Erectile dysfunction in men
- What is erectile dysfunction?
- Erectile dysfunction symptoms
- Types of erectile dysfunction
- Causes of erectile dysfunction
- Testing the innervation of the penis
- Erectile Dysfunction Treatment
- Prevention of erectile dysfunction
What is erectile dysfunction?
Erectile dysfunction is a disorder of sexual function that often becomes a real problem for men around the world. Statistics claim that almost every man, starting from 20 years old, at least once faced the symptoms of erectile dysfunction: insufficient stiffness of the penis in an excited state.
As a result, a full sexual intercourse cannot take place. But you should know that they talk about erectile dysfunction only when a high-quality erection cannot be achieved in more than 25 percent of intercourse.
Often erectile dysfunction becomes a serious challenge for men, because it is not only a physiological, but also a psychological problem.
Erectile dysfunction symptoms
Symptoms of erectile dysfunction can be divided into several types: impaired libido (sexual desire), erectile dysfunction, ejaculation and orgasm (anorgasmia).
The most common symptom associated with stress, fatigue, or feeling unwell is libido disorders - unwillingness to be physically close. This can occur both due to a disorder in the relationship of partners, depression, and due to hormonal disorders (a decrease in testosterone production).
Lethargy, inferiority of erection may indicate vascular diseases, and ejaculation disorders or its absence is associated with psychological problems. The least common in men is anorgasmia - orgasm disorder. It may be short or absent. This symptom is associated with psychological disorders.
Types of erectile dysfunction
There are several types of erectile dysfunction, and they are determined by the causes and approaches to the treatment of this problem: psychological (psychogenic), organic and mixed. About 20% of the causes of erectile dysfunction are psychological, but in 80% of cases, it speaks of serious diseases, the complication of which is (autoimmune diseases, hypertension, diabetes mellitus).
Each type of erectile dysfunction has its own characteristics. For example, psychological erectile dysfunction usually starts suddenly. She is associated with stress, overexertion or problems in the relationship of partners. At the same time, the morning erection and the ability of the penis to be in a tense state during intercourse are preserved.
Organic problems usually start gradually, and it becomes more difficult to maintain a normal erection each time. This indicates the presence of some kind of background disease that requires treatment. Also, organic problems can arise due to taking medications that affect potency. A man retains libido and ejaculation, but no nighttime erections, and during intercourse, the penis may suddenly lose rigidity.
It is very important, having noticed changes in the state of erection, not to attribute this to all sorts of external reasons (stress, fatigue, quarrels with a partner), because difficulties in the sexual sphere should not become the norm. To solve the problem, you should definitely contact a specialist.
Causes of erectile dysfunction
Erectile dysfunction usually has a number of causes, the most common of which we will look at in more detail:
- Endocrine causes of erectile dysfunction are a violation of the production of the male sex hormone - testosterone. This often occurs with genetic abnormalities, trauma, infections and tumors. Potency and erection in such diseases usually return after treatment with hormonal drugs (tablets, gels).
- Medicinal causes of erectile dysfunction consist in taking certain drugs that reduce the production of male sex hormones. These can be drugs that inhibit the activity of the cerebral cortex, and any drugs, including alcohol.
The neurological causes of erectile dysfunction include a number of diseases of the peripheral nerves or the brain and spinal cord. These can be both brain and spinal cord injuries, and autoimmune diseases, circulatory disorders in the brain, epilepsy, sclerosis, perineal and pelvic injuries.
- The psychological causes of erectile dysfunction are prolonged stress, neurosis, depression, problems with a partner, or a mismatch in sexual preferences and habits. Even ordinary fatigue can negatively affect male potency. Fear of failure in bed or intercourse with a new partner often affects erection.
Other causes include injuries to the penis and vascular problems (sclerosis). If the blood flow through the arteries is impaired, an erection may not occur for a long time, or it may occur in an insufficient volume. With a violation of the venous block, an erection occurs quickly, but it passes just as quickly, often preventing the completion of sexual intercourse. This happens due to inflammation of the inner lining of blood vessels, characteristic of heavy smokers or people with autoimmune diseases. It should also highlight penile angiospasm - a violation of blood circulation in the vessels of the penis.
