What Is Erectile Dysfunction (ED): Mytipstops

Erectile Dysfunction


Erectile Dysfunction


Erectile dysfunction (ED) is the disability of men to obtain and maintain a penile erection, which is necessary for satisfactory sexual activity. An erection ensures the implementation of the Sexual intercourse and is one of the components of sexual intercourse along with sexual desire, ejaculation and a sense of pleasure (orgasm), therefore ED is classified as a sexual disorder. The term ED has replaced the outdated concept of "impotence", which did not give an idea of ​​the essence of the problem and often caused a negative emotional reaction of men. Currently, it is believed that a normal erection is possible only with adequate functioning of the nerves and vessels of the penis with the full functioning of the mechanisms of tissue and hormonal regulation. In this regard, the appearance of ED in a man should be considered as a sign,

 

What are the causes of erectile dysfunction?

Large-scale studies conducted in many countries around the world have shown that ED is an extremely common problem. This disease is observed in aged 22 to 77 years, while the proportion of men suffering from it, as well as its severity, increase with age . In the development of ED, two leading components are distinguished - psychogenic, associated with psycho-emotional factors, and organic, due to the presence of diseases. Psychogenic ED is more often observed in young men, it can be caused by a conflict situation in the relationship of partners or some kind of emotional overstrain, for example, problems at work. Organic ED usually develops in older men, against the background of atherosclerotic vascular lesions, arterial hypertension, metabolic disorders - dyslipidemia, diabetes mellitus, age-related androgen deficiency. At the same time, in men with an organic nature of ED, there is often a psychogenic component, due to the lack of confidence in the ability to get and keep an erection, the fear of failing in an attempt to have sexual intercourse. Obviously, in this regard, an individual approach is required for each patient with ED.

 

Who is at risk for the first place? 

According to modern concepts, the highest probability of emering ED is in men with signs known as risk factors for the development of coronary heart disease (CHD): low physical activity, overweight and obesity, smoking, hypercholesterolemia, and metabolic syndrome.

In addition, ED often grow against the background of drug therapy, for example, when arterial hypertension is corrected with first-generation beta-blockers or thiazide diuretics, and is also a frequent complication of surgical interventions on the pelvic organs.

Therefore, it is so important to conduct a comprehensive examination of a man with ED and recommend a set of measures aimed at correcting existing disorders in addition to selecting adequate pharmacotherapy to normalize erectile function. Such a personalized approach allows you to count on the restoration of normal metabolism in the cavernous bodies and the return of your own erectile function. Click here


What are the treatments for erectile dysfunction? What experience in the treatment of dysfunction exists?

We can say with surety that today, in almost 100% of men with ED, it is possible to achieve restoration of an erection. It should be noted that approaches to the treatment of patients with ED in our country and abroad do not have fundamental differences. This was facilitated by recommendations prepared by the European Association of Urology and their approval by the leadership of the Society of Urology.

First of all, with ED, the existing risk factors should be eliminated, if possible, reversible pathological conditions should be eliminated, as well as informing the man and his partner about the essence of the problem, suggesting what ways to optimize sexual stimulation to eliminate ED can be applied taking into account individual characteristics. Pharmacological treatment with oral phosphodiesterase type 5 inhibitors (PDE5 inhibitors)—sildenafil, vardenafil, tadalafil, and udenafil is first-line therapy effective in about 80% of patients. Sildenafil was the first iPDE5 recommended for the correction of ED since 1998; therefore, today it is the most fully studied drug in this group in real clinical practice. Click here for ED treatment.

Studies have confirmed the dose-dependent ability of sildenafil to normalize erections and improve all indicators of the sexual function index: within 6 months, this was noted by 56%, 77% and 84% of those taking 25, 50 and 100 mg, respectively, of this drug. At the same time, both men and their partners noted an increase in self-esteem and quality of life. Side effects of sildenafil are rare, they include headache, "hot flashes" and dyspepsia, however, in most cases, their severity was insignificant and did not lead to the need to discontinue the drug.

Initially, doctors were advised to use a starting dose of sildenafil 50 mg, if necessary, depending on efficacy and tolerability, it should be increased to 100 mg or reduced to 25 mg. In addition, a lower initial dose of 25 mg is indicated for use in men with renal and hepatic. This approach to reduce the risk of developing postural hypotension is also justified in men taking alpha-blockers. Later, publications appeared that contributed to the development of ideas about a personalized approach to the selection of the dosage of sildenafil in men with ED. A lower dosage may be used for initial and less pronounced manifestations of ED, large - justified in cases of severe lesions of the penile nerves and blood vessels to achieve the maximum effect and in the hope of normalizing the function of the smooth muscles of the cavernous bodies. In this regard, a man with ED should definitely get a consultation from a urologist to select an approach appropriate to his pathological condition. In this case, it is necessary to take into account the characteristics of intercourse activity, risk factors for the development and clinical picture of EDs. We provide erectile dysfunction medications, contact us for free consultation and treatment.