“Misfire” in bed, the inability to achieve or maintain an erection sufficient for sexual intercourse level, happen in life of every man. It is unpleasant, but not fatal, that is, pathology is not here. If such episodes occur regularly for three months or more, then we can talk about it: erectile dysfunction (ED) in person.
If this article was written about 20 years ago, I have operated on another term: impotence, but with the filing of the American National Institute of health is somewhat pejorative for men definition was written off for scrap in favor of new, in the title of the article.
The content of the article
How an erection occurs
Erection in men a deeper understanding of the causes of erectile dysfunction and methods of its treatment it is necessary to correctly represent the process of occurrence of erection. First of all, under the action of mechanical or psychogenic stimulus, the reflex, simply put, generates a nerve impulse that is transmitted to the brain, and from there, transit through the spinal cord to the cavernous arteries and cavernous bodies of the penis. I will not give the whole cascade of biochemical reactions, focusing only on one thing: the result of all this “pandemonium” comes the relaxation of smooth muscles of arteries that flow into the cavernous bodies, expanding their lumen, which contributes to the blood supply of the most cavernous bodies of the penis. The increase in volume of the cavernous body squeeze podvolochnoye draining veins, thus impeding the flow of blood. So there is an erection. Thus, we have the following, seemingly counterintuitive phenomenon: the vessels are relaxed, the member of the tense and Vice versa. Maintaining an erection is realized through additional, previously unused, arteries. In response to stretching of arterial walls rushing blood, the endothelial cells lining the cavernous bodies secrete nitric oxide (NO), which is without exaggeration a major role in achieving maximum erection.
Causes of erectile dysfunction
Previously it was a common opinion that ED is mainly developed by psychogenic mechanism. This is not the case in 80% of cases erectile dysfunction is the result of diseases not related to mental activity (somatic). But, first things first.
Among psychogenic causes of the development of erectile dysfunction should be noted the different kinds of depression, stress and hectic state. This, perhaps, will stay, as it is more a question of psychotherapy than of applied medicine and list other reasons:
- age and age-related disease;
- neurogenic disorders at the level of the brain and spinal cord, peripheral neuropathy.
- endocrine diseases, primarily diabetes mellitus;
- diseases of the cardiovascular system (hypertension, atherosclerosis);
- other somatic diseases (kidney failure, lung disease and liver);
- diseases of the genitourinary system;
- bad habits: Smoking, alcohol, drugs;
- a side effect from medication, and those that encourage the development of erectile dysfunction, quite a lot: a number of drugs group of antihypertensives, diuretics, lipid-lowering, psychotropic.
Main reasons of the above is the cardiovascular disease and diabetes.
Diagnosis of erectile dysfunction
Erectile dysfunction: causes vozniknoveniya very thin, you might say, a touchy problem. It is very important in conditions of maximum psychological comfort and trust to collect reliable history, and not only from a medical bell tower, but also sexual, psychosocial: began as the disease proceeds, the availability and quality of morning and night erections. Followed by an examination of the “root of evil” — of the penis for structural changes in passing assesses the severity of secondary sexual characteristics. Further control measurements of testosterone and follicle-stimulating hormone and luteinizing hormone, ultrasound vessels of the penis. With the help of computer technology examines the duration and number of spontaneous nocturnal erections. All of these activities in the complex can accurately determine the cause of erectile dysfunction.
Treatment of erectile dysfunction in men
For the treatment of erectile dysfunction need to consult a doctor andrological sildenafil familiar for the most part health professionals. But viagra know all without exception. Meanwhile, if you look closely, the packaging in small letters will indicate that is sildenafil. He’s dynamic, he’s revatio, he maxigra, vizarsin… As you understand, it’s all trade names for one active ingredient, which is considered the most effective treatment for erectile dysfunction. The dose is adjusted individually (extension from 25 to 100 mg), it should be used 1 hour before intercourse. Effective at an average of 70% of persons suffering from erectile dysfunction.
The remaining groups of medications the severity of the desired effect much lower, no more than 30%. In fairness, after all these medicines, as they may be part of a comprehensive treatment erectile dysfunction:
- preparations of testosterone (andriol, androgel);
- inhibitors of prolactin (bromocriptine, parlodel);
- adaptogens (eleuterokokk, ginseng);
- biogenic stimulators (vitreous body, aloe);
- vasodilators (ksantinola nicotinate).
There is another medical method, but as they say, don’t try this at home. We are talking about intracavernosa injections. For this purpose, use of papaverine hydrochloride, however, a number of side effects such as priapism (prolonged and painful erection) and sclerosing cavernous (cavernous) bodies do not allow to speak about this drug in the superlative degree, although the effect observed in more than 50% of cases. More secure in this sense alprostadil (INN). With minimum side effects of its use successfully in 70 percent of cases.
The ineffectiveness of pharmacological correction of erectile dysfunction have resorted to surgical or invasive treatment: ligation or resection of the veins of the penis, arterial bypass grafting, implantation of the prosthesis (this is an extreme method after which there is no turning back).
And the last method used in the treatment of erectile dysfunction is vacuum constrictory method. With the help of a special device in the cavernous bodies of the penis creates a negative pressure that promotes blood flow to this area. Erection support special gripping the base of the penis ring which prevents the venous outflow. The effectiveness of the method 50 to 50.