Dealing With Erectile Dysfunction: What You Should know

WHAT IS IMPOTENCE (ERECTILE DYSFUNCTION)?

Erectile dysfunction is understood in common parlance as impotence. It signifies the failure to obtain and preserve an erection needed for an acceptable sexual relations. This is a relatively common condition and affects a huge bulk of males over.

This is not a lethal condition but might have a serious and considerable impact on the quality of life of patients, partners and families. It is very important that patients are effectively evaluated and investigated for underlying physical and mental conditions before starting treatment.

Causes of impotence (erectile dysfunction).

Erectile dysfunction can happen due to numerous causes. These might be both physical and psychological.

Physical causes include narrowing of capillary of the penis due to long standing high blood pressure, high blood cholesterol or diabetes. Surgical or traumatic injury to the penis or hormone issues might likewise trigger erectile dysfunction.

Certain mental causes such as anxiety, stress and anxiety and problems in the relationships might also cause impotence of erectile dysfunction.

Danger factors of erectile dysfunction.

erectile dysfunction

dealing with erectile dysfunction

Risk aspects of erectile dysfunction include:

-weight problems.

-smoking.

-high blood pressure.

-high blood cholesterol.

-absence of workout.

-diabetes.

-metabolic syndrome.

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Erectile dysfunction epidemiology.

Worldwide there is a high occurrence (of brand-new cases) and occurrence of this condition. Large number of males might not emerge with the condition and this means that the real numbers may be even bigger.

With the increase of conditions such as diabetes, hypertension and weight problems the danger of this condition is also rising.

Erectile dysfunction is the most common of the male sexual dysfunctions (occurrence age 30 to 80 years) at 19.2 % as compared to 31 % for all kinds of male sexual dysfunctions. There is a high rise with age. The occurrence of complete impotence for instance boosts from 5 % for men aged 40 years, to 15 % for males aged 70 years. Research studies show that 52 % of males (aged 40 to 70 years) were impacted at a long time (moderate 17 %; moderate 25 %; serious 10 %) and 40 % of men at age 40 might suffer some form of erectile dysfunction.

Of all sufferers about 10-20 % of clients with erectile dysfunction have a solely psychogenic or mental cause. Even when a physical cause is present there might be included existence of mental aspects.

Diagnosis of erectile dysfunction.

Erectile dysfunction needs to be assessed carefully for underlying problems–both physical, hormonal and mental. A comprehensive history of impotence and physical examination helps in medical diagnosis of the condition.

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Treatment of erectile dysfunction.

The commonest cause is narrowing of the arteries or atherosclerosis. Presence of danger aspects mandate changes in lifestyle and adopting steps to keep blood pressure, sugar and cholesterol under control.

There are several treatment alternatives that have shown really effective. Medication, such as sildenafil (offered as Viagra), can be utilized to effectively handle it in at least two-thirds of guys.

Other alternatives include usage of air pump that encourage blood to flow to the penis and assistance in the erection might be tried. There are numerous mental treatments such as cognitive behavioural therapy (CBT) and sex therapy that have actually revealed success.

 

Impotence (Erectile Dysfunction) Symptoms.

Regular penis and erection.

During sexual arousal and erection nerve impulses from the brain and from the local nerves lead to relaxation of the erectile dysfunctonmuscles in the corpora cavernosa and this permits blood to flow in and fill the areas within the tissue. The blood is trapped in the corpora cavernosa by a membrane called the tunica albuginea and hence a typical erection is preserved.

The erection stops when the muscles contract to stop blood streaming into the penis and open the channels that lead to outflow of the blood from the penis. The entire procedure is integrated and anything which interrupts this sequence can lead to issues either starting or keeping an erection.

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Signs of erectile dysfunction or impotence.

The main symptom of erectile dysfunction is the inability to get and maintain an erection for adequate intercourse.

There are other issues that may or might not be related or associated with erectile dysfunction. This includes ejaculation issues such as premature ejaculation, which is a condition where the procedure of arousal, orgasm and ejaculation takes place really rapidly. Premature ejaculation might have similar influence on the mental well-being and quality of life however is a separate condition. Impotence and early ejaculation should not be puzzled.

Failure to obtain an erection.

