“Erectile dysfunction is defined as inability to manage an erection ample for sexual intercourse. This is a problem that affects millions of gentlemen around the environment in various methods and with varying causes.”

What is it?

Erectile dysfunction is a clinical term used to define the incapacity to get an erection with sufficient rigidity for penetration and / or maintain it for a time period of time enough to the satisfaction of equally partners all through intercourse. It is vital to realize that it can happen even with motivation and orgasm (ejaculation) existing.

Erectile dysfunction (ED) has an effect on about two thirds of guys around 50 yrs of age, representing 10 to 20 million Brazilians.

Most gentlemen, at some stage in their lives, have knowledgeable episodes of erectile dysfunction, ordinarily thanks to tiredness, tension or alcoholic beverages abuse. Occasional failures ought to not be overrated. Nonetheless, if the trouble persists, a urologist should be sought.


The capability of erection is just just one of various features of male sexual functionality. The sexual response cycle has four levels of person major desire, erection, orgasm and peace. Every single can change unique.

The triggers of ED are divided into organic and natural, psychogenic and combined, can be identified with mixed factors. Natural and organic difficulties these as diabetes, cancer, arteriosclerosis and neurological accidents can generally direct to psychological complications, for example. It can also be secondary, and look as the 1st manifestation of many ailments this sort of as hypertension, diabetic issues, cardiovascular disease and renal failure.

ED of psychological origin can be manifested in numerous approaches, or delayed ejaculation, unpleasant ejaculation and even impotence. There may perhaps also be reduction of libido (sexual motivation), lack of orgasm and phobias (fears) intercourse, all for anxiety, depression or guilt. An individual who has an uncomfortable practical experience, this sort of as loss of erection to have sexual intercourse or ejaculate extremely early, tends to the following romantic relationship, keep in mind these “failures” and develop into nervous. This delivers a new fault, building a vicious circle.

Natural and organic brings about are subdivided according to the etiology. The vasculogênicas are more prevalent, specially the flow changes, arteriosclerosis and trauma (resulting in harm to blood vessels).Venous movement abnormalities are a lot less frequent. The neurogenic leads to are diabetic neuropathy, several sclerosis, liquor abuse, trauma, spinal wire and nerve hurt by radical prostatectomy (surgery to take away the prostate). Due to the fact the brings about are hormonal hipoandrogenismo most important or secondary (ailments of male hormones).

The ED may possibly also happen, for use and abuse of prescription drugs like marijuana, alcoholic beverages, heroin, cocaine, barbiturates, antidepressants.

Issues involved

The DE has many threat factors as sophisticated age, diabetes, hypertension, peripheral vascular health conditions neurological conditions, endocrine issues, spinal twine injuries, radical pelvic operation, radiation treatment, alcoholism, smoking, cannabis use and / or cocaine use of antihypertensives, tranquilizers and psychotropic substances connection difficulties with husband or wife, anxiety, stress and anxiety and dread of failure, despair, obsessive-compulsive temperament, sexual deviation.


The aims of the preliminary analysis of the client are to establish the possible trigger of ED and determine natural and organic or psychological components that may perhaps affect the related therapeutic.

A in-depth clinical interview is the most essential aspect in evaluating individuals with this problem. The heritage must discover the period, development and severity of ED and connected aspects.

After you have recognized a trouble in the patient’s sexual general performance, the next phase is to differentiate it from other sexual issues this kind of as decline of libido and ejaculatory conditions.

Actual physical examination is to assess the patient’s health, with particular awareness to the cardiovascular, neurological and genitourinary, owing to its contribution to the erection. The neurological analysis really should involve a notion of their patient’s panic or melancholy. Considering that the assessment of genital herpes is directed to detection of community abnormalities.

Some are essential laboratory exams to identify ailments that can consequence in ED.


In instances of psychogenic DE, psychotherapy is indicated. Quite a few factors need to be evaluated by the urologist and if feasible, by an pro in psychology or psychiatry. Things these kinds of as bodily, psychiatric, psychological, conflicted romantic relationship with the companion and sexual inadequacy need to be tackled to the couple.

Penile injections have been the very first efficient and objective, with tiny or no aspect consequences, with substantial improvement of erection, even in extreme OF and natural and organic. They were being the key complication, distressing erections. Also experienced the disadvantage of restricting the time limitation of erections and frequency of software (3 times per week). This system tends to be abandoned with the development of technological innovation.

With the progress of therapy, some oral medications are obtainable in the market place. They are:

Viagra (Sildenafil) of Pfizer: functions on the penis by enjoyable muscle tissues and escalating blood stream to the area. Powerful in scenarios of partial impotence, erection of supplying 40 to 60 minutes soon after ingestion of the treatment, with stimulation of the penis. Its outcome can last up to six horas.Tem aspect reactions these types of as headaches, nasal congestion, facial flushing and dyspepsia. Coronary heart individuals, specifically in drug therapy of nitrate (Sustrate, Monocordil, Isordil, Nitradisc, Nitroderm TTS, Isocord, Isosorbide, nitroglycerin) can not choose this drugs.

Uprima (apomorphine), from Abbott Laboratories, acts on the central anxious procedure, facilitating the carry out of sexual stimulation of the brain to the penis. Generates erection 10-20 minutes soon after oral administration sublingually. May possibly lead to headache, nausea, dizziness, fainting and flushing, but can be used by coronary heart patients.

Cialis (Tadalafil), created by Eli Lilly, acts directly on the penis by inhibiting the enzyme phosphodiesterase. Potential customers to an erection in 30 minutes, and sustained for up to 36 hrs. Can bring about headache, gastric intolerance, nasal congestion, back suffering, muscle mass pain, dizziness and flushing. As Viagra, can not be utilised for coronary heart sickness in the use of nitrates.

Levitra (Vardenafil) of Bayer and Glaxo, also functions directly and selectively on the penis by inhibiting the enzyme phosphodiesterase, with much less side effects (headache, flushing and runny nose). Prospects to an erection in 15 minutes, and retains up to 8 hrs. As Viagra and Cialis, can not be utilised for heart disease in the use of nitrates. A person of the most important rewards is the most affordable rate and currently being sold in solitary packs.

Even though drug treatment plans talked about, some clients may possibly not in good shape and demand therapy with mechanical devices these types of as vacuum erection equipment or penile implants inflatable or malleable. Others may possibly need surgical procedures to mend vascular arteries that supply the penis with blood, in particular situations.

For the reason that erectile dysfunction can have a lot of causes, there are numerous treatment options that act by distinct mechanisms, with distinct contraindications, a urologist need to be consulted.

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