sex or ejaculate very early, tends to the following relationship, keep in mind these "failures" and develop into anxious. This provides a new fault, making 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 abnormalities are less common. The neurogenic causes are diabetic neuropathy, a number of sclerosis, alcohol abuse, trauma, spinal cord and nerve damage by radical prostatectomy (surgical procedure to remove the prostate). For the reason that causes are hormonal hipoandrogenismo major or secondary (issues of male hormones).

 

 

The ED may additionally occur, to be used and abuse of medicine like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.

 

 

Issues related

 

 

The DE has a number of risk factors as advanced age, diabetes, hypertension, peripheral vascular ailments; neurological diseases, endocrine problems, spinal cord injuries, radical pelvic surgical procedure, radiation remedy, 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.

 

 

Prognosis

 

 

The objectives of the initial evaluation of the patient are to determine the probable cause of ED and determine organic or psychological factors that may affect the associated 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 associated factors.

 

 

After you have identified a problem within the patient's sexual performance, the subsequent step is to distinguish it from different sexual problems similar to loss of libido and ejaculatory disorders.

 

 

Physical examination is to evaluate the affected person's health, with particular attention to the cardiovascular, neurological and genitourinary, due to its contribution to the erection. The neurological evaluation should embrace a perception of their patient's anxiety or depression. Because the evaluation of genital herpes is directed to detection of native irregularities.

 

 

Some are fundamental laboratory tests to establish issues that may end up in ED.

 

 

Therapy

 

 

In cases of psychogenic DE, psychotherapy is indicated. Several factors needs to be evaluated by the urologist and if possible, 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 first 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. Also had the disadvantage of limiting the time limitation of erections and frequency of application (3 occasions per week). This method tends to be deserted with the advancement of technology.

 

 

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

 

 

- Viagra (Sildenafil) of Pfizer: acts on the penis by stress-free muscle tissues and growing blood flow to the region. Effective in cases of partial impotence, erection of providing 40 to 60 minutes after ingestion of the treatment, with stimulation of the penis. Its effect can last up to six horas.Tem side reactions reminiscent of headaches, nasal congestion, facial flushing and dyspepsia. Heart patients, particularly in drug treatment 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 utilized 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, cannot be used for heart disease 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 up to eight hours. As Viagra and Cialis, cannot be used for coronary heart disease in the use of nitrates. One of the primary advantages is essentially the most affordable value and being sold in single packs.

 

 

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