The individual might get an erection on waking up or while masturbating while fail to get or maintain an erection with a sexual partner. In case an individual is not able to get an erection under any circumstances the condition is likely to have a simply physical cause.

Inability to maintain an erection.

Lots of people with the condition complain of getting an erection however being not able to maintain it enough time to attain an adequate sexual intercourse.

History of modifications.

History of changes in relationships, surgery, and radiation to the pelvis or scrotum, certain substance abuse, smoking, high alcohol consumption, usage of leisure or body-building drugs long standing diabetes, high blood pressure or cholesterol is also substantial. There might be presence of peripheral vascular condition and lowered circulation of blood to the penis. There might likewise be a venous leak.

History of hormone conditions.

History of hormonal disorders like pituitary gland growths or abnormal levels of testosterone may be present. Presence of cavernously disorders like Peyronie’s condition.

Presence of mental causes.

These can include stress, mental disorders such as depression, schizophrenia, drug abuse, panic disorder, generalized stress and anxiety conditions, character conditions or characteristics and low self-confidence.

History of prostate and bladder cancer.

History of prostate and bladder cancer that has required eliminating tissue and nerves surrounding a tumour also enhances the threat for impotence.

Impotence (Erectile Dysfunction) Diagnosis.

Clients with erectile dysfunction present with the failure to initiate or preserve an erection for satisfactory sexual intercourse. Medical diagnosis involves taking a comprehensive history and examining the nature of the underlying reason for the impotence.

STEPS IN MEDICAL DIAGNOSIS INCLUDE:

Assessment of sexual history.

There are several authorized questionnaires to examine sexual function and the impacts of treatments in a bid to cure erectile dysfunction. One of the surveys includes the International Index of Erectile Function (IIEF). The client is inquired about their existing and previous sexual relationships, emotional health and wellbeing, symptoms of impotence (inability to start or maintain the erection), medications utilized, and problems in arousal, ejaculation or achieving orgasms and presence or absence of sensual and early morning erections.

Assessment of case history.

Information of medical disorders like diabetes, high blood pressure, high blood cholesterol, hormonal disorders, prostate and pelvic conditions or surgical treatments and so on are evaluated.

If mental causes are presumed.

erectile dysfunction

Signs of erectile dysfunction

If mental causes are suspected nature of onset (typically sudden), nature of ejaculation (normally changed) existence of self-stimulated or sensual erections, problems or modifications in relationships or major damaging life events or psychological events are evaluated.

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If physical causes are presumed.

If physical causes are thought nature of onset (typically progressive), nature of ejaculation (typically unchanged), typical libido, medical history and conditions, history of operations, radiotherapy, or injury to hips or scrotum or usage of medications that may influence erection are assessed. Smoking cigarettes, high alcohol consumption, usage of recreational drugs are likewise evaluated.

Health examination.

This consists of a total assessment of the genital areas and urinary system. This is necessary to exclude conditions such as Peronei’s illness, gonadal anomalies, and retractile foreskin. Endocrine irregularities and hormone issues may be thought if there are changes in testicular size and secondary sexual characteristics. All peripheral pulses and high blood pressure is determined to identify narrowing of capillary. A rectal evaluation (Digital Rectal Examination) is performed for clients over age 50 years to spot prostate irregularities.

Examinations

Recommended investigations by the European Association of Urology consist of:

-Blood glucose and lipid profiles for all clients especially if not checked in the past 1 year.

-Total blood testosterone as measured in the morning sample.

-If low testosterone is spotted then evaluation of hair follicle stimulating hormonal agent (FSH), luteinising hormone (LH) and Prolactin is prescribed.

-Examination of PSA (Prostate Specific Antigen) for clients with prostate problems.

-Blood urea and electrolytes to identify kidney function.

-Liver function tests to discover hepatic conditions.

-Haemoglobinopathy screen in Afro-Caribbean clients to leave out Sickle cell disease.

-Thyroid function tests.

-Studies to check for nocturnal penile tumescence and rigidity. Their absence may indicate an issue with nerve function or blood supply in the penis.

-Other tests include penile biothesiometry that utilizes electromagnetic vibration to examine level of sensitivity and nerve function in the glans and shaft of the penis.

