Sexual dysfunction is a factor that provokes not only physiological (), but also psychological problems (feelings of inferiority, loss of self-confidence). Erectile dysfunction instills in a man a fear of sexual intercourse, contributes to decreased performance, and isolation. The inability to fully carry out and complete sexual intercourse may be periodic or permanent. In the latter case, we are talking about an extreme degree of erectile dysfunction. Such a disorder can arise under the influence of numerous unfavorable factors and manifest itself in several forms. It is possible and necessary to treat the deviation: the sooner a man seeks help, the faster he will return to a full life.

Erectile dysfunction is a condition in which or, which makes it impossible to have full sexual intercourse. In addition, the man’s sexual desire is disturbed, orgasm is absent or unexpressed and short-lived, ejaculate is released in small quantities or not at all.

What form of erectile dysfunction is the most common - organic or psychological? The answer to this question will be given by psychotherapist Boris Gorodkov:

The disorder, contrary to popular belief, occurs not only in the elderly: in young men under the age of 30, it is also observed quite often. This is due to the presence of a large number of factors that negatively affect the state of the body as a whole and the functions of the reproductive system in particular.

Depending on the underlying cause, erectile dysfunction can be expressed in one of the following forms:

1. Psychological or psychogenic. The disorder occurs suddenly; the provoking factor is an uncomfortable psychological state. Psychogenic erectile dysfunction is the body’s reaction to stress, fatigue, and mistrust of a sexual partner. This form of the disorder occurs in approximately 20% of all cases of sexual dysfunction, predominantly in young men. In this case, there are no organic disorders in the structure of the genital organs, morning erections are present, and the ability to maintain an erection throughout sexual intercourse is preserved;
2. Organic. In this case, the disorders are associated with pathologies of the genitourinary organs, hormonal fluctuations, as well as insufficient blood supply to the vessels of the penis (more about). Attraction does not decrease, ejaculation remains, but maintaining an erection becomes more and more difficult each time. With organic erectile dysfunction, there are no nighttime erections, and there is a sharp weakening of the penis during sexual intercourse. In 80% of cases, erectile dysfunction is a complication of underlying diseases;
3. Mixed. This form of sexual dysfunction in men occurs when a combination of factors such as the presence of an underlying pathology and the stress state caused by it.

Regardless of the reason for the disorder of sexual function, a man needs the help of a specialist. To find out what was the starting point for the development of the deviation, the patient needs to undergo specific examinations.

Reasons for rejection

Erectile dysfunction in men occurs under the influence of various factors. These should include:

• Changes in the level of sex hormones in the blood. A decrease in testosterone due to dysfunction of the endocrine system is a common reason for the inability to have full sexual intercourse;
• Infectious diseases sexually transmitted (syphilis);
• Inflammatory processes occurring in the organs of the genitourinary system (,);
• Neurological pathologies (sclerosis, epilepsy, stroke, circulatory disorders in the vessels of the brain);
• Alcohol abuse, smoking, taking drugs, tranquilizers and sedatives, as well as medications to lower blood pressure;

• Psychological trauma received back in childhood, incorrect approach to sexual education of a child, unsuccessful sexual contacts that occurred in youth, which causes fear of sex in a mature man;
• Penis injuries that occur as a result of bruises, burns, wounds. Depending on the severity, they can lead not only to sexual impotence, but also swelling, hematomas, and skin death;
• Hypertension;
• Benign prostate tumors;

• Diseases in which the blood supply to the penis is disrupted. These are thrombosis, varicose veins, vascular atherosclerosis;
• Injuries of the pelvic organs;
• Violation of metabolic processes. Thus, sexual dysfunction is often observed in diabetes mellitus;
• An operation to circumcise the foreskin was performed. In the unprotected skin fold of the head of the penis, nerve receptors are irritated, which occurs upon contact with the fabric of underwear and active movements. This leads to loss of sensitivity in the head;

• Exposure of the body to radioactive rays, work in hazardous industries, contact with heavy metals;
• Performing heavy physical exercise;
• Obesity;
• Complications after surgical interventions.

Treatment of erectile dysfunction in men depends on the specific cause that provoked the deviation.

Symptoms

Some symptoms of erectile dysfunction were mentioned above. Full clinical picture, which indicates deviations, consists of the following manifestations:

1. Lack of response from the penis even in the presence of sexual desire in a man;
2. Sudden cessation of erection during sexual intercourse;
3. Insufficient penis hardness;
4. Decreased libido;

Symptomatic differences between organic and psychogenic forms of ED

1. Premature ejaculation or lack thereof;
2. Absence or dimness of orgasm;
3. Lack of spontaneous erections at night or in the morning;
4. Delay in the onset of erection even against the background of active stimulation of the penis.

Please note that there is a difference between erectile dysfunction and impotence. The last concept is an extreme form of sexual impotence. If with erectile dysfunction (especially of a psychogenic nature) a man retains the ability to ejaculate, although the quality of erection decreases, then with impotence there are no opportunities for sexual intercourse at all.

Diagnostic measures

Diagnosis of erectile dysfunction allows us to identify the causes of the pathology and begin adequate treatment. For this, methods such as:

• Taking an anamnesis to identify predisposing factors;
• General examination of the patient (determining weight, height and their ratio, as well as blood pressure level);
• Study of the functionality of the nerves of the penis. The procedure is called innervation testing. In this case, pressure is applied to the head of the penis. With such an impact, a reflex contraction of the anus should occur;
• Blood test. Testing is necessary to identify abnormalities such as diabetes and low testosterone levels;

• Test with vasoactive substances. This diagnostic event is carried out in order to evaluate the functioning of the vascular part of the genital organ. During the procedure, a medicine is injected into the base of the penis using a thin needle, which acts on the blood vessels. The drug causes them to expand, due to which the cavernous bodies of the penis after the injection are filled with blood and an erection occurs. The specialist evaluates the intensity, speed and degree of erection;
• Ultrasound Dopplerography of the vessels of the penis. Using the method, the doctor evaluates microcirculation and identifies structural changes. The procedure is performed in calm and erect states of the penis;

• Biothesiometry of the penis. This test uses electromagnetic vibration. In this way, the sensitivity of the penis is assessed. If it is low, nerve damage has occurred;
• , which is an indicator. Abnormalities in this test indicate an enlarged or infected prostate.

Researcher at the Urology Center named after. Academician B.U. Dzharbusynov Muravyov A. A on the importance of ultrasound Dopplerography of the vessels of the penis in the diagnosis of ED:

All the methods described allow us to draw conclusions about what caused the development of sexual dysfunction in men. Having this information, as well as data on concomitant pathologies, the specialist makes a diagnosis and is able to prescribe adequate treatment.

