A pathology that scares all members of the stronger sex, erectile dysfunction, is most often the result of another disease. It assumes the absence or insufficient erection of the penis, which is necessary for a full sexual intercourse.

In moderate and severe degrees, this type of disorder is observed in 20% of men. The interest of urologists-andrologists in this problem is due to a decrease in the quality of life of patients, the destruction of families and psychological problems that the disease leads to.

Glad to see you on the blog again, dear readers. Alexander Burusov is in touch and today we will talk in detail about erectile dysfunction and its diagnosis.

Erectile dysfunction in men involves impaired circulation to the genitals. In particular, there is an insufficient filling of the corpora cavernosa with blood. This is possible due to arterial insufficiency or excessive outflow of venous blood from the penis.

In this regard, it can be established that the risk factors for dysfunction are similar to cardiovascular diseases. These include:

• old and old age,
• overweight
• depressive conditions,
• metabolic syndrome
• smoking and drug addiction,
• diabetes,
• low physical activity.

It is known that this condition can be prevented by getting rid of bad habits.

Classification

Erectile dysfunction (ED) is subdivided into three groups depending on the risk factors that cause it:

1. Psychogenic ED... It occurs in men with neuroses, dependence on psychotropic drugs, as well as in some situations that provoke an episode of dysfunctional disorder.
2. Organic erectile dysfunction... Appears in patients with vasculogenic (vascular), neurogenic, hormonal disorders. Also, organic erectile dysfunction is typical for men with structural changes in the penis (Peyronie's disease, traumatic organ damage, micropenis, hypo- and epispadias, sclerosis of the corpora cavernosa after inflammation). Hormonal factors include: hypogonadism, hypo- and hyperthyroidism, Itsenko-Cushing's disease, hyperprolactinemia. Organic erectile dysfunction can occur in the presence of Parkinson's disease, tumors of the brain and spinal cord, multiple sclerosis, damage to the discs between the vertebrae, after strokes. Polyneuropathies of various etiologies provoke the appearance of pathology. Most often, it is cardiovascular changes that cause impotence in men. Organic erectile dysfunction can be a consequence of atherosclerosis, high blood pressure, smoking (spasm of the vessels of the penis), Leriche syndrome, veno-occlusive disorders, imbalance of fats and sugars in the blood.
3. Medicinal ED... Poor erection is often observed in people taking antidepressants, antiandrogenic drugs, psychotropic and blood pressure lowering drugs. This group also includes men who use drugs.

The causes and treatment of ED are closely related. Therefore, identifying risk factors and determining the nature of violations is important for further tactics of patient management.

Diagnosis of erectile dysfunction

First of all, the very fact of the presence of the disease becomes clear. To do this, the doctor carefully interviews the patient, summarizes the symptoms.

Specially designed questionnaires provide significant help. These questionnaires include the International ED Index and the Scale for the Quantification of Male Copulatory Function.

After erectile dysfunction in men has been established, its nature is determined. For psychogenic ED the following parameters are characteristic:

• occurs suddenly
• preserved morning erections,
• there are problems with a partner,
• pathology appears only in certain circumstances.

Organic erectile dysfunction is characterized by:

• gradual development,
• lack of morning erections,
• persistence of violations,
• lack of psychological and interpersonal problems.

Clinical diagnosis of erectile dysfunction includes examination for cardiovascular, neurological, hormonal pathologies. An examination of the patient is mandatory, including:

• weighing, measuring growth,
• assessment of the development of the musculoskeletal system,
• determination of the nature of hair growth,
• analysis of the distribution of subcutaneous fat,
• determination of the tone of voice, waist size,
• determination of the location of the testicles, their size and consistency.

All of these parameters are needed to identify the hormonal status of a man, which has a direct impact on potency.

Laboratory erectile dysfunction in men is confirmed in different ways. It depends on what pathology the doctor suspects. Can be assigned:

• lipid profile,
• determination of blood sugar levels,
• blood testosterone test.

Be sure to exclude inflammatory diseases of the prostate, seminal vesicles, testicles and their appendages.

To carry out the differential diagnosis of vascular disorders, use the introduction into the penis vasoactive drugs... The most commonly used drug is Alprostadil. It is administered at a dosage of 10mcg and the effect is expected.

If after 10 minutes an erection has not come, it is assumed that there is a vascular disease. You can confirm the problem by using UZDG arteries. The blood flow velocity is noted after the administration of pharmaceuticals.

The survey can be supplemented with the following methods:

• angiography of blood vessels,
• cavernosometry and cavernosography,
• determination of evoked potentials,
• EMG of the penis.

