Erectile dysfunction— the inability of a man to achieve and prolong an erection, and in some cases the end of sexual intercourse. This pathology has many diverse causes and, while not deadly and severe due to the absence of pronounced painful symptoms, it brings significant discomfort to the lives of patients. Treatment for such a disease is selected individually after a thorough examination of the patient.

What is erectile dysfunction?

Under the concept of erectile dysfunction, many problems of the sexual sphere in men are combined, which include the inability to obtain a stable erection, maintain it during intercourse, or end it with ejaculation (ejaculation).

Note! It is worth talking about the presence of an unpleasant diagnosis only when problems with an erection persist for 3 months or longer.

According to statistics compiled by the World Health Organization, at least 160 million men in the world know firsthand what it is. In this case, the dependence of the incidence rate of the disease on age is traced:

• among men in young and mature (from 21 to 40 years old) the proportion of those who have experienced erectile dysfunction is not more than 10%;
• among men from 40 to 60 years old, the proportion of men who have at least once experienced difficulties with an erection is 50%;
• among men aged 60 and over, the proportion of those who cannot complete a full sexual intercourse reaches 70%.

It is based on a change in the neurovascular process, which is an erection. Sometimes, specialists from other fields of medicine are involved in solving it. — psychologists and psychiatrists, endocrinologists and others.

Normally, the stimulation of nerve endings causes the release of biologically active substances, mainly nitric oxide, into the bloodstream. This compound relaxes the walls of arteries and smooth muscles, which are responsible for the contraction of the cavernous bodies in the penis (this is the spongy body that is located inside the penis). As a result of this, there is an increase in blood flow in the genital organ. At the same time, there is a narrowing of the veins that drain the blood from the spongy tissue of the penis. Blood fills the corpora cavernosa, an erection occurs. During intercourse, even more filling takes place, as a result of which the penis grows in size and becomes hard, the erection is strengthened until ejaculation occurs.

Under various conditions, a failure occurs at one of the stages of erection. This can happen during stimulation, at the stage of changes in vascular tone and with an increase in blood pressure in the corpora cavernosa.

Important! There is no single scheme for eliminating impotence. In each case, the causes and treatment are individual.

Causes of Erectile Dysfunction

Erectile dysfunction can occur against the background of psychological and organic problems, and therefore the classification includes three groups of these disorders:

1. Psychogenic. It occurs against a background of increased anxiety, neurosis, mental illness (depression, schizophrenia and others). It is accompanied by a lack of sexual arousal or its rapid fading.
2. Organic It arises against the background of vascular problems (inadequate blood supply to the cavernous bodies of the penis, hypertension, obliterating endarteritis, atherosclerosis, hyperlipidemia, heart failure, coronary heart disease and myocardial infarction), neurological pathologies (polyneuropathy, multiple sclerosis, and small bowel injury, .d.), endocrine diseases. Organic impotence can also develop against the background of taking medications, poisoning with toxic substances.
3. Mixed. It occurs in the presence of organic and psychological changes. According to statistics, organic lesions play a dominant role, against which psychological pathology develops.

The main reasons for this — gradual decrease in testosterone synthesis in the body, age -related changes in blood vessels.

Symptoms and signs of erectile dysfunction

Signs of erectile dysfunction include a variety of sexual disorders in men, including:

• weakening or absence of a morning erection, its irregular appearance;
• insufficiently stable or incomplete erection, because of which it is impossible to enter the penis into the vagina;
• the need for long-term stimulation to obtain an erection sufficient to start sexual intercourse or its complete absence even in the presence of arousal;
• a sudden or gradual decrease in the tension of the penis during intercourse, due to which its continuation and completion becomes impossible;
• premature (early) ejaculation, sometimes even before the introduction of the penis into the vagina;
• increased time between sexual intercourse or the onset of a full erection.

The degree of manifestation of these symptoms depends on the cause of the problem. It was found that with psychogenic origin, sexual dysfunction occurs suddenly and only under certain conditions. After their elimination, the ability to commit sexual intercourse is restored. Night and morning erections persist. With dysfunctions of organic origin, disorders appear systematically and tend to progress. Spontaneous penis erection is observed only in the initial stages of the disease.

Diagnosis of erectile dysfunction

Diagnosis of erectile dysfunction involves identifying the factors that caused problems in the sexual sphere, since the causes and treatment of the disease are directly related. To begin with, a doctor, most often a urologist, collects an anamnesis and assesses the current condition of the patient. In most cases, a man is asked to fill out a special questionnaire.

