Causes of erectile dysfunction or causes of impotence in men
The fact is that erectile dysfunction is a collective concept, the causes of which can be vascular pathology (both venous and arterial), hormonal imbalance, neurological disorders, and, finally, so-called psychogenic factors. In addition, erection suffers in diseases of the genital area, such as chronic prostatitis or adenoma. Naturally, treatment in each case is selected individually (this is the art of the doctor), and only with this approach can high efficiency and truly lasting results be guaranteed. Modern knowledge and achievements of medical science and surgical technology make it possible to cure 9 out of 10 patients suffering from erectile dysfunction.
Delayed ejaculation
In cases of pathology, a man experiences a long delay before he is able to ejaculate during sexual intercourse, and in some cases, he may not be able to ejaculate at all, despite having a normal erection.
Delayed ejaculation can be caused by physical problems such as diabetes, spinal cord injury, multiple sclerosis, bladder and prostate surgery, and old age.
Antidepressants called selective serotonin reuptake inhibitors (SSRIs), antipsychotics, muscle relaxants, high blood pressure medications, and pain relievers may also cause this problem. In this case, switching to another treatment may help.
Taking antidepressants
Psychological causes such as early sexual trauma associated with child abuse, strict parenting, depression, fear, sexual anxiety, relationship stress or stress in general can also cause delayed ejaculation. The condition can be managed through counseling and therapy.
Testing for erectile dysfunction
As my surgical andrology teacher said, “there are no unsolvable problems left in andrology.” The key to success is a correct and accurate diagnosis of the cause of erectile dysfunction. I have all the necessary equipment for an in-depth andrological examination, including examination of the vascular bed of the penis in a calm state and during a medicated erection. This allows you to determine the cause and prescribe appropriate treatment in one or two visits. When a patient comes in with complaints of poor erection, I check all possible mechanisms responsible for sexual function. There aren't many of them. A lack of testosterone (or hormonal imbalance) can easily be ruled out with a blood test for sex hormones. Vascular pathology (arterial insufficiency, venous leakage) is diagnosed using Doppler ultrasound with the introduction of a vasoactive drug into the penis. It is more difficult with neurogenic and psychogenic causes of erectile dysfunction; in these cases, I resort to the help of my colleagues of the relevant profile. Occasionally, more complex diagnostic tests, such as cavernosography, are also necessary.
Risk factors
The following unfavorable factors lead to a decrease in potency:
- A sedentary lifestyle causes chronic stagnation in the pelvis, and as a result, a decrease in potency.
- Fatty foods and overeating lead to atherosclerosis. Clogged vessels become unable to fully fill the penis with blood and maintain an erection.
- Smoking. Leads to vasospasm and deterioration in the filling of the penis with blood.
- Alcohol. Abuse leads to vascular spasms, deterioration of nerve conduction (the signal from the brain “does not reach” the penis), premature ejaculation, decreased orgasmic sensuality, and decreased libido.
- Chronic overwork, lack of sleep, stress. They lead to exhaustion of the nervous system, emotional burnout, and decreased testosterone levels. As a result, both libido and potency suffer.
- Obesity. This is fraught with diabetes, increased levels of female sex hormones and decreased testosterone.
As you can see, an unhealthy lifestyle can lead to serious health problems and, ultimately, harm potency to a greater extent than the notorious prostatitis.
Old age is also a risk factor - the level of sex hormones decreases, the intensity of blood circulation decreases, and chronic diseases accumulate.
Treatment of impotence or how to cure impotence
Drug (conservative) treatment of erectile dysfunction
I would like to reassure potential patients that this is not always about surgical treatment. According to statistics, the effectiveness of conservative measures (including modern methods of physical therapy, such as shock wave therapy) exceeds 80 percent.
Erectile dysfunction drugs for treatment
Erection enhancement pills
The appearance of the drug Sildenafil (Viagra) in the early 90s can be compared in importance to millions of men with the invention of antibiotics to treat infections. Indeed, never before has the treatment of erectile dysfunction been so simple - just take a pill 1 hour before sexual intercourse. Many men regained confidence in bed and returned to an active sex life. Over time, the line of drugs to enhance erection has been supplemented with new drugs. The most significant among them was (and remains) Tadalafil (Cialis). Its main difference from Sildenafil is its long-lasting action (up to 36 hours). According to the results of numerous studies, the effectiveness of the listed drugs for enhancing erection is at least 70%. Various regimens for the therapeutic use of these drugs have been developed to achieve optimal results in each individual patient.