All examinations are prescribed by the attending physician. Only he knows in what situation one or another diagnostic method can be applied.

Treatment

The main goal of therapy is to restore erectile dysfunction to a state that allows for normal intercourse. First of all, the treatment of diseases that caused the pathological condition (diabetes, atherosclerosis, obesity, etc.) is carried out. If there are anatomical changes in the vessels, surgical correction is performed.

One of the methods of treatment is the prescription of drugs. testosterone based... It is important to remember that the method is used only for men with a confirmed deficiency of the hormone in the blood.

After the provoking factors have been eliminated, the lifestyle has been normalized and the associated conditions have been corrected, they resort to prescribing basic drugs.

In most cases, erectile dysfunction can be cured by taking phosphodiesterase-5 inhibitors... The funds included in this group include the following drugs:

• sildelafil,
• tadalafil,
• udenafil,
• vardenafil.

They are produced under various brands. The most popular are Cialis, Viagra, Vizarsin, Dynamically etc. Means differ in dosage regimen and pharmacokinetic characteristics (half-life, time of onset of effect, duration of erection). As a rule, all funds must be taken some time before the planned sexual intercourse.

However, medications for daily use have already been released. They do not cause unwanted erections during the day. The action occurs only after an impulse is sent from the brain.

The second line of ways that ED can be cured are intracavernous drug administration... Solutions of alprostadil, phentolamine, papaverine are used.

The dosage is selected strictly individually. After administration of the drug, an erection occurs within 5-10 minutes.

It is important to remember that injections into the corpora cavernosa can be performed no more than 2 times a week with the already selected dosage.

The main side effect such treatment is prolonged unwanted erection. If the condition persists for 4 hours or more, you should contact a medical institution.

If all of the listed methods of treating ED are ineffective, they decide on penile prosthetics.

Erectile dysfunction (erectile dysfunction)- symptoms and treatment

What is erectile dysfunction (erectile dysfunction)? We will analyze the causes of occurrence, diagnosis and treatment methods in the article by Dr. BV Skatov, a urologist with 26 years of experience.

Definition of disease. Causes of the disease

erectile disfunction- long-term (at least 6 months) inability of a man to reach the tension of the penis sufficient for a full sexual intercourse.

Man is the only biological species on our planet that can maintain an erection for a long time. Violation of this ability is an important medical and social problem, leading to loss of self-esteem, family conflicts.

Causes of erectile dysfunction:

According to this scheme, there are 14 structures for the regulation of erection. A violation at any level can lead to a variety of violations in the intimate sphere of a man. These structures can be disrupted as a result of strokes, trauma, tumors of various localizations, multiple sclerosis, and other neurological diseases.

In addition, a group of reasons associated with disruption of the internal secretion organs (endocrine causes) is distinguished: diabetes mellitus, leading to damage to peripheral vessels and nerves, disruption of the thyroid gland,. The decrease in testosterone levels is also important, including age-related, due to fatigue, an imbalance in the hormonal background.

Inflammatory diseases of the genitourinary organs (vesiculitis, urethritis) can be the cause of erectile dysfunction.

If you find similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of erectile dysfunction

1.Early:

• weak (to complete disappearance) night and morning erection;
• decreased sex drive (libido);
• an increase in the time between foreplay and an erection;
• "Blurring" of the brightness of orgasm, up to the disappearance of its sensation;
• premature ejaculation (ejaculation);
• inability to re-intercourse;
• problems associated with "habitual" sexual intercourse;
• increased recovery time between erections;
• a decrease in the volume of ejaculate (the amount of sperm released during intercourse).

2. Late:

The pathogenesis of erectile dysfunction

In pathogenesis erectile dysfunction plays a leading role in the pathology of endothelial tissue, which ultimately leads to a violation of the blood supply to the cavernous bodies of the phallus. A huge role is played by vascular atrophy, leading to sclerosis, the replacement of healthy cells of the corpora cavernosa with coarse connective tissue. Consequently, the severity of erectile dysfunction depends on a combination of various causes and the degree of their effect on the corpora cavernosa.

Classification and stages of development of erectile dysfunction

Classification of erectile dysfunction (2017):

I. psychoactive:

1. Common form:

• general impairment of susceptibility;
• initial lack of libido;
• age-related decrease in sexuality;
• general impairment of libido;
• chronic disorder;

2. Situational:

a) In relation to a sexual partner:

• violation of libido for a particular partner;
• lack of libido to the preferences of the object;
• suppression of libido in connection with a conflict relationship with a partner;

b) Doubt about your capabilities:

• Dysfunctional disorders (rapid ejaculation);
• Expectation of failure (doubt about the onset of an erection, the ability to maintain an erection);

c) Chronic stress:

• Pathological mood (loss of a spouse, relative, dismissal from work).

