Erectile Dysfunction, Causes and Treatment

 

   "Erectile dysfunction is defined as the inability to maintain an erection sufficient for intercourse. It is a disorder that affects millions of men around the world in different ways and with different causes. " Qu'Est is that? Erectile dysfunction is a medical term used to define the inability to achieve an erection rigid enough for penetration and / or service for a period sufficient for the satisfaction of both parties during sex time.

     It is important to understand that this can happen even with the desire and orgasm (ejaculation) present. Erectile dysfunction (ED) affects about two thirds of men over 50 years, 10 to 20 million Brazilians. Most men, at some point in their lives, have experienced episodes of erectile dysfunction, usually due to fatigue, stress or alcohol abuse. Occasional failures should not be underestimated.

    However, if the problem persists, urologist should be sought. causes The erection ability is only one of many aspects of male sexual function. The sexual response cycle has four stages leading man desire, erection, orgasm and relaxation. Everyone can change different.
 
    The causes of erectile dysfunction are divided into organic, psychogenic and mixed, can be found with combined factors. Organic, such as diabetes, cancer, atherosclerosis and neurological injury can often lead to psychological complications, for example. Problems can also be high, and appear as the first manifestation of various disorders such as hypertension, diabetes, cardiovascular disease and kidney failure. Psychogenic ED can occur in various ways, or ejaculation, painful ejaculation and even impotence delayed. There may also be loss of libido (sexual desire), lack of orgasm and phobias (fears) sex, all for anxiety, depression or guilt.

     A person who has an unpleasant experience, such as loss of erection during intercourse or premature ejaculation tends to the following relationship, remember these "failures" and becomes anxious. This gives a new fault, creating a vicious circle. Organic causes are subdivided by etiology. The vasculogenic are more common, especially the change of flux, arteriosclerosis and trauma (causing damage to blood vessels) .Venous flow abnormalities are less common. Neurogenic causes diabetic neuropathy, multiple sclerosis, alcohol abuse, trauma, spinal cord and nerve damage radical prostatectomy (surgical removal of the prostate).
    As the causes are hormonal primary or secondary (alterations in male hormones) hypoandrogenism. Erectile dysfunction can also occur for the use and abuse of drugs such as marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants. associated disorders
   The ED has several risk factors such as advanced age, diabetes, hypertension, peripheral vascular disease; neurological diseases, endocrine disorders, spinal cord injuries, radical pelvic surgery, radiation, alcohol, tobacco, marijuana and / or cocaine; use of antihypertensive drugs, tranquilizers and psychotropic substances; relationship problems with your partner, stress, anxiety and fear of failure, depression, obsessive-compulsive personality, sexual deviation. diagnosis The objectives of the patient's initial evaluation are to determine the probable cause of erectile dysfunction and determine the biological and psychological factors that may influence the associated treatment.
     A detailed clinical interview is the most important in the evaluation of patients with this problem factor. The story must identify the duration, progression and severity of erectile dysfunction and associated factors. Once you have identified a problem with the patient's sexual performance, the next step is to differentiate it from other sexual problems such as loss of libido and ejaculation disorders. Physical examination is to assess the patient's state of health, with particular attention to the cardiovascular, neurological and genitourinary, because of its contribution to the erection.
   The neurological assessment should include a perception of anxiety or depression of your patient. Since the evaluation of genital herpes is directed to the detection of local abnormalities. Some are basic laboratory tests to identify disorders that can cause erectile dysfunction. treatment In case of psychogenic ED, psychotherapy is indicated. Several factors must be evaluated by a urologist and, if possible, an expert in psychology or psychiatry.
   
   Psychiatric and psychological factors physical relationship,,, conflict with the couple and sexual failure should be addressed to the couple. Penile injections were the first effective and objective, with little or no side effects, with a significant improvement of erection, even in severe and organic ED. They were the main complication, painful erections. It also has the disadvantage of limiting the duration of erection and frequency of application (3 times per week).
   
  This method tends to be left to the advancement of technology. With the progress of treatment, oral medications are available on the market. They are: - Viagra (Sildenafil) Pfizer acts on the penis to relax muscles and increase blood flow in the region. Partially effective in cases of impotence, erection to provide 40 to 60 minutes after ingestion of the drug, with stimulation of the penis. Its effect can last up to six horas.Tem side reactions such as headaches, nasal congestion, facial flushing and dyspepsia.

     Heart, especially in the pharmacological treatment of nitrate (Substrate, Monocordil, Isordil, Nitradisc, Nitroderm TTS Isocord, isosorbide, nitroglycerin) patients can not take this medicine. - Uprima (apomorphine), Abbott Laboratories, acts on the central nervous system, which facilitates the realization of sexual stimulation of the brain to the penis. Generates erection 10-20 minutes after sublingual administration.    
  
    It can cause headaches, nausea, dizziness, fainting, and flushing, but can be used by heart patients. - Cialis (Tadalafil) manufactured by Eli Lilly, acts directly on the penis by the inhibition of phosphodiesterase enzyme. Leads to an erection within 30 minutes, and held for up to 36 hours. It can cause headaches, gastric intolerance, nasal congestion, back pain, muscle aches, dizziness and flushing. As Viagra, can not be used for heart disease in the use of nitrates. - Levitra (Vardenafil) 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 within 15 minutes, and maintains a maximum of 8 hours. As Viagra and Cialis, can not be used for heart disease in the use of nitrates. A major benefit is the most affordable and sold in individual packages. Although drug treatments mentioned, some patients can not adapt and require mechanical treatment such as vacuum erection devices or malleable or inflatable penile implant devices. Others may need surgery to repair vascular arteries that supply the penis with blood, in specific cases. Because erectile dysfunction can have many causes, there are several treatments that work by different mechanisms, specific against-indications, urologist should be consulted.