“Erectile dysfunction is defined as inability to take care of an erection enough for sexual intercourse. This is a dysfunction that impacts millions of men all over the world in numerous ways and with various causes.”

What’s it?

Erectile dysfunction is a medical term used to define the inability to get an erection with sufficient inflexibleity for penetration and / or keep it for a time period adequate to the satisfaction of each partners throughout sex. It is very important understand that it can happen even with want and orgasm (ejaculation) present.

Erectile dysfunction (ED) affects about two thirds of males over 50 years of age, representing 10 to 20 million Brazilians.

Most males, sooner or later in their lives, have experienced episodes of erectile dysfunction, often resulting from tiredness, stress or alcohol abuse. Occasional failures shouldn’t be overrated. However, if the problem persists, a urologist ought to be sought.


The capacity of erection is just considered one of several features of male sexual function. The sexual response cycle has four levels of man principal desire, erection, orgasm and relaxation. Each can change different.

The causes of ED are divided into organic, psychogenic and combined, will be discovered with mixed factors. Natural problems similar to diabetes, cancer, arteriosclerosis and neurological accidents can usually lead to psychological issues, for example. It can be secondary, and appear as the primary manifestation of assorted disorders corresponding to hypertension, diabetes, cardiovascular disease and renal failure.

ED of psychological origin can be manifested in various ways, or delayed ejaculation, painful ejaculation and even impotence. There might also be lack of libido (sexual want), lack of orgasm and phobias (fears) sex, all for anxiety, depression or guilt. An individual who has an disagreeable expertise, equivalent to lack of erection to have sex or ejaculate very early, tends to the following relationship, bear in mind these “failures” and turn out to be anxious. This provides a new fault, making a vicious circle.

Natural causes are subdivided in accordance with the etiology. The vasculogĂȘnicas are more prevalent, particularly the flow changes, arteriosclerosis and trauma (resulting in injury to blood vessels).Venous flow abnormalities are less common. The neurogenic causes are diabetic neuropathy, multiple sclerosis, alcohol abuse, trauma, spinal twine and nerve damage by radical prostatectomy (surgery to remove the prostate). Since the causes are hormonal hipoandrogenismo major or secondary (disorders of male hormones).

The ED might also occur, for use and abuse of drugs like marijuana, alcohol, heroin, cocaine, barbiturates, antidepressants.

Issues associated

The DE has several risk factors as advanced age, diabetes, hypertension, peripheral vascular diseases; neurological ailments, endocrine disorders, spinal twine injuries, radical pelvic surgical procedure, radiation remedy, alcoholism, smoking, marijuana use and / or cocaine; use of antihypertensives, tranquilizers and psychotropic substances; relationship problems with partner, stress, nervousness and concern of failure, depression, obsessive-compulsive personality, sexual deviation.


The objectives of the initial evaluation of the patient are to find out the probable cause of ED and identify natural or psychological factors that may affect the related therapeutic.

An in depth medical interview is a very powerful factor in evaluating patients with this problem. The history ought to establish the period, progression and severity of ED and associated factors.

After getting identified a problem in the patient’s sexual performance, the following step is to distinguish it from different sexual problems equivalent to lack of libido and ejaculatory disorders.

Physical examination is to assess the affected person’s health, with particular attention to the cardiovascular, neurological and genitourinary, due to its contribution to the erection. The neurological evaluation should embrace a notion of their affected person’s nervousness or depression. Since the assessment of genital herpes is directed to detection of local abnormalities.

Some are basic laboratory tests to establish problems that can lead to ED.


In cases of psychogenic DE, psychotherapy is indicated. A number of factors ought to be evaluated by the urologist and if potential, by an knowledgeable in psychology or psychiatry. Factors corresponding to physical, psychiatric, psychological, conflicted relationship with the partner and sexual inadequacy needs to be addressed to the couple.

Penile injections have been the primary environment friendly and goal, with little or no side effects, with significant improvement of erection, even in severe OF and organic. They had been the main complication, painful erections. Also had the disadvantage of limiting the time limitation of erections and frequency of application (3 instances per week). This methodology tends to be abandoned with the advancement of technology.

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