Injections into the penis
For those cases when the drugs of the first group are ineffective, the urologist-andrologist has another trump card in the arsenal. These are injectable forms. The most famous and widespread injectable erection-stimulating drug in Russia is Alprostadil (Caverject). Injection of Caverject into the penis causes a strong and long-lasting erection. Moreover, unlike tablets, Caverject injections cause an erection regardless of sexual arousal. This property of Alprostadil is used to assess the reaction of the vascular bed when performing Dopplerography of the penis.
Herbal preparations and folk remedies to enhance erection
The 2020 European Association of Urology clinical guidelines make no mention of herbal medicines for the treatment of erectile dysfunction. At the same time, traditionally, domestic urologists widely use in their practice various nutritional supplements that improve potency. These include Yohimbe, Red Root, Eurycoma (Tongkat Ali), Tribulus terrestris (Tribulus), Leuzea and many others. Adherents of natural medicine prescribe drugs based on these plants, both separately and in various combinations. Like other herbal remedies, they have a complex mechanism of action, often involving stimulation of testosterone production and increased blood flow to the genitals. As a rule, these drugs are prescribed in long courses, 2-3 months. It should be noted that many patients taking herbal supplements actually note an increase in potency. However, it was not possible to confirm the high effectiveness of natural erection stimulants in clinical studies, so they are not included in official clinical recommendations.
Which doctor should I contact if I have erectile dysfunction?
A urologist treats diseases of the male reproductive system. Erectile dysfunction is a fairly common phenomenon, so specialists are well acquainted with it and have experience in treating even the most advanced cases.
Important!
If symptoms of ED occur, you should contact a urologist immediately. The organic form of the disease progresses and becomes less treatable over time. In addition to this, ED is often a symptom of an emerging systemic disease. Therefore, by consulting a doctor about erectile dysfunction, you can prevent the development of diseases that cause it.
Psychogenic ED should not be ignored. Only a doctor can objectively determine the type of ED. In addition, consultation with a specialist will allow you to better understand the specific cause of the disease. The doctor will tell you how to correct it and avoid it in the future.
Myths about the disease
Masturbation negatively affects erectile function
In reality this is not the case. A considerable amount of research has been conducted on the topic of masturbation and its effect on men's health. Most works talk about the absolute harmlessness and even some benefit that self-satisfaction brings. In particular, masturbation reduces the risk of inflammation and prostate cancer, which increases with long-term abstinence
Potency enhancing drugs provoke a constant erection even without sexual contact
In fact, for the drug to work, sexual stimulation is required. The medicine helps to achieve the desired state, but does not stimulate spontaneous erection in the absence of sexual arousal.
If erectile dysfunction occurs, diseases of the prostate and testicles are to blame
The main function of the prostate gland and testicles is the formation of ejaculate (sperm). Pathologies of these organs occupy a central place in issues of male infertility, but in the problem of erectile dysfunction they are given the most indirect significance.
Physiotherapy in the treatment of erectile dysfunction
Shock wave therapy is a new and very promising method for treating erectile dysfunction today. It was developed in 2011 by urologists from St. Petersburg and is currently being actively used throughout the world. The therapeutic effect of shock wave therapy is associated with improving the properties of the cavernous tissue of the penis and improving microcirculation. The effectiveness of the method has been confirmed, and it is officially included in the clinical recommendations of the European Association of Urology for the treatment of erectile dysfunction.
The method of vacuum therapy (treatment with local negative pressure) has some historical value, but nowadays, due to the availability of new effective methods for treating erectile dysfunction, it has lost its significance.
Testing the innervation of the penis
Regardless of the causes of ED, men experiencing erectile dysfunction should definitely visit a doctor. Qualified specialists of CM “Global Clinic” have sufficient experience in this area and will find ways to eliminate the problem. A method of testing the sensitivity of the nerve endings of the penis will help determine the bulbocavernosus reflex. When the doctor presses on the head of the penis with a normal reflex, an instant contraction of the anus should occur. A medical specialist studies this process and draws conclusions about the latency of the reflex.