A rare cause of erectile dysfunction can be a certain anatomical change in the penis (Peyronie's disease, misalignment of the urethral opening).
Among the causes of impotence, a special position is occupied by injuries of the penis. They can be the result of an accident, injury, injury (knife, gunshot), burn. Whatever the source of damage, a doctor's help is essential.
- Bruises. They are classified as closed injuries of the penis, can be obtained by falling from a height, fighting, exercising. In most cases, they lead to a violation of the urethra. They make themselves felt by painful sensations during movement, edema, hematomas. They are treated with compresses, non-steroidal analgesics, and sometimes surgically.
- Subcutaneous hemorrhage. Lead to damage to blood vessels, the formation of edema. The danger is the occurrence of scars (during healing), which impede the flow of blood, which is necessary for an erection. They can appear with prolonged sexual contact, its non-standard forms. The problem is solved with cold compresses.
- Fractures. They can be the result of a sharp bend of the organ, a heavy blow, rough sexual contact. They are a rupture of the corpus cavernosum that can cause erectile dysfunction. Symptoms are the formation of edema, extensive hematoma, acute pain, sometimes shock. Help is determined by the severity of the injury, from compresses to surgery.
- Burn. Damage caused by UV light, chemicals, hot liquids. Symptoms depend on the severity of the burn, ranging from swelling and redness to skin death. Treatment, as a result of which an erection is restored, is also determined by the severity of the damage.
The foreskin is a fold of skin whose main purpose is to protect the glans of the penis. In its absence, excessive irritation of nerve receptors is inevitable during movement (running, walking), contact with underwear. Its systematic repetition causes a reduction in the sensitivity of the head, which is necessary for the appearance of an erection.
It also increases the risk of a man becoming infected with an infection that stimulates inflammation in the genitals. One of the complications of STIs is impotence. Therefore, persistent erectile dysfunction after 40 is often a consequence of circumcision.
The frenum of the foreskin has the appearance of a longitudinal skin fold located between the foreskin and the head of the penis. Its purpose is to open the head in a state of excitement, regulate bending and prevent displacement.
Defects of the frenum (short fold) lead to pain and even bloody discharge on contact, early ejaculation. In this regard, a man develops a habit of restraining during intercourse, which can result in the development of persistent erectile dysfunction. The problem is successfully solved by plastic bridle.
The procedure involves a surgical dissection of the bridle, performed under anesthesia. The process takes a maximum of 30 minutes, after its completion, the man's ability to work is not limited by anything.
Testing the innervation of the penis
Regardless of what causes of erectile dysfunction are suspected, you should see your doctor. The specialist will conduct the necessary research. The functionality of the nerves in the penis is examined by testing the innervation (bulbocavernosus reflex). The procedure consists in pressing on the head of the penis, which should result in an immediate contraction of the anus. The urologist determines the latency of the reflex by studying the contraction of the sphincter or by palpation.
If testing the innervation of the penis suggests diabetes, a nerve disorder, additional studies of nerve functionality are included.
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Erectile Dysfunction Treatment
Treatment for erectile dysfunction depends on the reasons why it has occurred. In the case of endocrine disorders, patients are prescribed hormonal tablets or gels. For medicinal reasons, the doctor selects drugs that do not affect potency. Elimination of neurological causes is to treat the underlying disease that caused problems with potency. Psychological reasons require a special approach: rest, relaxation, creating a trusting atmosphere between partners, or even talking with a doctor (psychologist, sex therapist). Anatomical changes in the penis that negatively affect erection are removed surgically.
The doctor determines the optimal action in a situation of erectile dysfunction. The following methods are currently being practiced:
Local negative pressure
The method consists in positioning the penis in a pressure reservoir prior to sexual intercourse. The "vessel" adheres tightly to the body, the necessary action is carried out by means of a pump. Manipulation causes the arteries of the penis to expand, resulting in an erection. A special tourniquet is used to delay the venous outflow of blood; it captures the base of the organ before extraction.
An erection obtained in this way lasts for at least one contact. Among the positive aspects are safety, absence of pain, increased sensitivity. However, there are also disadvantages - insufficient quality of erection, inconvenience of use.
