Erectile Dysfunction refers to the inability of a man to consistently get or maintain an erection sufficient for satisfactory sexual intercourse . This condition is not due to a lack of sexual interest or desire and not for the occasional difficulty achieving or maintaining an erection ( a situation that affects all men at some time in their lives ) .
Erectile dysfunction causes sexual intercourse with penetration is not possible . This can affect the self-esteem of patients and undermine domestic harmony .
Cause
To understand the causes of erectile dysfunction , it is necessary to first understand the process of erection . In the penis there are two parallel rods spongy tissue called the corpora cavernous ( tungal : corpus cavernosum ) . Corpora cavernous surrounded by a membrane , called the tunica albuginea . The spongy tissue contains smooth muscles , fibrous tissues , spaces , veins , and arteries . The urethra , which is the channel for urine and semen flow longitudinally under the corpora cavernous .
Erection process is as follows :
- When a man desires to have sex , increasing sensitivity to sexual stimuli
- Sexual stimulation impulses sent to the brain , which triggers arousal .
- Arousal and intensify action at a point to be very active to increase body temperature , heart rate and blood flow . Erection begins when blood flow to fill the spaces of spongy tissue in the cavernous kopora . This creates pressure in the corpora cavernous , making the penis expand . The tunica albuginea helps trap the blood in the sponges , thereby maintaining an erection .
- Erectile dysfunction can occur when one part of the process interrupted : nerve impulses in the brain , spinal cord and around the penis and response of muscles, fibrous tissues , veins and arteries in and around the corpora cavernous .
The basic requirements for a normal erection is :
- Nervous system that works well to send the necessary signals to the penis .
- Effective blood vessels to allow blood flow to and from the penis .
- Smooth muscle in the penis , which loosened to allow the penis to fill with blood and swell .
- Ability to trap blood in the penis so that it stays upright .
Disturbances in the erectile mechanism of the above can happen from smoking , diabetes mellitus , atherosclerosis , depression , anxiety disorders , alcoholism , hypothyroidism , prostate cancer , testosterone deficiency , kidney disease , liver or nerve , and the side effects of the drug .
In addition to the physical condition , psychological problems such as depression , trauma , etc. can also cause erectile dysfunction .
Diagnosis
Diagnosis of erectile dysfunction is established when the inability to get and maintain an erection sufficient for sexual intercourse occurred in at least 50 % of the effort .
Therefore , sexual and medical history is very helpful diagnosis . Physical examination and lab may also be done on the endocrine system , cardiovascular urogenital , and nervous .
Therapy
Therapy for erectile dysfunction include :
- Eliminating the underlying factors such as the treatment of depression , drug discontinuation was not necessary , stop smoking , etc. .
- Counseling to restore sexual intimacy
- Direct therapy for erectile enhancement . This therapy works best in conjunction with other interventions above . These therapies include :
- Penis ring with or without a vacuum device .
- Tablet prostaglandin ( PGE1 ) . PGE1 causes increased blood flow corpora cavernous . These drugs produce erections that lasted from 30 to 120 minutes at approximately 70 % of patients .
- Intracavernosal injection : PGE1 combined with fentolamin .
- Systemic medications such as Yohimbine ( Yohimbe bark extract ) , testosterone and sildenafil ( Viagra )