II. Erectile dysfunction associated with organic lesions:

• vascular;
• neurogenic;
• anatomical;
• hormonal;
• medicinal.

III. Polyethiological erectile dysfunction.

Complications of erectile dysfunction

Diagnosis of erectile dysfunction

Diagnosis of erectile dysfunction should begin with a general history. At the first stage, they try to identify possible etiological factors, determine the individual characteristics of sexual activity. Should be allocated separately sexual behavior in the so-called "habitual" sexual intercourse. For this purpose, various questionnaires and scales are widely used, such as: the International Index of Erectile Dysfunction (ICEF-5), the Laurent-Segal scale, the profile of sexual intercourse (PSO) and others. A thorough examination reveals the nature of hair growth, defects of the penis, and the size of the testicles. Rectal examination is of great importance in order to judge the size, consistency and shape of the prostate.

Patients with erectile dysfunction should determine the hormonal background (free and bound testosterone, prolactin, estradiol, gonadotropin), determine the blood sugar level, glycated hemoglobin, blood lipid profile. The results of these tests will help to identify a certain type of pathogenesis of dysfunction.

Pharmacological test: the reaction of the tissues of the penis to the introduction of papaverine, prostaglandins and other medications into the cavernous bodies is investigated.

The study of neurological reflexes of the spinal cord roots also has a certain diagnostic value.

Ultrasound procedure:

Assessment of the state of the cavernous bodies:

• nuclear magnetic resonance imaging of the penis helps to determine the decrease in blood flow in the fibrosclerotic areas of the penis;
• biopsy of the tissue of the cavernous bodies, its histochemical study reveals the percentage of altered elements of the cavernous tissue.

Erectile dysfunction treatment

A real revolution in the therapy of potency disorders was made by phosphodiesterase-5 inhibitors, which have an effect on nitric oxide. This substance prevents a decrease in the tone of the veins of the penis and, therefore, improves erection. The name of the miraculous drug "Viagra" was prepared long ago and was waiting for its time for several years. This capacious and pleasant name translates as "the power of the huge Niagara waterfall." The hour came in 1993 when the American company Pfizer accidentally discovered an outstanding side effect of a new drug for lowering blood pressure - sildenafil citrate. The drug was quickly introduced into wide clinical practice and won first place among many pharmacological agents for the treatment of erectile dysfunction. This was followed by new generations of PDE-5 inhibitors. These drugs increased the clinical effect and minimized side effects. First of all, these are Levitra (vardenafil) and Cialis (tadalafil). The drugs can improve erection in many forms of erectile dysfunction, even with low testosterone levels in the blood of men.

Now a little about raising the level of testosterone in the body. Research in this area has been going on for many decades, but a real breakthrough has not happened yet. Testosterone does not want to accumulate in the male body, in addition, the drugs are expensive and have many side effects. Of these, one can distinguish "Nebido" - a medicine for intramuscular injection and "Androgel", which must be rubbed into the skin daily. The active use of testosterone and anabolic steroids is complicated by the widespread use of drugs of this group in bodybuilding and other strength sports, which makes it impossible to fully control their use and distribution.

Various herbal preparations are interesting in terms of mild stimulation and accumulation of their own testosterone. These are Altai "Red Root", African "Vuka-Vuka" and "Yohimbe", Thai "Butea Superba" and other natural remedies. However, the effectiveness ratio of these drugs is unclear, and clinical trials have not been carried out in the proper volume.

With most forms of erectile dysfunction, psychosexual therapy is of great importance, as well as lifestyle correction, elimination or reduction of adverse life factors.

Vacuum constrictor therapy (LOD therapy) plays a definite role in the therapy of erectile dysfunction. The main mechanism of this type of therapy is the creation of negative pressure (vacuum) on the corpora cavernosa of the penis with the help of special devices. Vacuum devices provide an adequate erection in 60% of cases.

Surgery for erectile dysfunction, they are used when conservative agents have been exhausted:

Forecast. Prophylaxis

The prognosis of the effectiveness of therapy for erectile dysfunction depends on the etiological factor, the neglect of the process (the degree of fibrosis of the corpora cavernosa), the age of the patient. Modern methods of treatment allow, basically, to restore potency. Even if therapy is ineffective, an erection can be achieved surgically.