How to help a man with erectile dysfunction?

Treatment of erectile dysfunction in men can be based on several methods.

Table 1. Basic approaches to correcting the condition of erectile dysfunction

Urologist-andrologist Denis Anatolyevich Cherepanov talks about treatment methods:

Treating erectile dysfunction at home

Effective treatment of erectile dysfunction involves a combination of medication and physical therapy, but to achieve the best results, a man needs to change his lifestyle. This applies to correcting nutrition, increasing physical activity, and giving up bad habits.

It is recommended to perform exercises for erectile dysfunction - they have a stimulating effect on potency. It is recommended to conduct a home workout, performing simple movements: running in place with your heels lifted, relaxing and tensing the muscles of the anus, as well as the gluteal region.

You can try using folk remedies, but only with the permission of your doctor.

1. Sage-based decoction. This herbaceous plant is known in folk medicine as a powerful source of male strength. To prepare the medicine, you need to take a tablespoon of chopped fresh sage leaves, pour 250 ml of boiling water and leave for 30 minutes. The resulting volume must be drunk per day, divided into three doses;

Three simple recipes from Tamir Sheikh to increase potency:

1. Dried fruits help increase arousal. You need to take 25 g of prunes, raisins and figs, chop or mince, and mix. You need to eat two tablespoons of the mass every day;
2. Celery and parsnip roots. The raw materials (of each type in the same quantity) need to be grated and poured with a tablespoon of vegetable oil. Every day you need to eat two tablespoons of the medicinal mixture.

Diet for sexual dysfunction is another important component of the treatment system. A man needs to use. These include:

• Fatty fish and seafood (herring, mackerel, shrimp, mussels). They contain substances that have a positive effect on blood vessels and are involved in the process of testosterone production;
• Cereals. Millet, oatmeal, pearl barley improve metabolism and the digestion process, prevent circulatory disorders;
• Meat. It contains a large number of protein, which promotes muscle growth and overall strengthening of the body;

• Celery. This vegetable contains many vitamins, as well as iron, phosphorus, potassium, magnesium. Celery contains an analogue of the male sex hormone – androsterone, which improves erection and enhances libido. The most useful part of the vegetable is the root;
• Oysters. In addition to being a powerful source of zinc, oysters are an aphrodisiac and have a positive effect on the prostate gland.

To avoid a decrease in sexual function, it is necessary to follow preventive measures:

1. Eat healthy and balanced, giving up fast food and other junk food;
2. To refuse from bad habits;
3. Exercise moderately;
4. Promptly treat existing diseases that can weaken a man’s sexual function;
5. Do not abuse masturbation, live a full and regular sex life.

Regular visits to the urologist will help avoid serious complications.

Erectile dysfunction can result from a variety of reasons, from psychological trauma to chronic illness. It is important to contact a specialist in a timely manner without being embarrassed by the problem, since delay not only reduces a man’s quality of life, but can also lead to infertility.

Content

Everyone should know what erectile dysfunction in men is, because this disease causes weakening of the sexual organ and can provoke complete impotence. This problem is very common among the stronger sex, especially those who have already reached old age. Read about what constitutes erectile dysfunction in men. Find out why this disease develops, what symptoms it manifests and how it is treated.

What is erectile dysfunction

This is what is called a sexual dysfunction disorder. This problem is very common among men, both old and young. With erectile dysfunction, a representative of the stronger sex cannot perform full sexual intercourse. The problem gives men severe psychological discomfort and causes self-doubt. The inability to be sexually active leads to many other health problems.

The concept of erectile dysfunction applies only to those men who do not achieve a quality erection in 25% of cases. Sexual intercourse and ejaculation are possible. However, it is very difficult to achieve and maintain an erection until both partners are completely satisfied. The older a man is, the more likely he is to encounter this problem, but some people begin having problems with erectile function in their 20s.

Symptoms

The main signs of dysfunction should be listed:

1. Libido disturbance. A man's desire for sex decreases opposite sex, I don’t want sex as much as before.
2. Erectile dysfunction. It is weak and unstable, the penis is not hard enough and is not fully enlarged. Lack of erection, both adequate and spontaneous (night, morning) is also included in this point.
3. Ejaculation disorders. Ejaculation occurs prematurely, immediately after insertion of the penis or even before that. If ejaculation does not occur at all, this is also a very dangerous symptom.
4. A blurred orgasm or its complete absence.

Types of disease

There are different types of erectile dysfunction in men depending on the reasons that provoke it:

1. Psychogenic. It occurs in men who often experience stress, neuroses, and are depressed. The disease can arise due to difficulties in relationships with a partner, problems at work.
2. Vasculogenic. It occurs in men due to cavernous insufficiency, problems with blood vessels in which the flow or outflow of blood in the penis is impaired. There is a gradual decline in sexual function until it disappears completely.
3. Neurogenic. Caused in men by diseases of the brain, spinal cord or peripheral nerves.
4. Hormonal. It appears in men when the degree of testosterone absorption is impaired, which can occur with diabetes mellitus and many other diseases.
5. Mixed. It is caused in men by both psychological and organic reasons.
6. Medication. Occurs while taking antipsychotic, antihypertensive, antihistamine medications, antidepressants, antiandrogens, and drugs. It is characterized by a decrease in libido, which gradually leads to other problems.
7. Spinal. Occurs in men due to spinal injuries.

Causes

Eat great amount factors on which erectile function depends. The following are the reasons for its decline:

1. Endocrine. As a result of tumors, infectious and other diseases (thyroid problems, hypogonadism, obesity), the process of testosterone production is disrupted.
2. Medication. If a man takes drugs that affect the level of sex hormones, then he may experience a deterioration in libido. Typically, to resolve the problem, you need to stop the drug that is causing the problem.
3. Neurological diseases. Some diseases, autoimmune, spinal cord or brain, lead to loss of erectile function (multiple sclerosis, stroke, myelitis, nerve entrapment by a spinal disc).
4. Problems with blood vessels (atherosclerosis, varicose veins, thrombosis, vasculitis). Especially typical for older men.
5. Alcohol abuse, smoking, poor diet, intake sports nutrition with hormonal supplements.
6. Diseases of the male genital area. Cicatricial fibrosis, sexually transmitted infections, cavernitis, curvature of the penis, scrotal hernia, Peyronie's disease can cause this disorder.

