Erectile Dysfunction
Erectile dysfunction (ED) is defined as the inability to achieve and / or maintain an erection that represents a satisfactory sexual intercourse.
The term erectile dysfunction is better than the term impotence because it defines more precisely the nature of this sexual dysfunction. Numerous physical and psychological factors are involved in normal erectile function, including neurological factors, vascular, hormonal and cavernosa. Alterations of one or more of these factors can cause a DE. For simplicity, the ED is frequently classified as:
organic, due to alterations or vascular, neurological injuries, hormonal or cavernous
psychogenic, due to an inhibition of the central mechanisms of erection in the absence of an organic cause detectable
mixed organic-psychogenic, due to a combination of organic and psychogenic factors.
In the majority of patients with ED, it is a combination of organic and psychogenic factors. According to an analysis of data from six clinical trials conducted over the past 10 years, about 78% of men with ED organic factors were detected with or without psychogenic factors. It ‘still important to note that the etiological classifications are relatively simplistic. In fact, the presence of organic alteration in the case of DE does not exclude concomitant psychological causes. For against the failure relief of an organic cause does not confirm, by itself, the exclusively psychogenic origin of ED.
The relaxation of the smooth muscles of the cavernous body and the penis erection depend on a delicate balance between the effects of vasoconstrictor and vasodilator factors.
To bring the flaccid penis, tonically contract, the state of erection it is necessary that the relaxation of the smooth muscle of the corpus cavernosum exceeds a certain threshold level. E ‘was shown that the basic defect in patients with ED may be, regardless of aetiology, an imbalance between the contraction and the capacity of the relaxation of the smooth musculature of the corpus cavernosum.
If the base tone of the corpus cavernosum smooth musculature is too high, the maximum relaxation level may not be sufficient to allow the increase of blood flow required for a normal erection. If you reach or maintain the threshold level of smooth muscle relaxation, resistance to venous outflow will be insufficient.
Since this would depend on the fact that you can have erections with different degrees of rigidity.
To all the men it can happen, at some point in life, not being able to achieve an erection, but the persistent erectile dysfunction is an infrequent problem under 40 years of age. From this age, however, the incidence rapidly increases to the point that 65% of men aged 70 presents problems of sexual potency. This increase is mainly due to vascular disease and occurs with about 10 years earlier in diabetic men.
Aging in itself does not cause erectile dysfunction, although it certainly involves physiological changes. Many men need greater stimulation of the penis, the erection becomes less stiff and any distraction can result in loss of erection, often difficult to achieve again. The frequency of sex is reduced even though sexual activity remains satisfactory and represents an important element for the sense of well-being.
It ‘important to emphasize the importance of smoking, hypertension and other cardiovascular problems, diabetes and alcohol abuse.
Erectile dysfunction (ED) is defined as the inability to achieve and / or maintain an erection that sexual intercourse soddisfacente.Il term erectile dysfunction is better than the term impotence because it defines more precisely the nature of this sexual dysfunction.
To all the men it can happen, at some point in life, not being able to achieve an erection, but the persistent erectile dysfunction is an infrequent problem under 40 years of age. From this age, however, the incidence rapidly increases to the point that 65% of men aged 70 presents problems of sexual potency. This increase is mainly due to vascular disease and occurs with about 10 years earlier in diabetic men. Aging in itself does not cause erectile dysfunction, although it certainly involves physiological changes.
Many men need greater stimulation of the penis, the erection becomes less stiff and any distraction can result in loss of erection, often difficult to achieve again. The frequency of sex is reduced even though sexual activity remains satisfactory and represents an important element for the sense of well-being. It ‘important to emphasize the importance of smoking, hypertension and other cardiovascular problems, diabetes and alcohol abuse.
Prostate diseases can cause ED
They are generally inflammation of the prostate, but also those of the rectum to cause a venous-lymphatic pelvic congestion with possible alterations of erectile capacity.
Correct imbalances of blood sugar in diabetic patient can make DE reversible?
Many of the effects of diabetes on erectile function are determined by chronic alterations caused by persistent hyperglycemia on the tissues and blood vessels, are therefore not fully reversible. However improving glycemic control is critical to stop or slow the progression of tissue damage.
The ED can be the alarm bell of other diseases?
ED and cardiovascular disease share common risk factors and the prevalence of ED in patients with coronary artery disease, myocardial infarction or stroke is very high. It is therefore considered that in some patients the onset of ED can be the first
sign of a cardiovascular disease and that therefore the subject with ED should also be evaluated for the presence of this condition.
The prostate surgery always cause a ED?
The radical removal of the prostate (radical prostatectomy), which is performed to treat prostate cancer is often associated with DE determined by lesion of the cavernous nerves. This, in selected cases, can be avoided by using a technique such savings nervous structures (technique called “nerve sparing”).
It 'true that the penis is a muscle?
NO. The penis is a complex organ, which is to the modifications of its volume and its shape not to the contraction of voluntary muscles, but to variations in the incoming and blood flow in its interior.
It 's true that ED increases with age?
YES. Age is the main risk factor for ED, but is not in itself cause of ED.
It 'true that if I had a heart attack I can not use inhibitors of type 5 fosodiesterasi?
NO. These drugs are contraindicated if you are among the drugs taken, nitrates, used for angina and often by patients who have suffered a heart attack, or if the heart attack led to a decrease in cardiac function as well accentuated by make dangerous physical activity connected with sexual function.
It 's true that cigarette smoking impairs erection?
YES. E ‘shown that many components of smoking, including nicotine itself, in contrast to the short or long term the erectile activity. Some of these effects may be rapidly reversible after smoking cessation, others are permanent.
It 'true that if I applied a penile prosthesis does not feel more pleasure?
NO. Penile implants, which are applied within the corpora cavernosa, can play the mechanism of erection, but do not affect other aspects of sexuality such as the sensitivity of the penis or orgasm.
It 's true that ED is always associated with deficiency of testosterone?
NO. In fact only a small share of DE (less than 5%) are associated with deficiencies of sex hormones; The most frequent causes are those related to vascular diseases or chronic diseases such as diabetes or kidney failure.