-Studies of penile blood vessel abnormalities using Duplex ultrasound spacious arteries, Intracavernous vasoactive drug injections, Dynamic infusion cavernosography, Arteriography (internal pudendal artery studies) and so on. An intracavernous injection test for instance involves injecting an artificial hormonal agent into the penis to enhance the blood circulation. This can assess the irregularity. If the injection fails to produce an erection it may suggest that there is a problem with the blood supply to the penis. Dynamic Infusion Cavernosometry is a technique where fluid is pumped into the penis at a known rate and pressure. This helps to find the vascular pressure within the penis. Corpus Cavernosometry is the measurement of the vascular pressure in the corpus cavernosum.

-A Penile Angiogram allows visualization of the blood circulation in the penis. Magnetic resonance angiography uses magnetic fields and radio waves to provide in-depth images of the blood vessels of the penis.

-Evaluation of psychological disorders.

When to consider recommendation?

-Presence of endocrinal or hormone conditions.

-Young clients with history of pelvic or genital trauma or injury.

-Cardiovascular or nerve conditions resulting in impotence.

-Penile irregularities that can be corrected by proper surgery.

-Complex participation of psychiatric, cardiovascular, psychosexual or endocrine elements.

-When asked for by the patient or his sexual partner.

Erection problems are common. Almost all adult men have trouble getting or keeping an erection at one time or another. Often the problem goes away with little or no treatment. But for some men, it can be an ongoing problem. This is called erectile dysfunction (ED).
Erectile dysfunction (ED) is a common type of male sexual dysfunction. It is when a man has trouble getting or keeping an erection. ED becomes more common …
There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and the tissues; and the veins, which carry blood from the capillaries back toward the heart.

Impotence (Erectile Dysfunction) Treatments.

Erectile dysfunction or impotence might not be a deadly ailment however has a considerable and severe influence on psychological health and wellbeing and quality of life. The goal of treatment is to detect and deal with the reason for the condition when possible.

These therapies can be chosen according to effectiveness, security, invasiveness, cost and choice of the patient. Actions and techniques in treatment of erectile dysfunction consist of:-.

Lifestyle changes.

Exercise and upkeep of healthy body weight lowers the danger of erectile dysfunction. The client is advised to give up smoking and usage of recreational drugs of abuse and decrease alcohol consumption. Decrease of tension also assists in prevention of impotence.

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Medications.

Phosphodiesterase type-5 inhibitors -Several oral drugs of the class phosphodiesterase type-5 inhibitors like sildenafil, tadalafil or vardenafil may work and in some cases require only be utilized short-term for remedy for symptoms of impotence. These representatives improve the relaxation of smooth muscle. Effectiveness of the drug depends on release of nitric oxide from the nerve endings of the cavernosal nerve.

These drugs can not be utilized in clients getting nitrates for conditions like angina. In these clients there might be a serious fall in high blood pressure which might result in intense myocardial infarction (cardiac arrest), stroke as well as death. Those with a history of low blood pressure, ischemic optic neuropathy, current stroke, unsteady angina or cardiovascular disease are also not recommended these drugs.

Sildenafil (Viagra) is usually well endured and efficiency is decreased after a fatty meal. 50 mg is the recommended starting dose and side effects are uncommon. The results start after 30 minutes and peak result is seen at 2 hours and lasts as much as 36 hours. Vardenafil is effective after 30 minutes. It is useful in non-responders to Sildenafil. Result reduced by fatty meals.

Apomorphine hydrochloride–This drug acts by boosting centrally-acting erectile signals. It is best reliable in patients with mild-to-moderate erectile dysfunction.

Yohimbine–This representative has been used for over a century as an aphrodisiac. It acts both on the brain and the genitalia. It has a modest impact specifically in psychological reasons for erectile dysfunction and does not act on physical causes of the condition. This drug is not accredited for National Health Service (NHS) treatment in the UK but used as a natural treatment by many clients.

Delequamine–This is a comparable agent as yohimbine.

Trazadone–This an antidepressant drug connected with long term and uncomfortable erections. This is not erectile dysfunctionrecommended for erectile dysfunction.

In some cases intrauethral alprostadil is likewise used. Here the drug is placed as a pellet into the uretha at the idea of the penis and this produces an erection after about 15 minutes. Alprostadil is damaging for an unborn baby and so condoms or other barrier birth control must be used if the sexual partner is pregnant.