Psychological reasons

A man's erectile function is highly dependent on his emotional state. Any stress, neurosis or depression can cause erectile dysfunction. Problems in the sexual sphere also begin with psychological dissatisfaction with your partner. For example, a man may have problems having sex with his wife, but there is no erectile dysfunction when interacting with other girls. Sometimes fear prevents sexual intercourse, for example, if this is the first contact with a new partner.

Penis injuries

As a result of a number of injuries, blood flow to the arteries of the penis is disrupted. Types of penis injuries:

1. Injury. Closed damage that can occur when falling from a height or fighting. As a rule, the site of the bruise is very painful, swollen, and covered with bruises.
2. Fracture. It can happen with a sharp bend in the penis, a heavy blow to it, or rough sexual contact. The cavernous bodies rupture, as a result of which a man develops this problem.
3. Burn.

Circumcision

In this procedure, a man's foreskin, a fold of skin that protects the head of the penis, is removed. If it is not there, then the nerve receptors are subject to excessive irritation, even when rubbing against clothing. As a result, the head of the penis loses its sensitivity, without which there will be no full erection. In addition, circumcision increases the risk of contracting infections that cause inflammation of the genital organs, which leads to impotence.

Plastic surgery of the frenulum

This is the name given to the longitudinal fold of skin between the foreskin and the head of the penis. The frenulum is necessary so that the head of the penis opens during arousal, does not move, and the bend is regulated. If it is too short, then pain and bleeding may occur during sex, but the most unpleasant phenomenon is premature ejaculation. This leads to persistent erectile dysfunction, but can be successfully resolved through simple plastic surgery.

Diagnostics

If a man feels that he has problems in the sexual sphere, then he should turn to specialists: andrologist, urologist, sexologist. They will conduct research for:

• confirmation of the presence of erectile dysfunction;
• establishing the severity of the violation;
• finding out the cause of impotence;
• identifying concomitant sexual dysfunctions.

The first stage of diagnosis is a detailed interview with the patient. It is necessary to determine the mental status and general state of health, to clarify the presence of diseases that can provoke erectile dysfunction in a man. It is imperative to obtain truthful information about the relationship with your sexual partner, and the ideal option would be to have a conversation with her too.

The next stage will be a clinical examination of the patient, which consists of assessing the condition of the reproductive, endocrine, cardiovascular and nervous systems. If pathologies are identified, a concomitant consultation with a specialized specialist should be scheduled. Another mandatory diagnostic measure is a physical examination: examination of the patient’s secondary sexual characteristics, external reproductive organs, measurement of blood pressure and pulse.

To identify erectile dysfunction, the following laboratory research methods can be performed:

1. Determination of testosterone levels. If hypodynamism or age-related hormone deficiency is suspected.
2. Determination of glucose and lipid levels.

According to strict indications, instrumental diagnostics are carried out, represented by the following studies:

1. Intracavernous test and echo Dopplerography of the veins of the penis. A special drug is administered to stimulate an erection and monitor the result at different stages.
2. Testing the innervation of the penis.
3. Selective penile arteriography.
4. Cavernosography.

In rare cases, additional studies are prescribed:

1. Ultrasound of the thyroid gland.
2. Computer or magnetic resonance imaging.
3. Neurophysiological tests.
4. Control of night tumescences with a special device. After the introduction of the intracavernous test, the study lost its relevance.

Treatment

Treatment tactics are selected taking into account the cause of the disease and are aimed, among other things, at its elimination. Treatment of impotence can be carried out with the participation of an endocrinologist, neurologist, psychologist and many other doctors. The main type of therapy for erectile dysfunction is medication, sometimes surgical intervention is advisable. In addition, treatment with special physical exercises and even traditional medicine (tinctures orally, compresses) are practiced. Each of the above methods should be discussed in more detail.

Medication

There are many drugs that increase blood circulation in the penis: tablets and capsules, creams, sprays. Characteristics of several of the most popular drugs:

1. Viagra (Sildenafil). Tablets to improve erection, affecting the cavernous bodies of the penis. The drug relaxes them and restores blood flow to the organ. The medicine causes a persistent erection. Take it about an hour before sex.
2. Levitra. Synthetic fast-acting drug.
3. Cialis. A medication that acts in the same way as Viagra, but much longer. For about a day, a man’s natural sexual needs will be fully supported.

Treatment with intracavernous injections is very effective. Before sexual intercourse, a drug is injected into the penis with a syringe to dilate blood vessels. This ensures a stable and long-lasting erection. Injection treatment is usually prescribed if the patient is not helped by tablet medications. There are also suppositories to increase potency, which are inserted into the urethra with a special device.

Exercises

Physical activity has vital importance for men's health. To increase potency, perform the following exercises:

1. Run in place. The toes do not come off the floor, only the heels rise. Perform the exercise several times a day. Start with one minute and gradually increase to five.
2. Straighten your back, slightly bending your knees. Tighten and relax your buttock muscles. Alternate actions several times. Gradually increase periods of tension.
3. Tighten and relax the muscles of the anus alternately. Start with 10 reps and gradually increase the load.

Folk remedies

Men who do not know how to treat erectile dysfunction can use numerous alternative medicine recipes:

1. Take 5-8 drops of Rhodiola rosea extract three times a day, half an hour before meals.
2. Chop 200 g ginger root 0.5 alcohol. Close tightly and leave in the dark for two weeks. Every evening, drink a solution of 10 drops of ginger tincture dissolved in half a glass of water.
3. Mix honey and crushed walnuts in equal proportions. Take 1 tbsp. l. the resulting mass three times a day. Drink half a glass of cow's or goat's milk.

Prevention

To reduce the risk of erectile dysfunction, follow these rules:

1. Control your weight. Follow a diet if necessary. Obesity should not be allowed.
2. Quit smoking, stop drinking alcohol or limit the amount of alcohol. Try to get rid of all bad habits.
3. Control your cholesterol levels and monitor your blood pressure.
4. Exercise.
5. Follow a work and rest schedule. Sleep at least 7-8 hours, try to go to bed at the same time.
6. Visit a men's health specialist periodically.

Video

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

What is erectile dysfunction, what are the causes of its occurrence and how to treat it? According to statistics, erectile dysfunction is observed in every tenth man under the age of 40; with age, the disorder manifests itself to one degree or another in almost half of the male population. At the same time, the numbers do not give a complete picture of the real picture, since not all representatives of the stronger sex go to the doctor with their problems, preferring independent treatment with the help of or synthetic drugs.

What is commonly called erectile dysfunction?

The term is used to refer to a male disease in which an erection necessary for full sexual intercourse is not maintained.