It consists in taking drugs that stimulate blood flow in the vessels of the penis, which solves the problem of erectile dysfunction. The most famous is Viagra, Levitra and Cialis are also used. According to clinical trials, the effectiveness of Viagra does not exceed 75%.
The drugs are not recommended to be used alone. The instructions contain a long list of side effects that are likely with continued use. Adequate choice of dose and frequency of use helps to reduce the danger. Therefore, a consultation with a doctor is required.
Intracavernous administration of drugs
This method of fighting erectile dysfunction has been practiced since 1975. An injection of a vasodilator is done before each act. The injection site is the cavernous body of the penis. The action of the drug provides a long-lasting erection. The permissible frequency of use does not exceed once a week, the selection is individual, made in conjunction with the doctor.
The method has disadvantages, including the danger of complications, inconvenience of use. The risk of side effects has significantly decreased in recent years, only compliance with medical prescriptions is important.
Administration of suppositories
The drug is injected half an hour before contact, using a special device. The zone of administration of the drug is the urethra. The result is a high-quality erection, which is maintained from one hour. As in the previous case, the method repels many of the inconvenience of use. Another disadvantage is the high cost of the medicine.
Surgical intervention becomes a necessity only in especially difficult cases, for example, this method eliminates the defeat of the veno-occlusive mechanism of the penis. In most situations, conservative treatment is effective.
Erectile Dysfunction Exercises
With erectile dysfunction, good results are shown by exercises that have a stimulating effect on potency:
- Simulate running in place. In the process of execution, the socks are kept on the floor, only the heels "work", the man shifts from foot to foot. Movement requires speed, knees function as intensively as possible. It is better to start with a minute of "running", gradually increasing the load to 5.
- A rock. The back is straightened as much as possible, the knees are slightly bent. The essence of the training is to relax and tension the gluteal region, you should hold an imaginary stone. The exercise is repeated several times, alternating tension and rest is applied.
- Clamp. This method is loved by yogis, who call it effective prevention of sexual impotence. The muscles of the anus are rhythmically tense / relaxed, the man "tries to stop urination." Exercise is good for the prostate gland, relieves congestion. The optimal repetition rate is 15 times for a beginner, the tension is maintained for a short time. Gradually, the number of contractions is increased to 50 times. The exercise can be performed in any setting, for example, when in a traffic jam.
- Vacuum cleaner. The exercise is performed in a sitting position, an ordinary chair is suitable. The shoulders are pulled back, the person leans forward, stretching the body as much as possible. One can imagine that croup is scattered on the chair, which needs to be removed with a vacuum cleaner "located" between the testicles and the anus. The number of repetitions gradually increases, the muscles tense and relax.
At first, do not perform more than 10 repetitions, the load increases gradually. The effect is felt already several days later.
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Prevention of erectile dysfunction
There is a whole range of preventive measures that reduce the likelihood of erectile dysfunction. They are relevant already for 30-40-year-old men:
- Balanced diet. The diet should contain a sufficient number of protein suppliers - eggs, meat. Various fermented milk products, herbs, fruits and vegetables are useful. Be sure to eat nuts, honey, give up heavy fatty foods.
- Quitting dangerous habits. Addiction to drugs, alcohol and cigarettes can be a source of erectile dysfunction.
- Modernization of sex life. For a man, it poses a threat to the abuse of masturbation, replacing it with full-fledged sexual contacts. It is also not recommended to protect against pregnancy by a partner through interrupted intercourse.
- Regular visits to the urologist. This measure contributes to the timely detection of diseases of the reproductive system (for example, prostatitis), their successful treatment.
- Prevention of diseases that can lead to impotence. Endocrine disorders, vascular problems, heart problems and other "sources" discussed above.
- Correct lifestyle. This concept includes 8 hours of sleep, moderate physical activity, avoidance of tension and stress.
Prevention will not require serious restrictions, but the measures taken will significantly reduce the threat of erectile dysfunction at any age.
Author of the article: Lebedev Andrey Sergeevich | Urologist
Education: Diploma in the specialty "Andrology" received after completing residency at the Department of Endoscopic Urology of the Russian Medical Academy of Postgraduate Education in the urological center of the Central Clinical Hospital No. 1 of JSC Russian Railways (2007). Postgraduate studies were completed here by 2010.