Erectile dysfunction
Introduction:-
Erectile dysfunction is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis sufficient for satisfactory sexual performance.
To understand erectile dysfunction you should understand what the erection is, Erection is physiological process due to engorgement with venous blood after sexual stimulation.
Since an erection requires a precise sequence of events, ED can occur when any of the events is disrupted. The sequence includes nerve impulses in the brain, spinal column, and area around the penis, and response in muscles, fibrous tissues, veins, and arteries.
The major causes for erectile dysfunction include:
1- Psychological factors as depression, stress, anxiety and mental disorders
2- Cardiovascular diseases especially hypertension and atherosclerosis
3- Diabetes and obesity
4- Drugs as antidepressants and blood pressure drugs
5- As a complication for bladder or prostate surgery
6- Smoking and substance abuse
7- Low level testosterone
8- Aging
Diagnosis:-
History: help define the degree and type of the dysfunction.
Physical examination: for penis and testicles.
Blood and urine tests: for diagnosis underlying diseases as hypertension or diabetes.
Ultrasound: to check penis blood flow.
NPT: Nocturnal penile tumescence to test erection while sleeping, lack of these erections may indicate there is a problem with nerve function or circulation to the penis.
Treatment:-
It depends on the cause of the erectile dysfunction.
1- sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) enhance the effects of nitric oxide.
2- Alprostadil self-injection or penis suppository produces erection that last for long time.
3- Testosterone replacement is used if the dysfunction caused by low testosterone level in the blood.
4- Penile implants and pumps.
5- Psychotherapy is used when the cause of the dysfunction is psychological.
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10 comments:
so if erection caused by venous engorgement these causes affect mainly arterial supply?
OK, WELL BUT WHAT ABOUT ED IN THE OLDERS ? AS THEY MORE SUFFERING , HAVE THEY SIMILAR CAUSES?
I believe that as a Dr., your patient should first of all change his lifestyle.
Diet, excerise + stretches such as brisk walks, swimming, running, biking.
If the patient maintains a seddatary lifestyle, even with a short term erection, the patient will be unable to perform intercoitus more then several minutes as due to the lack in cardio.
Also, adding several natural foods to the diet which I have found to help:
Green peppers, ginko, ginseng Korean root, kumin, pumpkin seeds, queen bee honey.
The added food groups the day before with activity will help to perform the next day.
However, the patient should first of all have had plenty of sleep as sleep, as well as mentally allowing himself to perform and not subconciusly denying himself. A self denile will only lead to a quick fall in libido several seconds before penetration.
If all of the above are taken into consideration and fail, I believe the next step would be to begin with medicication.
However, even with medication as I had mentioned if the patient is subconsciously denying himself the results will be poor and will only lead to negative spiral. The negative actions will be multiplied with the female's prospect as if she is not good enough or that there is a problem with him.
The patient will see himself as a further failure and will deny himself further.
All of the above must be taken into consideration.
All of this information are true about ED. The best we can do is discipline in ourselves like eating the right kind of food and proper exercise.
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It's about keeping a finger on the pulse of his marriage. After the hyper stage is the depressive state, in which the person becomes quiet.
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