The following forms of the disease are distinguished:

1. constant lack of erection;
2. weak erection, which is not enough for insertion of the sexual organ;
3. inability to maintain a sufficient erection throughout sexual intercourse.

The disease can be primary (a full erection has never occurred) and secondary (when a patient who has not had problems with sexual activity, the number of sexual acts with a weak erection gradually increases and reaches 25% or more).

How does an erection occur?

To determine, you need to know how the process occurs. With a normal level of libido, a man experiences arousal in certain situations. A signal is transmitted from the brain to the genitals through nerve endings to increase the flow of incoming blood. Blood filling the free cavities of the cavernous bodies leads to hardening of the penis and an increase in its volume.

Accordingly, a decrease in libido, disruption of the nervous system or the circulatory system can lead to the disease. There are also some other causes of erectile dysfunction in men. All of them are divided into psychological and organic. Let's look at each of these groups in more detail.

Physiological causes of sluggish erection

There are several conditions under which normal erection is impossible. First of all, this concerns disturbances in the functioning of the cardiovascular system. These include various diseases of the heart and blood vessels, hypertension. Diabetes mellitus negatively affects the blood supply and functioning of the nerve endings of the penis.

Neurogenic factors include dysfunction of the brain and spinal cord and nerve endings. These can be a variety of head and spinal injuries, multiple sclerosis, Parkinson's disease, partial or complete paralysis.

A certain percentage of disorders cause hormonal imbalance in a man’s body. First of all, this concerns a decrease in the level of production of the male sex hormone. Erectile function is also negatively affected by improper functioning of the thyroid gland. At the same time, a lack of hormones produced by the gland is just as undesirable as their excess.

Taking certain medications can cause erectile dysfunction. Moreover, the same drugs, depending on a person’s individual tolerance, can have different effects on the body.

Particular attention should be paid to your condition while taking the following drug groups:

• diuretics (increasing the body's production of urine can affect blood pressure levels);
• antihypertensive drugs (used to lower blood pressure);
• fibrates ( medications to lower cholesterol);
• neuroleptics (used to treat mental disorders);
• hormonal drugs;
• antidepressants and antispasmodics;
• anticonvulsants;
• antihistamines (used to relieve allergy symptoms).

In cases where dysfunction is associated with the use of medications, you should try to find alternative drugs.

Sometimes dysfunction of the reproductive system is observed after surgery in the pelvic area.

According to statistical studies percentage The physiological factors that led to erection problems are distributed as follows:

1. diabetes mellitus – 33%;
2. vascular diseases – 24%;
3. psychogenic disorders – 20%;
4. surgical intervention – 10%;
5. head or spine injuries – 6%;
6. hormonal imbalance – 5%;
7. multiple sclerosis – 2%.

Physiological causes of erectile dysfunction are more often observed in men over 40 years of age, while among young representatives of the stronger sex, psychological factors come first.

Psychological factors of weak potency

Quite often, erection problems are caused by. A man’s emotional state and his ability to have sexual intercourse can be negatively affected by chronic fatigue, conflicts at work and at home, stressful situations, and depression.

The psychogenic form of the disease can be generalized and situational. The first type occurs predominantly in mature men and is associated with a natural decrease in libido. The situational form is associated with a decrease in attraction to a particular partner. This may be caused by a loss of sexual attractiveness or the presence of conflicts.

A fairly common psychological factor is the syndrome of expectation of failure. It is known that almost all representatives of the male half of humanity have had to deal with one or another erectile dysfunction at least once in their lives. However, some men take everything too seriously and begin to pay increased attention to the problem. As a result, before the next sexual intercourse, they have a fear of failing again, which ultimately occurs due to the inability to relax and receive pleasure.

Psychological causes of weak erectile function can be observed in those couples where intimacy is mandatory, or those who have been subjected to sexual violence.

At the first manifestations of erectile dysfunction, it is very important to establish the reasons that caused it. The choice of method by which treatment will be carried out will depend on this. Symptoms for dysfunctions of a psychogenic and organic nature are somewhat different.

Psychogenic disorder begins suddenly. A weak erection can be observed from time to time, and there is a clear dependence on the psychological state of the man, the specific sexual partner and the situation. Another sign of psychogenic dysfunction is morning and night physiological erections, as well as normal erections during masturbation.

The organic disorder develops gradually, becoming more and more aggravated. At the same time, weak erectile function is observed with every sexual intercourse and does not depend on the situation. Even in cases where a man still manages to achieve the hardness of the penis necessary to insert it into the vagina, the duration of the erection is not enough to perform full sexual intercourse. A characteristic feature is also the absence of morning and night spontaneous erections. At the same time, it is not possible to achieve hardness of the genital organ even during prolonged masturbation.

Treatment methods for erectile dysfunction

Before deciding on a treatment method for erectile dysfunction in men, it is necessary to establish the reasons that caused it.

With psychogenic dysfunction, it is often enough to protect yourself from stressful situations, have a good rest and sleep, and tune in to positive emotions. If you are not confident in your abilities, after consulting your doctor, you can try herbal or synthetic stimulants. The support and help of your partner is of great importance. In difficult cases, a man may be recommended to consult with specialists followed by psychotherapy. In most cases, this type of disorder can be eliminated fairly quickly, returning the patient to a normal sex life.

If weak erectile function is caused by organic causes, the disease that led to the disorder must first be treated. Modern medicine offers many methods to solve the problem. Among them, the most often recommended to patients are:

• Reception based on extracts and extracts from raw materials of plant and animal origin.
• Injections into the cavity of the cavernous body of the penis.
• Administration of prostaglandin E1 drugs through the urethra.

In some cases, a positive effect can be achieved by using a vacuum pump immediately before sexual intercourse.

If therapy does not give the expected result, the man may be recommended surgery. Operations are performed to eliminate vascular pathologies, as well as to install special implants.

It is worth remembering that the development of erectile dysfunction, like any other disease, can be prevented or significantly slowed down through regular prevention. To do this, it is necessary to give up bad habits, lead an active lifestyle, minimize the number of stressful situations and promptly treat all identified diseases, especially in the genitourinary system. Compliance with these rules will help maintain sexual health for many years.

In modern medical practice, erectile dysfunction (ED) is not considered a separate disease. This is a syndrome based on one or another men's health problem, which can be quite serious. Therefore, when symptoms of ED appear great importance has a comprehensive examination of the male body, which will help determine the exact cause of the pathology.