The next step — physical examination, during which signs of vascular, hormonal, neurological disorders are detected. Screening studies (tests) help to identify pathological changes:

• intracavernous test;
• sexual stimulation with registration of brain potentials (electroencephalography or myelography);
• penile ultrasound;
• electromyography of the perineal muscles;
• Dopplerography of the arteries of the genital organ.

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If there is a suspicion of psychogenic or situational impotence, a series of tests are performed to determine causality, anxiety, and depression. If the doctor suggests the endocrine origin of erectile dysfunction, laboratory tests are performed during which the concentration of testosterone, prolactin, luteinizing and other hormones in the blood plasma is established. ​

Instrumental evaluation of nocturnal erections helps to differentiate psychogenic impotence with organic ones. In the case of psychological and mental problems in a dream, a normal erection occurs, and with organic lesions, erection is defective or absent altogether.

Erectile Dysfunction Treatment

Select treatment for erectile dysfunction, depending on the causes of its occurrence. Methods can be very diverse. — from medication and psychotherapy to arthroplasty. However, first of all, it is necessary to eliminate the causes of sexual problems.

Treatment of psychogenic impotence

To eliminate problems of a psychogenic nature, they pay attention to reducing intrapersonal and interpersonal conflicts with the help of psychotherapy or cognitive-behavioral therapy. If the man is in a permanent relationship, sessions are recommended to attend and his partner. Goal of treatment — teaching couples effective interaction and the formation of adequate ideas about sex.

Organic Impotence Treatment — medicines

More difficult is the treatment of erectile dysfunction of organic origin. Her goal — elimination of pathologies, as a result of which there was a deterioration in sexual functions, normalization of the functioning of organs and systems and stimulation of blood flow to the genital organ.

The following medicines are recommended for men:

• hormonal drugs (prescribed primarily for endocrine diseases);
• PDE-5 inhibitors (stimulants of erection Viagra, Cialis and their analogues);

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• vasodilator drugs (used including injections into the genitals).

Important!

Massage and exercise therapy for impotence

Vacuum constrictor therapy helps stimulate blood flow to the penis. The method involves the use of a special vacuum pump equipped with a constrictive ring (photos of such devices can be easily found on the network). The device activates the blood flow in the penis and helps fill cavernous theses with blood and prevents its outflow.

Massage and self-massage of the pubic area, pelvis and perineum will help increase the tone of the vessels supplying the penis with blood. A similar effect is exerted by a set of exercise therapy exercises to stimulate blood circulation and strengthen perineal muscles:

• tension and relaxation of the perineum and anus — at least 200 times a day;
• deep squats — 50-100 times a day;
• lifting the pelvis from a supine position with arms extended along the torso — 30 to 50 times a day;
• walking in place with a high knee lift.

Massage and exercise therapy are used for any form of the disease as auxiliary methods of therapy. Relying only on them is not worth it.

Surgical treatment of impotence

Surgical methods to eliminate erectile dysfunction are resorted to with the ineffectiveness of conservative methods. There are several types of operations to restore an erection in men:

• endofaloprosthetics — it is indicated for pathology of the cavernous bodies of the penis, prostheses can be inflatable and plastic;
• penis revascularization (microsurgical procedure) — It is used for vascular pathologies;
• embolization, ligation of veins or legs of the penis, spongiolysis — interventions that are used in the pathology of the veno-occlusive mechanism of the penis.

The effectiveness of operations is good, but they require careful preparation, especially in the presence of concomitant diseases.

Surgery to restore an erection in age-related patients (older than 70 years) is rarely performed.

Erectile Dysfunction Prevention and Prognosis

For the prevention of erectile dysfunction, general measures are used, which include rationalizing nutrition, adhering to the daily routine and maintaining sufficient physical activity. To reduce the risk of problems in the sexual sphere will help to abandon bad habits: smoking, drinking alcohol and drugs. For men in adulthood, a special role is played by the preservation of sexual activity. Prolonged abstinence can significantly worsen an erection.

A special role in the prevention of diseases of the genital area is played by chronic diseases. Both systemic pathologies and medicines that need to be taken for a long time can cause problems with erection.

Food addiction can also affect a man’s ability to have sexual intercourse. How and what to eat to reduce the risk of impotence or help the body overcome problems with erection, see the video: