Erectile dysfunction (impotence), Cause, symptoms, treatment, diagnosis-diseasecares

Erectile dysfunction

Erectile-dysfunction-ED


Erectile diesfunction is called the inability to get or maintain a hardly sufficient erection for sex (ED).Sometimes it is also called impotence.

Introduction

The inability to obtain or maintain an erection is referred to as erectile dysfunction.suitable for a sexual encounter Impotence is another term for this condition. ED can be caused by any medical condition that reduces blood supply to the penis. Smoking, diabetes, high blood pressure, alcohol, and depression are all common causes of ED. ED can also be caused by various prescription drugs.

Etiology of erectile dysfunction

Symptoms of erectile dysfunction include difficulty obtaining an erection, difficulty maintaining an erection during sexual activities, and decreased interest in sex, as well as premature ejaculation, delayed ejaculation, and anorgasmia, or the inability to achieve orgasm after adequate stimulation.
Erectile dysfunction can be caused by a variety of factors, and many men have more than one:

Aging: 

The first is that older men are more likely to acquire disorders related with erectile dysfunction (such as heart attacks, angina, cardiovascular disease, strokes, diabetes mellitus, and high blood pressure). Second, changes in the muscle and tissue of the penis caused by the ageing process might cause erectile dysfunction in some individuals.

Diabetes mellitus: 

The increased risk of erectile dysfunction in men with diabetes mellitus may be due to the earlier onset and severity of atherosclerosis (hardening of the arteries), which narrows the arteries and reduces blood delivery to the penis.

Hypertension: 

The risk of developing erectile dysfunction is increased in men with high blood pressure. Hypertension can cause erection problems due to atherosclerosis or low levels of nitric oxide produced by the arteries in the penis.

Cardiovascular diseases:

 The narrowing and hardness of arteries, which restricts blood flow, is the most common cause of cardiovascular atherosclerosis. Hardening of the pelvic organs and penis arteries, atherosclerosis, causes inadequate blood flow to your penis.

Cigarette smoking:

Smoking cigarettes increases the risk of erectile dysfunction and can cause vasospasmas (blood vessel spasms). erectile dysfunction can occur with various substances such as marijuana, heroin, cocaines, methamphetamin, methyl crystal, opium and alcohol abuse.
Alcoholism may lead to testicular and lower levels of testosterone, apart from nerve damage.

Low testosterone levels:

Testosterone (the principal sex hormone in men) is required not just for libido, but also to keep nitric oxide levels in the penis at a healthy level. As a result, hypogonadism (low testosterone with symptoms) can lead to a lack of sexual desire and erectile dysfunction in men.
Medications: Erectile dysfunction is a common side effect of several medications.

Depression and anxiety:

Erectile dysfunction may be caused by psychological causes. Stress, worry, guilt, sadness, widower syndrome, low self-esteem, posttraumatic stress disorder, and fear of sexual failure are some of these issues (performance anxiety).

Pathogensis of erectile dysfunction

The nerves that innervate the corpora cavernosa and tiny arteries of the penis are stimulated in the higher centres of the brain, resulting in upregulation of (NANC) Nor adrenergic and nor cholinergic activity and withdrawal of sympathetic activity. Nitrous Oxide (NO)release from the endothelium and NANC nerve terminals is elevated as a result of increased NANC and cholinergic activity.

NO diffuses into the corpora cavernosa smooth muscle and the tiny arteries/arterioles of the penis, where it binds to the reduced heme iron of soluble guanylate cyclase, activating the enzyme and boosting CGMP synthesis from GTP. GMP-dependent protein kinase activity in smooth muscle cells opens potassium channels and enhances calcium uptake into storage. This causes smooth muscle cell relaxation and a decrease in intracellular calcium concentration.

The blood flow into the corporal sinuses rises, and the cavernosal sinuses enlarge, trapping blood in the corpora, resulting in a penile erection. The release of vasoconstrictors from sympathetic terminals and endothelium triggers detumescence. A cGMP-specific phosphodiesterase (type 5) converts cGMP to GTP and stops cGMP from acting. Detumescence and flaccidity have been found to be mediated by kinase/RhoA activation. Within smooth muscle cells, Rho kinase suppresses the regulatory subunit of myosin phosphatase and maintains contractile tone despite low cytosolic calcium concentrations. The activity of Rho-kinase has been found to be upregulated in the ED.