Impotence or erectile dysfunction

The scientific definition of erectile dysfunction is: “the inability to achieve/maintain an erection necessary to fully satisfy sexual needs.” We can talk about such a disorder if a man has problems in the sexual sphere for three months. ED is a relatively new term. It was proposed by American health experts instead of the familiar word “impotence”. The fact is that the old term sounds too categorical, burdens the perception of pathology and is not associated with the possibility of a successful cure.

WHO statistics are disappointing - about 10% of men over the age of 20 have erection problems. And among representatives of the older age category (over 60 years old), every third person is unable to perform sexual intercourse. In addition, there is a negative trend in this problem. Now, according to rough estimates, 150 million men in the world have ED. Doctors predict that in a quarter of a century this number may double. Data on the epidemiology of ED in Russian Federation are missing. But given the prevalence of bad habits, high level injuries, the practice of taking medications without medical consultation, it is not difficult to assume that the problem of erectile disorders in our country is very relevant.

According to medical statistics, only every fifth man suffering from ED consults a specialist. And only 37% of those who apply undergo the necessary course of treatment. Many people mistakenly believe that ED is not a medical pathology, but simply a manifestation of fatigue and nervous tension. That is, the pathology is very common, but men are in no hurry to seek help from specialists. They prefer to ignore the problem or engage in ineffective (and sometimes dangerous) self-medication. As a result, the disease progresses, and then it becomes more and more difficult to establish a normal sex life.
It is important to understand that erectile dysfunction cannot be considered on its own (as a separate urological diagnosis). It is necessary to take into account the general condition of the male body and involve medical specialists of different profiles in solving the problem. This will allow us to provide qualified assistance to patients with erectile dysfunction and achieve lasting positive results.

An erection is an increase in the elasticity of the penis with a simultaneous increase in its volume, which is caused by the rapid filling and stretching of the cavernous bodies as a result of sexual arousal. This mechanism is quite complex; it involves a number of sequential neurovascular changes, ultimately leading to relaxation of the smooth muscle tissue of the sinusoids, arterioles and arteries.

At the end of the 20th century, medical scientists obtained new information about the mechanism of erection and the causes of sexual dysfunction. This means that there are more ways to adequately treat erectile dysfunction in men facing problems in the sexual sphere.

According to the latest research, an erection occurs in the following way. Sexual stimulation activates the parasympathetic nervous system. Neurotransmitters (in this case, nitric oxide) are released from the vascular tissue of the corpora cavernosa, which causes the accumulation of cyclic guanosine monophosphate (cGMP) in the cavernous tissue, which reduces the concentration of intracellular calcium, which leads to relaxation of the walls of blood vessels and cavernous bodies. The lacunae fill with blood from the arteries, as a result the venules are compressed, and the outflow of blood from the penis is suspended. This phenomenon is called the veno-occlusive mechanism.

This gives grounds to identify the main causes of erectile dysfunction: a significant lack of cGMP, a reduced response of vascular tissues to cGMP, insufficient compression of the penile veins due to overgrown connective tissues. In complex cases, ED is caused by a combination of all these factors.

So, erection should be considered as a multi-stage neurovascular process that occurs according to the following scheme: sexual stimulation - release of neurotransmitters - accumulation of cGMP in the cavernous tissues - relaxation and contraction of smooth muscle tissues.

Causes underlying erectile dysfunction

Depending on the factors that influenced the development of erectile dysfunction, it is divided into three main types:

Mixed ED.

Main causes of impotence (table)

Male sexual problems have traditionally been associated primarily with a mental component. It was believed that stress and nervous tension directly affect the quality of sexual life. Today, a different point of view has emerged. Doctors have concluded that the vast majority of cases of ED (up to 80%) are caused by organic causes. That is, ED is a complication of any physical illness. It has been noted that erection problems are related to lifestyle. Factors such as physical activity and bad habits play a big role here.

Naturally, a man’s age has a certain impact on the quality of his sexual life. In an elderly person, testosterone levels drop, the speed of blood flow decreases, the nervous system is no longer so sensitive, and blood vessels lose elasticity. But these natural age-related processes in themselves cannot underlie erectile dysfunction. The main cause of sexual dysfunction is a more serious somatic illness. If a man does not suffer from chronic illnesses, he can retain the ability to have sexual intercourse until he is very old.

Multiple medical studies confirm the direct connection of ED with atherosclerosis, diabetes mellitus (DM) and arterial hypertension (AH). The presence of one of these pathologies increases the risk of ED several times. Some medical scientists even believe that erectile dysfunction may indicate the presence of one of these chronic illnesses in an initial latent form.

Erectile dysfunction and atherosclerosis

The blood vessels of a person suffering from atherosclerosis become less elastic, their lumen decreases. As a result of such changes, the male organ does not receive the amount of oxygen it needs. Significant risk factors in this case are dyslipidemia, diabetes, and nicotine addiction. About 60% of ED sufferers are experienced smokers. And hypercholesterolemia occurs in them twice as often as in people who do not have erectile dysfunction. Approximately 40% of men with atherosclerotic changes in the penile vessels experience difficulties in the sexual sphere after 50 years. Various complications of atherosclerosis can develop in parallel. For example, erectile dysfunction is often diagnosed in patients with coronary artery disease. The fact is that these pathologies are caused by the same risk factor – dysfunction of the penile and coronary vessels. This may explain the fact that in hypertensive patients without ED, cardiovascular pathologies are much less common than in patients with both hypertension and ED. If Doppler ultrasound has detected a significant decrease in blood flow, stress ECG tests must be performed before the course of ED therapy.

Erectile dysfunction and hypertension

Many researchers note that erectile dysfunction occurs more often in patients with high blood pressure. The combination of these two problems affects a man’s quality of life and makes treatment significantly more difficult. Thus, many hypertensive patients note a decrease in sexual function when taking medications that lower blood pressure and refuse antihypertensive drugs.

ED is especially often associated with taking OI-blockers and thiazide diuretics.
But it cannot be said that all types of hypertension medications lead to a high risk of erectile problems. Some drugs (in particular, angiotensin II antagonists), on the contrary, can increase a man's erectile capabilities. The positive effect of AA II on male sexual function is most likely associated with blocking angiotensin II receptors, which, as researchers have found, can stop spontaneous erections.

