Erectile dysfunction does not refer to independent diseases, but is considered a syndrome that occurs on the background of another disease. It is characterized by insufficient volume and hardness of penis so that a man could perform sexual intercourse and complete it fully.
Normally, sexual intercourse for a man begins with sexual desire and love affection, continues with onset of erection, performing frictions, and ends with ejaculation and onset of orgasm. About erectile dysfunction we speak in those cases when one of components of this chain is violated, in most cases – ejaculation or erection.
Statistical data of recent years confirm that 20% of men face erectile dysfunction after 20 years. Men who have reached the age of 40 face symptoms of erectile dysfunction 2 times more often – 39%, and after 50 years – 70%.
It is worth knowing that such diagnosis can only be given to those representatives of the stronger sex who do not manage to achieve full erection more often than in every fourth sexual intercourse. If deterioration of erection is provoked by severe stress, use of certain medications, etc., sexual dysfunction is not diagnosed, because these factors affect quality of erection temporarily.With such prevalence of this ailment, low activity of men with regard to finding out its causes was noted – only 16% of patients with signs of erectile dysfunction seek advice of urologist. Others attribute this to age-related changes, worsening relations in family and other fictional factors, ignoring need for treatment of the syndrome and possible co-morbidities. At the same time if you go to doctor in time and start therapy, in 95% of cases problem of erectile dysfunction is cured completely.
Causes of Erectile Dysfunction
Erectile dysfunction can be caused by many pathological conditions in the body, psychological factors and other problems.
- Endocrine disorders: the most common cause is testosterone deficiency, which may be a consequence of dysfunction of testicles or pituitary gland. This pathology often occurs in older men, especially during the so-called male menopause – after 42 years. Also, there is excessive production of prolactin in the body, which is testosterone antagonist and slows down erection process. Erectile dysfunction can be a consequence of endocrine diseases such as hypothyroidism, diabetes, pituitary gland tumors, hyper- or hypoplasia of adrenal glands.
- Urologic pathologies: diseases of bladder and prostate, malformation of genital organs, renal insufficiency are often diagnosed in men with erectile dysfunction.
- Vascular diseases: atherosclerosis, ischemic heart disease, hypertension, endarteritis, which indirectly affect blood filling of penis. In such cases, cholesterol is raised in blood, which leads to destruction of walls of vessels, as well as formation of atherosclerotic plaques. Such violations can touch vessels of penis, which will lead to weakening of erection.
- Neurological disorders: Parkinson’s disease, epilepsy, multiple sclerosis. Erectile dysfunction can lead to strong and regular stresses, depression. In some cases, problem is caused by consequences of surgery of spinal cord and brain, perineum, pelvis, their trauma, blood stroke. The cause of pathology becomes difficult or absent passage of nerve impulses into cavernous bodies. The fourth part of sexual disorders on the background of neurogenic pathologies develops due to hernias of intervertebral discs, syringomyelia, neoplasms and other diseases. In 75% of cases – because of spinal cord injuries.
- Reception of medications: a side effect such as erectile dysfunction may have some drugs for treatment of ulcers, cardiovascular diseases, gout, severe allergic reactions, mental disorders.
There are other reasons that can affect every man, because erectile dysfunction can develop due to presence of certain habits and lifestyle characteristics:
- use of alcohol causes increase in the body of female hormones;
- smoking causes blockage of blood vessels, especially those located in penis (due to their small diameter);
- unprotected sex increases risk of contracting syphilis, chlamydia, gonorrhea, HIV, herpes and other diseases that lead to erectile dysfunction;
- use of harmful and fatty foods that cause increased blood cholesterol and development of cardiovascular pathologies;
- frequent visits to saunas, baths, driving a car with heated seats should be prohibited for men with erectile dysfunction, since all this causes overheating of scrotum and death of spermatozoa, disrupting process of ejaculation.
It is proved that about one third of men aged 18 – 50 years experience more or less symptoms of erectile dysfunction. Erectile dysfunction is diagnosed when during more than 25% of all sexual contacts patient experiences the following symptoms:
- absence of erection, both adequate and spontaneous (night and morning). If adequate erection worsens, but spontaneous remains unchanged, specialists often diagnose psychological causes of the pathology. When both adequate and spontaneous erections are disturbed, erectile dysfunction of organic form (caused by hormonal, cardiovascular, neurogenic and other diseases) is usually diagnosed;
- weak erection, which is expressed in insufficient firmness and volume of penis. This includes reduction in frequency of its appearance, as well as decrease in rigidity;
- difficulties in maintaining erection: uncontrolled ejaculation before sexual intercourse or at its very beginning, which is especially characteristic of men with erectile dysfunction.