Prevention:

1. Elimination of destructive habits - the use of nicotine, alcoholic beverages, drugs, masturbation and others.
2. Plays a huge role physical activity ... Massage of the pelvic and pubic areas is quite effective. Massage perfectly activates the vascular tone of the male genital organs. Constant physical education is required, since erectile dysfunction develops as a result of an inactive lifestyle. This leads to congestion in the prostate and other male organs. Regular squats are considered very effective. They are recommended to be performed 60–90 per day. This helps to normalize blood circulation in the vessels of the small pelvis. A very effective way of prevention is alternating tension and relaxation of the muscles of the perineum. Excellent results in the fight against insufficient erection are given by walking and running.
3. Balanced diet plays a leading role in the prevention of the development of erectile dysfunction. So, seafood is rich in essential trace elements such as potassium, zinc, magnesium, calcium, and omega acids, which are essential for a full erection. They are especially rich in oysters, crabs, red caviar, mackerel, soleus fish, sea crustaceans. Honey and nuts contain a significant amount of zinc, increase immunity, prevent the development of prostatitis, and increase male strength. Parsley, asparagus have significant reserves of tocopherol - the strongest antioxidant that has a regulatory function in relation to potency. Spices such as cardamom, ginger, and red pepper are unique for male strength. They are rich in vitamins E, C, B2, B6, which help to improve blood flow to the male organs, and promote a full erection.
4. Timely diagnosis and therapy of inflammatory diseases urogenital area.

All these preventive measures will help to postpone erectile dysfunction, up to the most venerable age.

The other day I gave one more comment to a medical publication. I already wrote about some points, in some ways I will repeat myself, and added some points to the question. So the conversation was about

erectile dysfunction

Which doctors can diagnose erectile dysfunction? And which specialists should be involved in the treatment of ED - urologists, andrologists, endocrinologists, sexologists, psychotherapists? Is there a difference in approaches to ED therapy in our country and in the West, for example?
Let's begin with that erectile disfunction, it is, in essence, a symptom. The same as the rise in temperature. Successful treatment in medicine should be, first of all, pathogenetic, and then symptomatic. This is logical. Why can a patient have erectile disfunction? Perhaps this is a syndrome of anxious expectation of sexual failure with the reasons for incorrect attitudes? Or psychological disharmony, as a result of which the patient simply “does not want” a rival? Or is it a different direction of sexual attraction, due to the regular viewing of pornography? Or maybe this is a consequence of maladaptive masturbation and other reflexes? Or maybe these are gaps in psychosexual development? There are thousands of reasons. Man is too complicated. It should be noted that erection Is often a response. Response to stimulus. Agree, it is important in diagnosis of erectile dysfunction evaluate both the situation and this incentive. After all, the sexual function is a pair. A sexologist is one of the few doctors who pays attention not only to the patient himself, but also to his sexual partner. Without this, a full-fledged therapeutic approach is unthinkable.

- it is always a combination of reasons, both above the belt and below the belt. It is impossible to provide quality assistance without high-quality and comprehensive diagnostics. Based on this, it is worth considering the issues of the boundaries of competence.

Urology (from the Greek - urine and - doctrine, science) is literally the science of urine. The male penis has two functions: urinary and sexual. Therefore, patients who have problems with the urinary function of the penis, of course, should consult a urologist, and if these are problems with the sexual function of the penis - a sexologist. If you look at the list of diseases within the scope of the urologist, according to the 10th International Classification of Diseases (ICD-10), we will see: inflammatory diseases of the genital organs, testicular torsion, infertility, urolithiasis, bladder stones, chronic pyelonephritis, varicocele , hydrocele, hydronephrotic transformation, purulent lesions of the kidney, abnormalities in the development of the kidneys, undescended testicle, hypospadias, foreign body of the urinary tract, prostate adenoma, prostatitis, pyelonephritis of pregnant women, urinary incontinence, renal cysts, priapism, genitourinary fistulas, stricture of the external urethra , bladder and urethra, kidney injury, cystitis, neurogenic bladder, genital neoplasms, urinary tract neoplasms. There is not a single word about erectile dysfunction and sexual dysfunction here. Therefore, very often urologists send patients with sexual problems to me.

If a person suspects infertility and wants a child, then, of course, he should consult an andrologist and take a spermogram. Every professional should do his own thing . In the mechanism of erection, as noted above, not only the penis is involved, but also hormones, the human psyche. Therefore, it is very strange, short-sighted and ineffective to treat only the executing organ in isolation, without diagnosing the “command post”. As well as dealing only with the "top floor". Specialists in the field of psychology and psychotherapy have previously tried to correct the behavior of their patients with their own methods, without taking into account, for example, their sexual constitution, sometimes devoting a lot of time, for example, to the patient's childhood. Psychotherapy is certainly necessary, but with treatment erectile dysfunction it is not enough, it must be specific, and this sometimes requires physiotherapy and drugs.

