Erectile dysfunction or impotence is the inability to achieve or maintain an erection sufficient for intercourse. Erectile dysfunction is experienced by almost half of men over 40.
Erection problems that occur from time to time should not be a major concern. However, frequent sex problems cause stress, reduce self-confidence and can lead to breakdown in relationships.
A bad erection can be a signal of other pathologies. For example, the absence of a morning erection indicates the organic nature of dysfunction: pathology of the cardiovascular system (atherosclerosis, ischemic disease), metabolic disorders (for example, diabetes mellitus).
The causes of impotence can be mental or psychological factors: stress, depression, etc. But to confirm psychogenic erectile dysfunction is possible only if organic options are excluded.
The most severe forms of impotence are of a mixed nature, they occur in diabetes mellitus, renal failure, after extensive operations on the pelvic organs. This is due to a deterioration in blood flow due to irreversible changes in the vascular and cavernous tissues of the penis.
Diagnosis of erectile dysfunction
Diagnostics consists in determining its psychogenic or organic cause. Organic forms are treated by urologists, psychogenic – by psychiatrists and / or sexologists. In most cases, an examination by a urologist is enough to choose the treatment tactics.
- Physical examination. Examination, palpation of the penis and testicles, checking the nerves for sensitivity.
- Blood and urine tests. The state of the cardiovascular and endocrine systems, the presence of diabetes or other diseases that affect potency are checked.
- Ultrasound procedure. It is sometimes combined with an injection of special drugs into the penis to stimulate blood flow. Thus, the blood supply to the organ is assessed.
- Psychological test. Depression or other possible psychological causes of the disease are identified.
Treatment of impotence with pills is effective in 95% of cases
The first thing a doctor should do is to make sure that the correct therapy for chronic diseases, if any, is prescribed.
Depending on the cause and degree of erectile dysfunction, you will be offered different treatment options. The doctor will explain the risks and benefits of each. In 95% of cases, it is enough to take stimulating medications: Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra, Staxin), Avanafil (Stendra).
All of these impotence remedies enhance the effects of nitric oxide. It is a natural chemical that the body produces to relax the muscles of the penis and stimulate blood flow.
Before taking any medications, including over-the-counter supplements and herbal remedies, check with your doctor to help you make the right choice.
Pills for impotence may not work immediately. It may take time to find the right dosage. Medication may be less effective in certain conditions, such as after prostate surgery or diabetes.
Some erectile dysfunction medications can be dangerous if you:
- Are taking nitrate medications commonly prescribed for chest pain (angina), such as Nitroglycerin, Isosorbide Mononitrate, and Isosorbide Dinitrate;
- Have heart disease or heart failure;
- Have low blood pressure (hypotension).
Vasodilator injections
For each injection, an individual dosage is selected to induce an erection lasting no more than an hour. Since the needle used is very thin, there is little pain at the injection site. You can do the injections yourself.
Alprostadil
Injection with a thin needle into the base or penis. In some cases, a combination of papaverine, alprostadil, and phentolamine. These combination drugs are known as bimix (if two drugs are included) or trimix (if three are included). Side effects: Light bleeding at the injection site, prolonged erection (priapism) and, rarely, the formation of fibrous tissue at the injection site.
Alprostadil pellets
The size of a match head, the drug is injected into the urethra through a special applicator. An erection usually occurs within 10 minutes and lasts from half an hour to an hour. Side effects: minor bleeding and fibrosis of the tissue inside the penis.
Testosterone replacement therapy
It can be the first line of treatment or be combined with other methods if impotence occurs due to a decrease in the level of this hormone.
Penile prosthetics
It is possible to install semi-rigid implants, or through a paid service channel – inflatable hydraulic prostheses that completely imitate the functions of the penis.
Inflatable implants
The most common. The mechanism of their work is to pump soft silicone rods inside the penis. After intercourse, the fluid is drained back into the reservoir.
Semi-rigid prostheses
Two flexible rods in the body of the penis. It is always held in a bent state and does not change its size and stability.
Penis pump
Hollow tube vacuum device with manual or battery control. Helps draw blood into the penis. To maintain an erection, its base is squeezed with an elastic ring, which is removed after sex. Possible side effects: bruising of the penis, difficulty ejecting sperm if the ring is compressing the urethra.