To understand how to treat erectile dysfunction in men, it is necessary to conduct a comprehensive diagnosis, including:
- studying complaints. This is the first stage of diagnosis, when doctor is interested in problems with erection, finds out frequency of their appearance, nature. After that, a man is offered to fill out the simplest questionnaire consisting of 5 questions, which allows urologist to assess degree of pathology and conduct further differential diagnosis;
- psychosocial examination, which involves assessing psychological state of a man: presence of depression, anxiety, etc. Of great importance is analysis of relationship between partners, their reactions to sexual problems of men;
- collecting anamnesis. This stage is necessary to determine previous surgical interventions and to determine whether a patient has recently taken medications, if so, which ones;
physical examination, which consists of:
- estimations of physique of a man and severity of his secondary sexual characteristics. Particular attention is paid to possible signs of low testosterone levels – small testes size, enlarged mammary glands, slow growth of facial hair, etc.;
- estimations of correct functioning of thyroid gland: presence of skin problems, hair loss, changed heart rate;
- examination and evaluation of development of genital organs;
- examination of prostate, carried out rectally;
- bulbocavernosus reflex test: normally, when you press penis blanus, anus contracts immediately;
- lipid profile study (cholesterol, triglycerides, etc.);
- analysis of level of sugar in blood;
- analysis of sex and thyroid hormones;
- ECG at rest and exercise;
- ultrasound examination of blood vessels and veins of penis;
- cavernosography is a contrast X-ray study to assess condition of veins and vessels of penis, structure of cavernous bodies and detection of plaques or foci of atrophy or sclerosis;
- registration and evaluation of nocturnal erections with the help of sensors. The study is conducted in clinic.
- establishment of sensitivity and innervation of penis by vibration;
Erectile dysfunction is a serious disorder that can develop due to many reasons. Therefore, in order to establish and prescribe suitable therapy, a complex study is carried out, consisting of a number of procedures.
Treatment of Erectile Dysfunction
Treatment of erectile dysfunction should be aimed at eliminating the cause that triggered this pathology. Therefore, in each case, individual therapy is selected:
- if there were endocrine disorders, hormonal creams and pills are prescribed;
- psychological reasons for development of erectile dysfunction require advice of sex therapist, sexologist and clear compliance with their prescriptions;
- anatomical organ changes and problems with prostate gland require surgical intervention;
- neurological, urological and cardiovascular diseases require serious therapy aimed at eliminating pathology.
In addition, drugs for the treatment of erectile dysfunction are prescribed:
- inhibitors of PDE-5: Levitra, Viagra, Cialis. Such medications give a short-term effect and have many side effects;
- herbal preparations based on eurycoma longifolia and ginseng. On responses of men they give steady effect on the background of basic medicamental therapy directed on treatment from accompanying pathologies;
- injection of drugs that dilate vessels into cavernous body of penis. Such manipulations must be carried out before each sexual intercourse;
- introduction of suppositories for treatment of erectile pathologies in urethra, which is possible with a special device.
Conservative therapy helps to get rid of erectile pathology (dysfunction) in overwhelming majority of cases. Only 5% of patients require surgical intervention.
In some cases of erectile disorders doctors can recommend prosthetics of penis. In modern medicine plastic or hydraulic three-component protheses are used for this purpose, while the latter variety is more popular due to its obvious merits.
To minimize likelihood of erectile dysfunction, men from the age of 30 (or better as soon as possible) should observe the following rules:
- correct nutrition: diet should be rich in greens, fresh vegetables, fruit, meat, eggs, sour-milk products, porridges. it is necessary to eat nuts, seeds and honey;
- healthy way of life: perform feasible physical exertion, get enough sleep, avoid stresses;
- refuse from unhealthy habits: drinking alcohol (even non-alcoholic beer), smoking, addiction to drugs;
- regular visits to urologist: this will help in time to identify and treat such common urological diseases as prostatitis and prostate adenoma;
- normalize sexual life: during a week a man should have 3 full sexual intercourses (not recommended abuse masturbation). Do not use interrupted intercourse as method of contraception;
- do not ignore prevention, timely diagnosis and treatment of diseases that can lead to sexual dysfunction – endocrine, cardiovascular and other pathologies. Maintain general health.
When the first signs of erectile dysfunction appear, the best way out of this situation is to visit urologist and undergo full examination followed by treatment. In this case, you can save sexual function for many years and live full sexual life without restrictions.