This is a disease (condition) in which erectile dysfunction occurs in men, leading to the absence or deterioration of sexual life, making it inferior and leading to psycho-emotional disorders and a decrease in the quality of life. The issue of erectile dysfunction arises when there is an inability to achieve or maintain an erection sufficient for sexual intercourse. As a diagnosis, this disease is considered when the described violations are observed in more than half of the attempts to have sexual intercourse within six months and subject to regular sexual activity.
Risk factors for this pathology are cardiovascular diseases, diabetes mellitus, arterial hypertension, high blood cholesterol, radiation and chemotherapy, overweight, sedentary lifestyle, smoking, the use of drugs and certain drugs and substances and persons who usually works under high physical and psycho emotional stress environment. Men with erectile dysfunction experience their condition prone to depression, irritability, withdrawal and anger.
Erection of a man mostly depends on hormonal, mental, vascular, neurogenic and anatomical factors. Accordingly, drawing a conclusion from the above, the causes of this disease can be the following:
1)Mental disorders and diseases: Among the causes of psychogenic erectile dysfunction, there are strict upbringing, religious beliefs, fear of sexual life, sexual perversions (perversions), depression, fear of aging, physical shortcomings, a certain sexual preference of a partner, a conflict with a partner, a negative first sexual experience in a man, the expectation of failure when contacting a partner, mental illness and some other conditions.
2) Neurogenic erectile dysfunction occurs as a result of damage to the central nervous system (brain and spinal cord) and or peripheral nerve structures. Tumors, epilepsy, strokes, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, cerebrovascular disease can lead to erectile dysfunction due to suppression of sexual desire (libido) or excessive inhibition of the spinal erection centers or impaired nerve conduction at the site of the lesion that is involved in the emergence and maintenance of an erection necessary for the implementation of a full-fledged sexual intercourse. With lesions of the structures of the spine and spinal cord, such as osteochondrosis and herniated disc, tumors, multiple sclerosis, the innervation of the penis may be disturbed, which also leads to erectile dysfunction.
3) Endocrine diseases are the most commonly spread and often detected in patients with erectile dysfunction Disease. Patients with diabetes mellitus are most often treated. The cause of erectile dysfunction in this case is not so much the main endocrine disease as vascular problems and damage to peripheral nerves. Tumors of the hypothalamus and pituitary gland can also lead to a decrease in sexual desire, a change in the level of hormones that are responsible for erection. In a certain percentage of cases, thyroid diseases directly and indirectly affect a man’s ability to have sexual intercourse. Recently, a view on the problem of male aging has been relevant, because. with age, many of the physiological functions of a man fade, and many of this group of patient’s desire and have the opportunity to live a full sexual life. One of the first terms that appeared in men is the term “male menopause”, which is quite widely used as a description of a set of symptoms that develop in a man after 45-50 years and are manifested not only by a decrease in sexual desire but also depression, decreased attention and memory, increased nervousness, fatigue, decreased muscle strength, sweating, sleep disturbances, hot flashes and other symptoms. But men do not have a clear age period for the decline in the production of sex hormones, unlike women. Therefore, the use of the term male menopause (from the Latin “climax” means step, ladder) is not correct, because. in men, this condition has a blurred and gradual onset, lasting for years, and in women it has a sharp and spasmodic course. That is why, the term male menopause must be considered as age-related androgen deficiency.
4) The Pathology of arteries and veins of the small pelvis, arteries and veins which supply the penis with blood can, to a certain extent, lead to insufficient blood supply to the cavernous bodies with the development of erectile dysfunction. Arterial pathology is most often caused by stenosis or atherosclerotic lesions of the arterial wall, resulting in reduced blood perfusion through the cavernous bodies of the penis with the development of erectile insufficiency. With pathological venous outflow, patients also note the weakness and rapid disappearance of an erection soon after its onset.
5) Sometimes drugs that are recommended to the patient for another disease can lead to erectile insufficiency. This occurs most often in patients taking sleeping pills, sedatives, antidepressants, hormones and anabolic steroids, blood pressure lowering drugs (diuretics, beta-blockers, ACE inhibitors and Ca-channels) and other drugs. Therefore, such patients need to correct prescriptions by canceling or replacing drugs together with the therapist or cardiologist (if, for example, erectile dysfunction is caused by taking antihypertensive drugs).
In the differential diagnosis of sexual dysfunction, a detailed sexual history of the patient, as well as a thorough laboratory and visual examination, play an important role. Considering that there are many causes of erectile dysfunction, patients are required to prescribe:
general analysis of blood and urine,
determination of fasting glucose levels,
prolactin and other hormones as needed.
These tests are carried out at the initial stages of the examination, further diagnosis and treatment by a urologist depend on the general condition of the patient, the desire to be treated and the financial capabilities of the patients can contact us.