It is worth noting that the monodisciplinary approach is a voice from the past. Previously, neuropathologists also believed that the main problem was a decrease or increase in the sensitivity and transmission of nerve impulses. Endocrinologists have tried to treat patients with hormones without being interested in who the patient is going to fulfill his potential with. At the beginning of the 20th century, Samuil Voronov and Eigen Steinach, with the aim of rejuvenating, including sexual, carried out hundreds of transplantations of monkey testicles to humans. The testosterone revolution was not so successful - the increasing incidence of prostate cancer cooled the fervor of many pioneers.

Each of the specialists wanted to make a breakthrough, but the limited specialization prevented them from doing it. The creation of sexopathology, as a separate science, with its own methodology, examination methods made it possible to approach the assessment, diagnosis, and strengthening of sexual health in a comprehensive manner. Contemporary sexology takes into account both mental and endocrine, mental, vascular factors in etiology, that is, the causes of sexual dysfunctions. The sexologist is trained in these areas of medicine and is able to see the whole clinical picture, not just the "top" or "bottom" floor. In addition, the sexologist takes into account the principle of pairing. After all, it is obvious that attraction has not only an energy component, this is called a neuro-humoral component in sexology, but also a vector. Selectivity is important. Human sexual behavior is no less complex than that of animals, and this factor must be taken into account. Therefore, based on both common sense and the law, the treatment of erectile dysfunction is the prerogative of a sexologist.

As for the differences in therapeutic approaches to therapy erectile dysfunction in the West and here. There are many similarities. Prescribing PDE-5 or hormones to everyone indiscriminately and indiscriminately. Or psychoanalytic sessions. Sex - therapeutic concepts based on behavioral psychotherapy. Unfortunately, there is also a monodisciplinary approach. But I would like to note that such a school, created by our domestic scientist, G.S. Vasilchenko, with whom I was lucky to study at one time, is not abroad to this day. At scientific events, Western colleagues present within the framework of discoveries what Georgy Stepanovich and his team of scientists wrote about several decades ago. We still don't appreciate our successes.

Are there any statistics on what proportion of men suffer from erectile dysfunction? Or how often do patients present with similar problems?

Strictly speaking, the prevalence erectile dysfunction among men - 100%, because any man during his life may face the inability to have an erection. In some cases, this is due to lack of sleep, sometimes due to the abundance of alcohol, sometimes cause of erectile dysfunction strained relations with a partner or poor living conditions can become. Of great importance is how often failures occur and what is the dynamics of the development of complications. Therefore, a man who is faced with the first "misfire" should not immediately label himself erectile dysfunction and worry. It's another matter if negative dynamics are observed and new failures occur in the future. For a man, this is an important area for self-esteem. Therefore, almost everyone is trying to solve this issue. Most begin their journey as a self-medication, taking all sorts of advertised pills and tablets. After that, many go to urologists (they simply do not suspect about a separate specialty - a sexologist). There they often treat prostatitis. After such treatment erectile dysfunction and experiments PDE-5 (well-known Viagra, Cialis, Levitra, Zidena) are often heard as a consolation that "you are fine with physiology, you need a psychotherapist or psychologist." After attending comforting sessions and engaging conversations with the patient, he rushes to the Internet and begins to study the issue. In the end, he finds a specialized sexologist doctor. For example, patients often come to me with a huge batch of analyzes and studies, which, unfortunately, are prescribed in the format of overdiagnosis. Although, for example, it turns out that during masturbation, for example, the patient has no erectile dysfunction... But in recent years, many are exploring the issue even before the "therapeutic carousel" and come straight to the address. When collecting anamnesis, the details are sometimes terrifying - a 25-year-old patient with “pure” and mild psychogenic ED may report that he was persuaded in the previous clinic to undergo penile endoprosthetics: “we will do you an operation and forget about your problems”

Can we say that ED is an age-related disease or is there a tendency towards “rejuvenation” now?

According to my observations, and I have been doing sexology for about 20 years, the prevalence of somatic causes is observed over 50 years. Up to 50 - more often psychogenic reasons. Of course, this can be a combination of reasons. Over the past 5-10 years, the audience has rejuvenated. And this is an alarming symptom. It should be admitted that some of the patients from 20 to 30 years old, even 10 years ago, may simply not have been able to find a sexologist. By the way, even today this specialty is one-of-a-kind, since it is very laborious. Many doctors have about 10-20 minutes to see a patient. Only a sexologist is recommended to allocate 1 hour or more for the initial appointment. Now the search for information is facilitated by the widespread development of the Internet. My patients, for example, often come to an appointment already prepared, having read many articles on this issue.