Diagnosis of erectile dysfunction (ED). 

Underlying conditions may be tested for using the following methods:

Physical exam. 
This may include an attentive examination of your penis and testes and sensation checking of your nerves.

Blood tests.
A sample may be sent to a laboratory to check for signs of heart disease, diabetes, low levels of testosterone and other conditions of health.

Urine tests (urinalysis).
Urine tests are used to find signs of diabetes and other health conditions, just like blood tests.fo

Ultrasound. 

Usually, this test is done by an office specialist. It consists of the use of a transducer that is held over the blood vessels that provide the penis. It creates a video to show your doctor if you have problems with blood flow.This test is occasionally done in combination with medication injections in the penis, so that blood flow is stimulated and erected.

Psychological exam.
Your doctor may ask you questions to see whether you're depressed or if there are any other psychological explanations for erectile dysfunction.

Treatment of erectile dysfunction (ED).

You may have a variety of therapy choices depending on the origin and degree of your erectile dysfunction, as well as any underlying health concerns. Your doctor will discuss the risks and advantages of each treatment with you and will take your preferences into account. Your treatment decisions may also be influenced by your partner's preferences.

Oral medication 

For many men, oral medicines are an effective erectile dysfunction treatment. They are as follows:
  • Sildenafil (Viagra)
  • Tadalafil (Adcirca, Cialis)
  • Vardenafil (Levitra, Staxyn)
  • Avanafil (Stendra)
All four drugs boost the effects of nitric oxide, a natural substance produced by your body that relaxes penile muscles. This permits you to obtain an erection in response to sexual stimulation by increasing blood flow.

One of these tablets does not produce an erection automatically. To stimulate the release of nitric oxide from your penile nerves, sexual stimulation is required first. These drugs increase that signal, allowing some persons to have normal penile function. Oral erectile dysfunction drugs are not aphrodisiacs, do not promote excitement, and are unnecessary for men who have normal erections.

Side effects of medication in erectile dysfunction (ED) 

The dosage, duration of action, and adverse effects of the drugs differ. Possible side effects include
  •  flushing
  • congestion of the nose
  • headache,
  •  eye changes and
  •  backaches and
  • upset stomach.

Other medications for the treatment of erectile dysfunction (ED) 

Alprostadil self-injection:

This procedure involves injecting alprostadil (Caverject, Edex) into the base or side of your penis using a small needle. In some circumstances, drugs used for other illnesses are utilised alone or in combination for penile injections. Alprostadil and phentolamine are two examples. These combination drugs are frequently referred to as bimix (if two medications are included) or trimix (if three medications are included) (if three are included).
Each injection is precisely dosed to produce an erection that lasts little more than an hour. Because the needle is so small, the injection site normally causes only little discomfort.

Mild injection-related bleeding, extended erection (priapism), and, in rare cases, fibrous tissue growth at the injection site are all possible side effects.

Alprostadil urethral suppository

Intraurarethral therapy of Alprostadil (Muse) involves inside the penile urethra putting a small alprostadil suppository. The suppository is inserted into your penile urethra with a specific applicator.

The erection normally begins within 10 minutes and lasts between 30 and 60 minutes if it is successful. Side effects can include burning in the penis, minor urethra bleeding, fibrous tissue formation inside the penis.

Testosterone replacement

Some men suffer from erectile dysfunction, which may be exacerbated by low testosterone levels. In this scenario, testosterone replacement therapy may be prescribed as a first step or in conjunction with other treatments.

*Penis pumps
*Penile implants

Exercise

Exercise, particularly moderate to strenuous aerobic activity, has been shown in recent research to help with erectile dysfunction.

Regular exercise, which is less demanding, may help to lower the risk of erectile dysfunction. Increasing your level of activity may help you minimise your risk even more.

Consult your doctor about an exercise regimen.

Read also 👉 about Hypogandism

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