Surgical treatment of erectile dysfunction in men
If you still cannot do without surgery, then you can be sure that it will be performed at an expert level, using the latest equipment and in the most comfortable conditions. The standard surgical treatment for severe erectile dysfunction is penile prosthesis (or penile prosthesis). In my practice, I use only the best prosthetics from world manufacturers that have proven themselves to be highly effective, reliable and safe.
I consider patient safety and the final result to be my priorities, so in complex and unusual cases I do not hesitate to consult with leading experts in surgical andrology and, if necessary, perform the operation together with them.
By contacting me ( a doctor treating impotence ) with such a delicate problem as erectile dysfunction, you can be sure that you will receive the highest quality services at reasonable prices!
Sources
- Urology: textbook / B.K. Komyakov. — 2nd ed., revised. and additional - M.: GEOTAR-Media, 2021. - 452-458 p.
- Ludwig W, Phillips M. Organic causes of erectile dysfunction in men under 40. Urol Int. 2014;92(1):1-6. doi: 10.1159/000354931. Epub 2013 Nov 21. PMID: 24281298.
- Ametov A.S., Stelmakh M.V. ERECTILE DYSFUNCTION AND OBESITY // Therapeutic archive. 2013. No. 10.
- Vertkin A.L., Vodolazkaya A.N., Galkin I.V., Morgunov L.Yu., Uryadnova M.N. Erectile dysfunction: TREATMENT AND PREVENTION // MS. 2010. No. 3-4.
- Borisov Vladimir Viktorovich Psychogenic erectile dysfunction, correction of sildenafil citrate (clinical lecture) // Consilium Medicum. 2021. No. 7.
Questions about the article
Timur
October 25, 2021 at 04:05
Hello. About 10 days ago I began to notice that the head of my penis and testicles began to freeze. Erection has worsened. The inverter is not made of stone like before and falls off quickly. There is also prostatitis. I am 44 years old. If I understand correctly, then I have vascular ED. Are there any chances of recovery?
Anton Evgenievich Rotov
October 25, 2021 at 07:58
Before making any conclusions or making recommendations, I would suggest getting tested. If the diagnosis is accurately established, treatment will be effective.
Diet and sports are the key to men's health
Lifestyle modification plays an important role in treatment. Atherosclerosis, obesity, and type 2 diabetes mellitus are common causes of ED, and lifestyle correction for these conditions is central to therapy. Corrective measures include healthy eating, physical activity and getting rid of bad habits.
The diet involves minimizing the consumption of foods high in cholesterol and fat, confectionery, sweet drinks, and flour products. Also, the diet should contain more fresh vegetables, fruits and herbs. Bananas, apples, persimmons and citrus fruits not only contain many useful macro- and micronutrients, but also have a protective effect on blood vessels.
It's easy to be active!
Physical activity does not necessarily mean continuous exhausting workouts. Often there is no energy left for training: after a long day of work, you want to relax and not run in circles. In this case, the following measures may be helpful:
- You can go up and down the stairs instead of the elevator.
- Buy groceries not for a week, but for a couple of days, so that you can go to the store more often.
- When working sedentarily, do, for example, 10 squats, etc. every half hour or hour.
This way, training will not take much time, and fatigue from it will not even be noticeable.
Paying attention to nutrition and physical activity is important for a reason. The incidence of ED and obesity are statically strongly interrelated: the more people in a country with a high body mass index, the more cases of ED are observed. The same can be said for coronary heart disease and diabetes. A healthy lifestyle not only significantly reduces the risk of these common causes of erectile dysfunction, but also has a good effect when the disease has already manifested itself.
To increase the chances of successful treatment, it is important to make lifestyle changes. Photo: everyonephoto / freepik.com
Prevention
You can reduce the likelihood of erectile dysfunction. For this, doctors recommend:
- Proper nutrition.
- Limiting and eliminating bad habits (alcohol and tobacco consumption).
- Regular sex life.
- A healthy lifestyle, including rest and active physical activity.
- Control and correction of body weight.
- Control and correction of glucose and lipids in the blood.
- It is recommended that the patient be monitored by a urologist-andrologist.
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Classification
Erection disorders are usually classified according to severity: mild; average; moderate and severe degrees of erectile function. The classification based on the development of the disease is also generally accepted and important:
Alarming symptoms of erectile dysfunction are:
- difficulty in the onset of sexual arousal and its continuation;
- weak erection;
- partial or complete absence of morning erection.