Which part of men have a problem erectile dysfunction is associated with psychology, and which one is of a physiological nature (for example, systemic diseases)? Or is it always a complex of reasons and such a division is incorrect? Is it possible to completely solve this problem, or do patients still have to constantly take drugs to maintain sexual activity?

As already mentioned, patients with a leading psychogenic cause are more common. erectile dysfunction under the age of 50, and in older people, somatic reasons are not uncommon, that is, associated with the body, and not with the psyche, because the general state of health, as a rule, deteriorates. But even in these cases, a psychogenic component is often added. Therefore, we can say that psychogenic erectile dysfunction is observed almost always, it just can be complicated or not complicated by a somatic component. As for somatic causes, they can be listed endlessly, an accurate diagnosis can only be made by a doctor - sexologist . When making a diagnosis, it is important to evaluate all factors - from the analysis of the drugs that the patient takes, to the endocrine status, reflexes, vascular condition, lifestyle and bad habits. If necessary, a sexologist engages specialized specialists. In terms of supportive care, I usually recommend taking a preventive course every three to five years. After all, sometimes we even send a car for maintenance every year. You should also take care of yourself.

In most cases, erectile disfunction treated with drugs? Which doctors can prescribe them or do patients most often purchase drugs on their own without a doctor's supervision? How acute is the problem of dietary supplements (do they, on the contrary, worsen the condition of men)?

Different words and concepts: it is treated and cured. So it is often cured without drugs. Sometimes it is important to normalize the patient's life. Lecture on sexual hygiene. Invite the other half. Sometimes pharmacotherapy is required. Only a sexologist has the right to treat patients with sexological disorders, including prescribing drugs, both legally and from the side of common sense. The choice of drugs and dietary supplements is very wide, and patients often try many options. Taking on their own and dietary supplements, and even PDE-5, patients can sometimes worsen their condition. Unjustified hopes are fraught with disappointments and falls in self-esteem (“even such a magic drug did not help me”). Few patients know that PDE5s “do not work” in the presence of high stress. And they are disappointed in drugs that could be effective and could help, but with the right prescription. That is why a doctor should prescribe drugs. I often use a metaphor with a car at a patient appointment: if the car is on the hand brake, it is senseless and unjustified to press harder on the gas pedal. You need to see the big picture. Both the doctor and the patient.

Every man can face erectile dysfunction. However, do not panic: many reasons can lead to problems with erection, and often only minor medical intervention is required in order to regain sexual strength.

You will learn about the causes, symptoms, types and treatment of erectile dysfunction by reading the article.

What is erectile dysfunction?

Erectile dysfunction (ED) is a common sexual dysfunction characterized by the inability to achieve or maintain an erection during intercourse.

At a younger age, the cause is usually psychogenic. The elderly have a serious illness.

The term "erectile dysfunction" was introduced in 1992, when American researchers proposed to use it as a broader concept than "impotence".

According to modern statistics, about 10% of men between the ages of 20 and 30 face problems in the sexual sphere, 20% at the age of 30-35, and in the period from 40 to 70 they know firsthand what erectile dysfunction is. approximately 50% of respondents.

At the same time, in the coming years, according to the forecasts of researchers, the number of men experiencing difficulties with intercourse will only grow.

The definition states that sexual dysfunction is a violation of the quality of an erection: the inability to achieve or maintain it to the extent required to perform a sexual act.

For men, sexual disorders are a pretext for serious psychological trauma. After all, the lack of the opportunity to have sexual intercourse causes self-doubt and inferiority complexes that extend throughout a person's life.

Unfortunately, as a result, many men are embarrassed to see a doctor, believing their problem to be "shameful". However, there is no need to be afraid to seem not masculine enough: impotence can be caused by goals for a number of reasons, and often minor intervention is required to solve the problem of sexual impotence.

It is also important that erection problems in most cases are not an independent disease, but signal that there is another disorder, for example, atherosclerosis, etc.

Other name of the problem: erectile dysfunction (ED), impotence, impotence.

Types of erectile dysfunction

Depending on what reasons caused the impossibility of sexual intercourse, there are two main types of erectile dysfunction: organic and psychogenic.

As the name implies, organic is associated with somatic problems, and psychogenic is associated with mental.