Erectile dysfunction and diabetes

Statistics on ED in diabetes mellitus are disappointing. In diabetics, erectile dysfunction occurs three times more often and begins on average 10-15 years earlier than in men without a diagnosis of diabetes. According to the latest data, more than half of men with diabetes suffer from erectile dysfunction. The risk of ED in diabetics increases steadily with age and is associated with the duration of the underlying disease. In young men with diabetes (under 30 years of age), the prevalence of ED does not exceed 15%. Among men from 30 to 60 years old, erectile dysfunction is observed in approximately half. As for the older age category (70 years and over), the vast majority suffer from ED - 95%. Moreover, erectile dysfunction most often occurs in men suffering from type 2 diabetes. The main cause of ED in diabetes is of an organic nature and is associated with polyneuropathy, micro- and macroangiopathy. Researchers also note that in men diagnosed with diabetes, erectile dysfunction is correlated with the content of glycosylated hemoglobin, retinopathy, peripheral and autonomic neuropathy.

Erectile dysfunction and hormonal disorders

Hormonal disorders also play a significant role in the occurrence of erectile disorders. Thus, it is noted that up to 35% of patients with ED have a lack of testosterone. Many metabolic disorders are associated with this: overweight, hypogonadism, etc.

Erectile dysfunction and chronic renal failure

Chronic renal failure (CRF) is another pathology that is commonly associated with ED. More than half of these patients complain of problems in the sexual sphere. Nocturnal erections have been studied in men with kidney failure, and it turns out that after dialysis, sexual function improves somewhat, but does not completely return to normal. The most effective solution in this case is a kidney transplant (if it functions without disturbances).

Erectile dysfunction and bronchial diseases

A connection was also found between ED and obstructive pulmonary pathologies. More than half of men with obstructive bronchitis and asthma experience erection problems. In addition, it is known that ED occurs in patients with ulcers duodenum(especially associated with helicobacteriosis), urinary infections, steatohepatitis. But research in these areas is still scarce.

Erectile dysfunction and stress

The dependence of ED on the mental state of the man has also been revealed. So, depression is a risk factor. Men suffering from moderate depression have a 25% chance of experiencing erection problems. In cases of severe depression, this figure increases to 90%. A severe shock (such as the death of a loved one) can also cause ED. But the most common psychogenic factor is a man’s lack of confidence in his sexual capabilities. This phenomenon is known as situational ED. In this case, the man is simply afraid to enter into an intimate relationship, believing that he may “disgrace himself” due to unsuccessful sexual intercourse. Another risk factor is aggression. Researchers have found that erectile dysfunction is quite common in men who are prone to anger attacks. We also must not forget that a combination of organic factors with psychogenic causes is possible.

In general, it can be argued that about 80% of all cases of ED are of organic origin and are a complication of some physical disease (diabetes, hypertension, chronic renal failure, atherosclerosis, etc.). ED is based on different mechanisms: vascular, neurogenic, and associated with side effects of medications. The dependence of erectile problems on the level of education and lifestyle is also important.

Male impotence is manifested by the following symptoms:

Problems achieving/maintaining an erection;

Weak erection;

The ability to maintain an erection only through conscious effort;

Morning erections weaken and occur less frequently.

Such problems are usually attributed to the personal sphere and kept secret from others. This is why most men with ED are in no hurry to share their problem with specialists and remain without treatment. In addition, many of them are sure that modern medicine is unable to fix anything. However, this is not true; erectile dysfunction can be successfully cured. According to statistics, treatment helps in nine out of ten cases. It was mentioned earlier that ED is not an independent diagnosis, but a manifestation of another disease. Therefore, therapeutic courses are prescribed taking into account the underlying disease. Moreover, treatment can be both medicinal and psychological.

Features of diagnosing erectile disorders

A comprehensive diagnosis of erectile disorders involves examining the patient, studying anamnesis, instrumental studies, and laboratory tests. To effectively collect the necessary information, patients are given special questionnaires. Questioning has two important advantages: it saves the doctor’s time and helps the patient not experience the feeling of awkwardness that is inevitable during a personal conversation.

In the Russian Federation, the ICF Scale (male copulatory function) is traditionally used, which was developed by O. B. Laurent and A. S. Segal in the 90s of the last century. The scale is designed primarily for the analysis of erectile dysfunction of an organic nature. It can be effective only under several mandatory conditions:

Having a regular sexual partner;

Sympathy for this partner;

Conditions favorable for sexual intercourse.

Mandatory laboratory tests for ED are testosterone and blood glucose levels. The level of prolactin, lipids, and PSA can also be determined.

Further examinations are recommended for men with primary erectile dysfunction, in order to exclude the organic nature of the disorder. They will also be needed if there is a history of injuries in the pelvic or perineal area.

The next diagnostic method is monitoring spontaneous nocturnal erections. As you know, a healthy man has up to six erections during REM sleep. Each episode of erection lasts 10-15 minutes. The total time of night erections reaches one and a half hours, that is, 20% of the duration of night sleep. In the case of ED, both the quality and quantity of spontaneous erections at night decrease. This makes it possible to use monitoring for the purpose of differential diagnosis of mentally caused and organic forms of erectile disorders. If the erection lasted less than 10 minutes, and its rigidity was only 60%, we can talk about sexual dysfunction. It is the study of spontaneous nocturnal erections that is considered today the most reliable method of qualitative and quantitative assessment of a man’s erectile ability.

Another informative diagnostic method in this case is ultrasound Dopplerography of blood vessels male organ . This procedure gives a good picture of blood microcirculation. And if carried out in B-mode, changes caused by Peyronie's disease and cavernous fibrosis can be detected. However, using the two modes separately does not provide accurate results. Therefore, they often resort to the duplex examination method. In addition, the effectiveness of the procedure largely depends on the technical level of medical equipment. The study of the arteries of the penis is performed twice: at rest and during an erection, which is achieved through visual stimulation (erotic video) or with the help of an erection-stimulating drug. Then the results obtained are compared.

The quantitative parameters of the study are peak systolic velocity and end-diastolic velocity (PSV and EDV). Using standard formulas, relative indicators are calculated based on absolute indicators: resistance index, pulsation index (RI and PI). It is considered normal if PSV is 30-35 cm/s, sometimes the lower limit of normal is lowered to 25. As a result of drug stimulation, the peak value for a particular patient is reached within 6-10 minutes.

For diagnostic purposes Viagra test can be combined with video stimulation, while conducting erection monitoring and monitoring hemodynamics in the penis using ultrasound. The main advantage of such an examination is that it is non-invasive and does not pose a threat of priapism. But the method also has a significant disadvantage. The fact is that visual stimulation does not make it possible to completely standardize the technique, because different patients require different stimuli for arousal.

Vasculogenic erectile disorders are detected using a special test that involves intracavernosal administration of vasoactive substances(most often alprostadil). The appearance of a full erection after 10 minutes, which lasts for at least half an hour, indicates that arterial and veno-occlusive hemodynamics are normal.