Red Korean ginseng has an unidentified mechanism of action.

Vacuum gadgets.

These gadgets are shaped like an external cylinder fitted over the penis to permit air to be pumped out. This results in engorgement of penis with blood. This helps finest when the partner is comprehending and encouraged. Adverse effects include pain, bruising and feeling numb.

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Penile prosthesis.

These are synthetic extensions utilized over the penis. The material is semi-rigid, malleable or inflatable that is surgically placed into the penis to produce an erect state.

Hormone treatment.

In clients with testicular failure testosterone is utilized for treatment. Those with pituitary or hypothalamic reasons for impotence need to be treated with different hormone agents.

Surgery.

Patients with pelvic or genital injury might establish Post-traumatic arteriogenic erectile dysfunction. Medical diagnosis is made using duplex ultrasound and arteriography. Surgery reveals around a 60-70 % success rate.

Treatment of Psychosexual causes

These patients might benefit from sex treatment and counselling, cognitive behaviour treatment and group psychiatric therapy. These might be used in conjunction with physical therapies.

Pelvic floor muscle workouts

There are studies that reveal that workouts of the pelvic floor muscles may assist prevent impotence. These workouts benefit a group of muscles around the underside of the bladder and anus, in addition to at the base of the penis.

 

IMPOTENCE (ERECTILE DYSFUNCTION) HISTORY

Erectile dysfunction has been a condition affecting guys since ancient times.

Early treatments

The earliest efforts at treating this condition were in the medieval Islamic world by the Muslim physicians and pharmacists. These doctors were the first to prescribe medication for the treatment of this issue. They recommended a single drug therapy for the condition or a combination of prescribed diet plan and drugs.

Apart from oral drugs they likewise attempted local application of medication and application of drugs through the urethra. This was prevalent between the 9th and the 16th Century and some of the well-known Muslim physicians and pharmacists consist of Muhammad ibn Zakarīya Rāzi, Thabit bin Qurra, Ibn Al-Jazzar, Avicenna (who wrote the “The Canon of Medicine”), Averroes, Ibn al-Baitar, and Ibn al-Nafis (who wrote the “The Comprehensive Book on Medicine”).

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Testosterone treatments

In the 1800’s sheep testis extract was injected as a source of testosterone to fix impotence. This was the standard till testosterone was cleansed in the 1940s.

Penile implants and vacuum pumps

In the 1970’s cosmetic surgeons began offering clients with inflatable penile implants. In 1960 Geddings Osbon invented a gadget which he called the “YED” or “youth equivalence device”. It is still being used today as the air pump for erectile dysfunction

The development of medications to treat erectile dysfunction.

All attempts to deal with erectile dysfunction with medication failed till in 1983 British physiologist Giles Brindley, Ph.D. actually revealed an American Urological Association audience the result of phentolamine on inducing an erection. He had actually injected a non-specific vasodilator, an alpha-blocking representative in his own veins to trigger corporal smooth muscle relaxation. This laid the path for the later development of oral agents that could lead to similar vasodilation and corporal smooth muscle relaxation in the penis resulting in erection.

The discovery of Viagra

erectile dysfunction

treating erectile dysfunction

Treatment of erectile dysfunction was transformed with the discovery of sildenafil or Viagra. Pfizer workers Peter Dunn and Albert Wood were depicted as the as the inventors of sildenafil, now called Viagra. They synthesized the drug in 1989, in addition to other Pfizer colleagues at the company’s Sandwich, Kent research facility in England. Andrew Bell, Dr. David Brown and Dr. Nicholas Terrett likewise aided in development of the molecule.

Terrett was named in the 1991 British patent for sildenafil as a heart medicine, and some experts consider him as the father of Viagra. Dunn and Wood however were responsible for bringing Viagra into its tablet type

 

These doctors were the first to prescribe medication for the treatment of this problem. They recommended a single drug therapy for the condition or a combination of recommended diet plan and drugs.

It is still being utilized today as the vacuum pump for erectile dysfunction

All attempts to treat erectile dysfunction with medication failed till in 1983 British physiologist Giles Brindley, Ph.D. literally showed an American Urological Association audience the impact of phentolamine on inducing an erection. Treatment of erectile dysfunction was reinvented with the discovery of sildenafil or Viagra.

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