Naturally, the symptoms of the two types of sexual dysfunction are almost the same: insufficiently strong erection, impossibility of achieving it, etc.

However, there is one difference: as a rule, organic impotence begins gradually, psychogenic impotence comes suddenly.

A number of factors can cause organic sexual dysfunction:

• diseases of the genital organs;
• alcohol, drug abuse and even smoking;
• diseases of the cardiovascular system that affect blood pressure;
• violation of the transmission of nerve impulses, leading to a decrease in the sensitivity of the penis;
• disruption of the endocrine system, leading either to an excess of female sex hormones, or to a lack of testosterone;
• Taking certain medications, such as blood pressure lowering drugs, antidepressants, or diuretics
• genital trauma.

Psychogenic erectile dysfunction is caused by:

• depressive disorder. With depression, a person loses the ability to receive pleasure and joy, which affects the genital area .;
• experienced stress or prolonged stay in a traumatic situation;
• too long refusal to have sex or, on the contrary, frequent change of sexual partners;
• religious and personal beliefs. For example, psychogenic impotence can be caused by infantilism, panic fear of contracting a sexually transmitted disease, fear of unwanted pregnancy of a partner, etc. Sometimes the reason for the impossibility of having a full sexual intercourse is the belief that the size of the penis is too small.

Sometimes the symptoms of impotence appear after a man experiences psychological trauma associated with the sexual sphere of the personality. For example, a partner may speak unflatteringly about his sexual ability, which leads to the development of an inferiority complex and fear of new sexual contacts.

Symptoms of impotence

The main symptoms of sexual dysfunction include the following:

• the penis does not reach the required degree of tension when aroused, as a result of which there is no opportunity to perform normal sexual intercourse;
• directly during coitus, the level of erection may decrease;
• sexual desire is either completely absent or significantly reduced;
• there is no ejaculation, orgasm cannot be achieved.

The presence of such symptoms for a short time does not indicate the development of erectile dysfunction. Sometimes they can be the result of overwork, severe stress, and even drinking too much coffee or alcohol.

However, if symptoms persist for a long time, a urologist should be consulted.

The following signs indicate the absence of erectile dysfunction:

• at night or in the morning, a spontaneous erection occurs;
• in most cases, the tension of the penis is sufficient for a full-fledged intercourse;
• the penis becomes erect during masturbation.

Causes of erectile dysfunction

Erectile function may not disappear, but significantly weaken. This can cause real panic in men. However, do not be alarmed: perhaps, after the elimination of the factor that led to the weakening of the erection, everything will return to normal.

The following reasons can cause mild erectile dysfunction:

• overwork. The resources of the body are not infinite, so it is quite natural that the loss of strength affects sexual function;
• experienced a serious illness. After an illness, the body is exhausted. After recuperation, sexual function will return to normal;
• self-doubt. Often, young people have high expectations of themselves, and the first negative experience undermines their confidence in themselves;
• tactless behavior of the partner. Impressionable, insecure men may have difficulty with erections after a critical careless remark;
• climate change, moving to another country;
• excessive consumption of beer. Beer contains female hormones, so it reduces sexual function;
• elderly age. After 60 years, most men experience erection problems: unfortunately, this is an almost irreversible process that is associated with natural age-related changes;
• weakening of the emotional connection with a partner, a habit. Often spouses who have been married for many years lose passion for each other, resulting in sexual dysfunction.

Naturally, this is not a complete list of reasons that can cause weakening of sexual function. Only a specialist can understand what caused the problem in the sexual sphere.

Seeing a doctor early will help you quickly return to your normal sex life. If you refuse treatment, the problem will begin to worsen due to the psychological factor.

Erectile Dysfunction Treatment

Many men who are faced with the problem of erectile dysfunction, before seeking help from specialists, try to prescribe themselves treatment at home.

Of course, sometimes such remedies give a result (we will even talk about them), especially if impotence has psychological causes.

However, if the ailment has arisen due to any disease, you can simply waste time. Therefore, it is important to coordinate any alternative methods with the attending physician, who will first give you an accurate diagnosis.

Treatment of impotence at home with folk remedies

Typically, various herbs are used to treat impotence. Here are the recipes that are considered to be the most effective:

• you need to take equal amounts of nettle, flaxseed and mint... Two tablespoons of the mixture are brewed with two glasses of boiling water. It is advisable to infuse the broth for at least eight hours, for example, it can be left in a thermos overnight. You need to take the medicine for three weeks, one glass in the morning and evening. The collection helps not only to solve the problem with potency, but also effectively relieves of premature ejaculation;
• to prepare this collection, you need to take the immortelle and calendula in a ratio of 2 to 1, respectively... One tablespoon of the mixture should be brewed with 200 ml of boiling water. It is necessary to insist the broth until it cools down, and it is important to do this without access to light, for example, in a teapot made of clay or ceramics. You need to take one tablespoon of infusion between meals for four weeks;
• there is also an easier recipe for strengthening male strength... It is necessary to take one tablespoon of yarrow broth for three weeks. Pour 200 grams of grass with a glass of water and boil for about a quarter of an hour over low heat. The remedy for the treatment of erectile dysfunction is ready.