Some other studies are also being conducted for a number of indications. These include:
cavernosometry. The purpose of this method is to assess the elasticity of a sinusoidal system and determine its closing ability. To do this, a physiological solution is injected into the cavernous bodies, and its volumetric velocity is established, which is necessary for the appearance of an erection.

Cavernosography. The method involves examining the vessels through which blood is discharged from the corpora cavernosa.

Radioisotope phalloscintigraphy. Such diagnostics gives full picture hemodynamics in the cavernous bodies of the male organ.

Neurophysiological diagnostics(the bulbocavernosus reflex is assessed in patients with a damaged spinal cord or diagnosed with diabetes).

Unfortunately, many patients with erectile dysfunction are pessimistic. They do not believe that modern medicine can help them return to a full sexual life. Moreover, some doctors believe that the decline of sexual function with age is natural and is an irreversible process. However, studies show that accurate diagnosis and adequate courses of treatment help improve sexual function in 95% of patients.

The treatment regimen and correction of impotence is determined by the attending physician, depending on the diagnostic results and existing somatic diseases associated with ED. For example, men diagnosed with diabetes need safe glucose-lowering therapy. Those suffering from hypertension need to take antihypertensive drugs. In chronic obstructive pulmonary disease (COPD), adrenergic agonists and theophylline are discontinued, and anti-inflammatory inhalation treatment is indicated. Patients with chronic renal failure need to increase dialysis and prescribe a course of treatment for anemia. For patients with gastric ulcers, histamine H2 blockers are replaced with proton pump inhibitors.

Drug therapy for erectile dysfunction

The most effective treatment for organic and psychogenic erectile dysfunction at the moment are phosphodiesterase type 5 inhibitors (PDE5). During sexual stimulation, the nervous system is activated and NO is released. This leads to the accumulation of cyclic guanosine monophosphate (cGMP) in vascular smooth muscle cells. It was already noted above that it is he who triggers a chain of sequential reactions leading to the appearance of an erection. When the simulation stops, cGMP levels are reduced by phosphodiesterase-5. If due to any factors there is a lack of cGMP, then its destruction by phosphodiesterase-5 leads to erectile problems. The use of inhibitors does not have a direct relaxing effect on the cavernous bodies. The mechanism of action is different: as a result of PDE5 inhibition, cGMP levels increase and the relaxing effect of nitric oxide increases.

In domestic medical science there are a number of publications related to the use of Viagra (sildenafil citrate). Recently, another PDE5 inhibitor, tadalafil (Lilly/ICOS, Cialis), began to be used in Russian practice. It differs from sildenafil in several characteristics: chemical structure, selectivity, pharmacokinetic profile, clinical action. In terms of pharmacokinetic profile, the difference is significant: tadalafil has a much longer half-life than sildenafil. In every third patient who took tadalafil, the clinical effect is achieved already at the 16th minute and lasts for 36 hours. This allows the couple to freely choose the time for sexual intercourse. Let's say a man took the drug on Friday evening. Full intimacy is possible until Sunday morning, and a man can choose any moment that suits him. Another advantage of the drug is that its concentration does not decrease under the influence of alcohol and rich fatty foods. Therefore, the patient can adhere to his usual lifestyle.

The most common side effects that occurred while taking tadalafil were headaches and dyspepsia. In some cases, flushing to the face, nasal congestion, and back pain were recorded. No visual impairment was noted.

It is extremely undesirable to take tadalafil (as well as sildenafil) simultaneously with nitrates. The combination of these medications can cause a sharp drop in blood pressure in some patients. If an angina attack occurs while taking a PDE5 inhibitor, the use of nitroglycerin is strictly prohibited. The use of any nitrate is allowed only two days after taking tadalafil.

The prescription of tadalafil and sildenafil should be approached with caution if the patient has an anatomical deformation of the male organ or suffers from a disease that can lead to priapism (leukemia, sickle cell anemia, etc.).

A comparison of drugs: Viagra, Cialis, Levitra according to all characteristics and parameters was carried out in an article on our website.

Vascular surgery for erectile dysfunction

Most often, erectile dysfunction is associated with vascular pathologies. In many cases, surgical intervention is possible to help increase blood flow to the penis and impede its outflow. The effectiveness of such operations ranges from 20% to 80%.

Endoprosthetics

Most radical method eliminating erection problems - installing prostheses in place of the corpora cavernosa. There are such prostheses different types. The simplest prosthesis is a special semi-rigid rod. However, today doctors have more advanced devices at their disposal - special cylinders into which liquid can be injected. Significant disadvantages of the method are the risk of complications and the irreversibility of the operation.

Psychological treatments for erectile dysfunction

If erectile dysfunction is caused by psychogenic factors, a course of treatment with a psychotherapist who specializes in sexual problems. Such a specialist is called a sex therapist.

Erectile dysfunction (sexual impotence, impotence) is the main fear of all men in the world without exception. The inability to engage in sexual relations deprives a man of more than just the joy of sex. Such a problem devalues ​​a man in a woman’s eyes and causes serious harm to him. psychological trauma. We will talk about why sexual impotence develops and whether this disease can be cured in this article.

The essence of the disease

Sexual dysfunction is a pathological condition in which a man has a greatly weakened erection or no erection at all, which makes sexual contact impossible.

In the vast majority of cases, impotence occurs in men at the age of 60, and this is considered a completely normal phenomenon due to the aging of the body and changes in hormonal levels. However, if erectile dysfunction occurs in a young man, this is a serious reason to consult a doctor. True, it is worth understanding that one-time “misfires” happen to absolutely everyone, and therefore isolated cases of erectile dysfunction should not be considered a disease. We can talk about sexual impotence only if an erection cannot be achieved in every 4th case. Let's deal with possible reasons this condition.

Types of erectile dysfunction

It turns out that this disease has several types, which differ in causes, as well as in the approach to treating the disease. So, dysfunction happens:

• psychological (psychogenic);
• organic;
• mixed.

According to statistics, only 20% of cases of sexual impotence develop as a result of problems psychological nature. The remaining 80% is the result of serious diseases (diabetes, hypertension, autoimmune diseases).

Each type has a number of features. For example, erectile dysfunction caused by psychological problems usually appears suddenly. It can be triggered by severe emotional fatigue and emptiness, problems in partner relationships, or severe stress. At the same time, a man’s morning erection may persist.

As for organic erection problems, they do not develop immediately. A man begins to notice over and over again that it is becoming more and more difficult to maintain a normal erection. And this gives reason to believe that the problem is associated with some kind of disease. Organic erectile dysfunction also includes taking certain medications that negatively affect potency. In this case, the man retains sexual desire (libido), he can ejaculate, but at the right time an erection does not occur or the penis loses rigidity during intimacy.

