“Erectile dysfunction is defined as the inability to maintain adequate erection for sexual intercourse. It is a disorder that affects millions of men around the world in different ways and for different reasons.”
What is this
Erectile dysfunction is a medical term used to define the inability to obtain an erection with sufficient rigidity for penetration and / or to hold it for a sufficient period of time to satisfy both partners during sex. It is important to understand that it can also occur with ejaculation and ejaculation.
Erectile dysfunction (ED) affects about two-thirds of men over the age of 50, representing 10 to 20 million Brazilians.
Most men, at some point in their lives, experience episodes of erectile dysfunction, usually due to fatigue, stress or alcohol abuse. Occasional failure should not be exaggerated. However, if this problem persists, a urologist should be sought.
The ability to erect is one of the few aspects of male sexual function. The sexual response cycle consists of the four stages of man’s main desire, erection, orgasm and rest. Everyone can change differently.
The causes of ED are divided into organic, psychogenic and mixed, can be found with combined factors. Organic problems such as diabetes, cancer, atherosclerosis, and neurological injuries often lead to psychological complications, for example. It can also be secondary, and appears as the first manifestation of various disorders such as hypertension, diabetes, cardiovascular disease and renal failure.
ED of psychological origin can manifest in various ways, or in delayed ejaculation, painful ejaculation, and impotence. Loss of libido (sexual desire), orgasm and phobias (fear) can also be due to lack of sex, anxiety, frustration or guilt. Someone who has a vague experience, such as having sex too early or ejaculating to stop erection, tends to have subsequent relationships, remembers this “failure” and becomes restless. This provides a new fault, creating a vicious circle.
Biological causes are subdivided according to etiology. Vascular ê Nix is more prevalent, especially with changes in flow, arteriosclerosis and trauma (resulting in injury to blood vessels). Flow abnormalities are less common. Neurogenic causes include diabetic neuropathy, multiple sclerosis, alcohol abuse, trauma, nerve damage to the spine and radical prostatectomy (surgery to remove the prostate). Causes Hormonal hypoendrogenesis is primary or secondary (disorder of male hormones).
Can also be used for drugs such as ED, marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.
The disorder is related
DE has many risk factors such as old age, diabetes, hypertension, peripheral vascular diseases; Neurological diseases, endocrine disorders, spinal cord injuries, radical pelvic surgery, radiation therapy, alcoholism, smoking, marijuana use and / or cocaine; Use of antihypertensives, tranquilizers and psychotropic substances; Relationship problems with partner, stress, anxiety and fear of failure, frustration, obsessive compulsive personality, sexual deviation.
The objectives of the initial assessment of the patient are to determine the probable cause of AD and to identify the organic or psychological factors that may affect the associated therapeutic disease.
A detailed medical interview is the most important factor in evaluating patients with this problem. The duration, progression, and severity of ED and associated factors in history should be identified.
Once you identify a problem in a patient’s sexual function, the next step is to differentiate it from other sexual problems such as decreased libido and ejaculatory disorders.
Physical examination is to assess the health of the patient, with a particular focus on cardiovascular, neurological and genitourinary, due to its contribution to erection. The neurological assessment should include an understanding of their patient’s discomfort or frustration. Assessment of genital herpes is in the direction of detecting local abnormalities.
There are basic laboratory tests to identify some of the abnormalities that can result in ED.
In the case of psychogenic DE, psychiatry is indicated. Some factors should be evaluated by a urologist and, if possible, by a psychiatrist or psychiatrist. Factors such as physical, mental, psychological, conflicting relationships and sexual incompetence with the spouse should be taken into consideration by the couple.
Penile injections are the first efficient and objective, with little or no side effects, even in severe and organic, with significant improvement in erection. They were the main complication, the painful erection. There was also the disadvantage of limiting the time of erection and the frequency of application (3 times a week). This method is abandoned with the advancement of technology.
With the progress of treatment, some oral medications are available in the market. They are:
– Viagra Pfizer’s (sildenafil): Works on the penis by relaxing the muscles and increasing blood flow to this area. Effective in case of partial 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 hours. Side effects such as headaches, nasal congestion, facial flushing and dyspepsia. Patients with heart disease, especially nitrates (Cistrate, Monocardil, Isordil, Nitradisk, Nitrodum TTS, Isocard, Isosorbide, Nitroglycerin) cannot be treated with this drug.
– On top (Apomorphine), from Abbott Laboratories, works on the central nervous system, facilitating the administration of sexual stimulation to the penis in the brain. Subtly administration of oral administration produces erection after 10-20 minutes. It can cause headaches, nausea, dizziness, fainting and flushing, but can also be used by heart patients.
– Cialis (Tadalafil), produced by Ally Lily, acts directly on the penis by inhibiting the enzyme phosphodiesterase. Leads to erection in 30 minutes, and lasts up to 36 hours. Headaches, gastric intolerance, nasal congestion, back pain, muscle aches, dizziness and flushing may occur. As with Viagra, the use of nitrates cannot be used for heart disease.
– Levitra Bayer and GlaxoSmithKline (Verdenafill), but with fewer side effects (headache, flushing and runny nose), act directly and selectively on the penis by inhibiting the enzyme phosphodiesterase. Leads to erection in 15 minutes, and lasts up to 8 hours. As with Viagra and Cialis, the use of nitrates cannot be used for heart disease. One of the main advantages is the cheapest price and selling in one pack.
Although drug treatment is mentioned, some patients may not need treatment with mechanical devices such as vacuum erection devices or penile implants inflatable or malleable. Others may require surgery to repair vascular arteries that, in certain cases, supply blood to the penis.
Because there can be many causes of erectile dysfunction, there are many treatments that work by different methods, with specific contraindication, a urologist should be consulted.