An excellent result in the treatment of impotence can be achieved alcohol infusion of calamus or ginseng... Infusions have a tonic effect on the body, stabilize hormones and improve blood circulation.

Diet to restore potency

It doesn't matter what you choose: home treatment or mainstream medicine. In any case, the best results are achieved by combining therapy with a healthy diet. It is important to adhere to the following principles:

• give up bad eating habits. Eliminate fatty foods, foods high in spices, smoked meats and fast food from your diet;
• eat foods high in protein: meat, lean fish, nuts. True, it is better to refuse fatty meat: excess weight helps to weaken potency;
• try to give up alcoholic beverages at least for a while. This is especially true of beer, which contains a small amount of female sex hormones that weaken male potency;
• eat as many fresh vegetables and fruits as possible. If this is not possible, take multivitamin complexes. On sale you can find vitamins specially designed for the needs of the male body: give preference to them.

Preparations for increasing potency

The physician can assign two categories. If a patient is diagnosed with any disease that negatively affected the ability to perform normal sexual intercourse, then therapy will be aimed at combating the underlying disease.

In this case, the choice of treatment will depend on the specifics of the disease. For example, if impotence is psychogenic in nature and has arisen due to the fact that the patient has experienced severe stress, mild sedatives and adaptogens may be prescribed.

These drugs work on the same principle. They act on smooth muscles, improving blood circulation in the penis. You need to take drugs immediately before having intercourse.

Unfortunately, drugs to improve erection have a number of unpleasant side effects. In particular, they can lead to high blood pressure and are addictive, that is, addictive.

It is important to remember that all drugs in this group have many contraindications, so it is better not to take them without first consulting a doctor.

Stick to a healthy lifestyle

Sometimes, in order to improve your sex life, you need to rethink many habits. In order to improve potency and get rid of erectile dysfunction, doctors recommend:

• do not give up physical activity. Physical inactivity and a sedentary lifestyle lead to stagnation of blood in the pelvic organs. Due to the impaired blood circulation, erection problems begin. It is important to walk as much as possible, do gymnastics every day, sign up for a gym;
• being overweight can cause problems in your sex life. Firstly, shortness of breath interferes with normal sexual intercourse, and secondly, excess weight often causes hormonal imbalance in the male body;
• it is very important to give up smoking and alcohol. Tobacco and alcohol have a negative effect on blood vessels and worsen the general condition of the body;
• to avoid psychogenic potency disorders, it is important to learn how to effectively cope with stress. Sometimes this may require working with a psychologist or psychotherapist;
• Not getting enough sleep can negatively affect your ability to have normal intercourse. It is important to plan your day carefully and pay sufficient attention to proper rest;
• often psychogenic impotence occurs due to insufficient trusting relationship with a permanent sexual partner. Family problems often cause temporary erectile dysfunction in men. To avoid this, it is important to learn how to negotiate with your “other half” and avoid confrontations, solving emerging problems in a constructive way.

Prevention of erectile dysfunction

What to do in order not to face the problem of inability to perform normal sexual intercourse? It is important to be guided by the following rules:

• regularly perform preventive medical examinations. It is easier to identify the disease in the initial stages than to treat its consequences, among which there may be impotence;
• wear quality underwear. Unfortunately, too tight synthetic underwear can lead to a violation of potency. Such underwear compresses the vessels and overheats the external genital organs, which leads to the impossibility of performing a full sexual intercourse and even to infertility;
• exercise and eat right;
• do not have unprotected sex with unverified partners: sexually transmitted diseases can cause problems with potency and other serious problems.

Erectile dysfunction is a serious problem that every man can face. It is important to consult a doctor as soon as possible, without waiting for the changes to become irreversible and serious surgical intervention is required to eliminate them.

Prognosis for patients

Mortality due to serious causes in patients with erectile disease rises to 25%, while the risk of cerebrovascular events increases by 44%, and in myocardial infarction - by 62%.

Associated conditions include premature ejaculation, hypoactive sexual desire, lack of pleasure, and depression.

Related Videos

Interesting