Impotence, Erectile Dysfunction
Erectile dysfunction in particular and sexual dysfunction disorders in general are much more common than we previously thought.
Erectile dysfunction is defined as the persistent and recurring inability to achieve or maintain an erection sufficient for sexual performance.
It is not the practice of patients to talk, in general, with their family doctor about sexual performance disorders, based on the assumption that this is not his job (his specialty) and for fear of damaging their image, but do you know the most important information about him?
Causes and risk factors of erectile dysfunction
Many diseases and problems may cause disturbances in sexual performance. In the past, these factors were classified according to their sources: emotional - psychological and physical - physical.
Today we are aware that this classification is artificial, because the connection between the soul and the body is very close and inseparable.
Causes of erectile dysfunction are varied and include:
Psychological stress: such as personal and marital problems, anxiety about sexual performance (fear of sexual failure, etc.).
Some common diseases: such as: diabetes, hypertension, hyperlipidemia, calcification and hardening of the arteries in the body. The common denominator between these diseases is that all of them affect blood flow to the penis, and thus may affect sexual performance and lead to erectile dysfunction.
Some types of medicines: The same applies to medicines used to treat the aforementioned diseases (beta blockers, lipid-lowering drugs, diuretics, etc.).
Innervation problems: such as after a herniated disc in the spine, or after pelvic surgery or radiotherapy.
Depression and anxiety (Anxiety): They are two very common diseases, and one of their prominent symptoms is a decrease in sexual desire and a decline in sexual performance. Also, treatment with modern drugs, selective serotonin reuptake inhibitors, exacerbates the problem, and this is one of the side effects of these drugs.
Heart disease and its treatments: It can also harm the level of sexual performance. Today it is known that a person who has had a heart attack can return to a normal sexual life, but he only needs help and encouragement.
Medicines: such as sedating drugs, drugs to reduce stomach acid, chemotherapy and various hormones - may affect the level of sexual performance.
Erectile dysfunction treatment
There are a variety of treatments that help treat erectile dysfunction. It includes:
1- Medicines
The first line of treatment recognized today is the tablets Viagra / sildenafil (Sildenaphil / Viagra), Levitra (Vrdnaphil / Levitera) or Cialis (Tdalaphil / Cilas), and finally a new drug has been approved in this family called Avanafil.
These drugs are sold in pharmacies, and every doctor can give them in appropriate cases.
Side effects of erectile dysfunction medications
These drugs have minor and transient side effects, including:
Slight redness of the cheeks
A slight decrease in blood pressure is reflected in a feeling of dizziness, a slight feeling of weakness and nausea.
Most of these symptoms subside and go away before you start having sex (after about an hour). There were almost no patients for whom the side effects of these drugs were so severe that they could not take them again.
However, it is strictly forbidden to take these medicines with medicines that contain nitrates (medicines to increase the flow of blood in the coronary arteries in heart patients), and it is also prohibited to take them for anyone whose physical, medical and psychological status does not allow them to have sex.
2- Testosterone test
This hormone is considered a regulator of sexual desire, in some cases of erectile dysfunction, doctors may recommend tests to find out its concentration in the blood, and if it appears that its concentration is low, then doctors advise alternatives to testosterone as an appropriate treatment.
Sometimes doctors may prescribe a combination of Viagra and testosterone alternatives, which may be effective.
A person who is unable to take one of these medicines orally, or a person who was found to be unable to treat this medicine, may be helped by direct injection into the corpora cavernosa, where active substances are injected into the blood vessels.
It is also possible to use a special vacuum pump that creates a strong erection, which is kept by a ring at the base of the penis.
Another treatment available today is the direct injection of alprostadil (a vasodilator substance) into the urethra, which has produced satisfactory results during recent scientific research.
3- Surgeries
In the event that all of the above mentioned erectile dysfunction treatment methods fail, it is recommended that surgeries such as:
Penis implantation: This surgery is simple and has a very good success rate. The participation of the primary physician (the family doctor) in the decision-making process and in the treatment measures greatly increases the chances of success, and also increases the willingness of the therapists and their partners to receive treatment.
Penile revascularization is another available procedure with relatively low success rates. In a few special cases, this procedure can be an effective treatment.
The primary doctor (family doctor) must diagnose these cases, and he is most likely able to treat them. However, in every major hospital there are clinics specialized in treating erectile dysfunction and dysfunction.
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