It should be said here that if you notice changes in erections that become regular, you should not attribute everything to fatigue and stress. Erection problems in men of reproductive age are not the norm, and therefore do not hesitate to contact a specialist who will conduct the necessary diagnostics and be able to determine the cause of the ailment.

Causes of sexual impotence

Now let’s look at a number of reasons that provoke sexual impotence in men.

1. Endocrine diseases
Very often, the cause of lack of potency is hormonal imbalance, in particular, disruption of the production of testosterone, the most important male sex hormone. This can happen in the case of infections, genetic abnormalities, a tumor or injury. In these cases, it is enough to carry out hormonal therapy, as well as remove a tumor or eliminate the consequences of an injury, so that the man regains potency.

2. Taking medications
Taking certain medications, the side effect of which is a decrease in the production of male sex hormones, can also lead to erectile dysfunction. These may be medications that inhibit the activity of the cerebral cortex, as well as drugs and alcohol.

3. Neurological causes
This should include diseases of the peripheral nerves, as well as pathologies of the brain or spinal cord. For example, sexual impotence can develop as a result of head or spinal cord injury, in case of cerebrovascular accident, sclerosis, epilepsy, autoimmune diseases, as well as injuries to the pelvis and groin area.

4. Psychological reasons
Psychological causes of impotence lie in acute or prolonged stress, depression, neuroses, as well as problems with a sexual partner. Sometimes even ordinary physical fatigue turns into erectile dysfunction. Moreover, for some men, the lack of erection may be explained by fear of failure in bed or fear of intimacy with a new partner.

Other causes of impotence in men include vascular pathologies and injuries to the penis. That is, an erection may not occur or may not appear in full if blood flow to the organ is disrupted. This may be penial vasospasm (poor blood circulation in the vessels of the penis) or inflammation of the inner lining of the blood vessels, which is often found in smokers and people with autoimmune diseases. In rare cases, impotence can be caused by Peyronie's disease, an anatomical change in the opening of the urethra in the genital organ.

Penis injuries

In rare cases, sexual dysfunction develops as a result of trauma to the penis. For example, this situation leads to:

• Injury. This closed organ damage can be sustained in a fight, falling from a height, and even while doing physical exercise. As a rule, the inability to achieve an erection in this case is accompanied by problems with urination, pain during movement, swelling and the appearance of a hematoma. Treatment in this case consists of taking analgesics and applying compresses. If necessary, the doctor performs surgery.
• Fractures. Heavy blows, as well as sharp bends of the penis during sexual intercourse can lead to its fracture. In this case, rupture of the cavernous bodies occurs, which leads to the inability to achieve an erection. In this case, the man feels a painful shock, observes swelling and the formation of an extensive hematoma. Medical assistance in this case, it can vary from applying compresses to surgery.
• Subcutaneous hemorrhage. Typically, this problem appears in the case of prolonged sexual contact or non-standard forms of intimacy. In this situation, the blood vessels are damaged, resulting in swelling, hematoma and aching pain. This problem can usually be solved with cold compresses.
• Burn. Such damage to the genital organ can be caused by flammable liquids, chemicals and even ultraviolet radiation. In this case, the symptoms will depend on the degree of the burn (swelling or serious damage to the skin). The possibility of restoring an erection depends on the degree of damage.

Circumcision

Circumcision refers to a common operation in which the foreskin of men or boys is removed. Circumcision of the foreskin can be performed according to medical indications, as well as for religious or social reasons. However, in the absence of flesh covering the head of the penis, irritation of its receptors may occur (upon contact with underwear or while walking).

In addition, circumcision can lead to infection in the reproductive system, causing the development of impotence. By the way, doctors associate persistent erectile dysfunction after 40 years with circumcision.

Symptoms of erectile dysfunction

Symptoms of sexual impotence can be divided into several types. It could be:

• Violation of libido (sexual desire). This is the most common symptom and is usually associated with stress, feeling unwell or tired, as well as relationship breakdown or hormonal imbalances. In this case, the man loses sexual interest, and he simply avoids physical intimacy.
• Erectile dysfunction. Lethargy, incomplete erection, as well as its complete disappearance and the inability to complete sexual intercourse, hints at the development of vascular and other diseases.
• Violation of orgasm and ejaculation. This condition, medically called anorgasmia, is quite rare. Orgasms in this case may be too short or absent completely. This is due to psychological problems.

Diagnosis of the disease

First of all, the doctor interviews the patient to understand in which direction to carry out the diagnosis. To check the functioning of the nerves of the penis, an innervation procedure (pressure on the head of the penis) is performed. The result in this case should be an instant contraction of the anus muscles. If testing of innervation suggests a disturbance in the functioning of the nerves or the development of diabetes, the patient is referred for additional studies.

In addition, the doctor conducts a visual examination and palpation of the penis to identify possible bruises and fractures. The patient must submit general analysis blood, blood tests to determine sugar, cholesterol and testosterone levels. He is being measured arterial pressure, and if necessary, an ultrasound scan of the thyroid and adrenal glands is performed.

Treatment of erectile dysfunction

Therapy for an existing disease depends on the cause that caused it. If sexual impotence has developed as a result of hormonal disorders, you cannot do without taking hormonal medications or using gels with hormonal components. When impotence is caused by neurological causes, treatment of the underlying disease is required, after getting rid of which the erection will return. Eliminating psychological problems requires a special approach. Here it is important to achieve a trusting relationship between partners, as well as to help the patient cope with existing psychological difficulties. When erection is negatively affected by the anatomical features of the structure of the penis, the problem is solved surgically.

Drug treatment

A specialist can prescribe medications that stimulate blood flow to the penis and thereby improve erection. The most popular medications in this group are Vigara, Levitra and Sealis. True, it is recommended to use them only after a doctor’s prescription, since each of the medications has a number of serious side effects.

Intracavernosal administration of drugs

This therapy involves administering injections into the corpus cavernosum of the penis that dilate the blood vessels. The injection is performed immediately before sexual intercourse, but no more than one procedure is allowed per week. This method has few side effects and is characterized by inconvenience of use, but for people with serious illnesses this is practically the only way to have sexual intercourse.

Management of suppositories

There is another way to ensure an erection before sexual intercourse. To do this, half an hour before the intended intimacy, a suppository is inserted into the urethra, which ensures a high-quality erection. There is also inconvenience of use, which is complemented by the high cost of the drug.