Erectile dysfunction is the inability to get and keep an erection during sexual intercourse. This condition negatively affects sexual activity, making it inferior and leading to psycho-emotional disorders and a decrease in the quality of life. ED is diagnosed when the condition persists for six months.
This disease occurs quite often, every tenth man suffers from it. If this condition lasts more than three months, it must already be treated as a disease. This disease occurs in men of any age, but it is most common in men over 40. Men often refuse to visit a doctor and prefer to believe that they work a lot, get very tired, have a lot of stress, and all their failures in bed are associated with these factors.
Common ED Medications
Currently, there are various certified drugs that help to restore the erectile function or even completely pharmacologically replace the lifelong links in the mechanism of an adequate erection. Thanks to active advertising, today everyone knows the names of the most popular ED drugs – Viagra, Cialis, and Levitra.
These drugs have an identical principle of action. The active ingredients create conditions for the release of nitric oxide and relaxation of the smooth muscles of the penis. In addition, they stimulate blood circulation. The main action is a hard and long-lasting erection. Each of these drugs starts working when a man is sexually aroused. If a man does not feel an attraction to his partner, then an erection will not occur.
ED pills may not work immediately. It may take time to find the right dosage. Medications may be less effective in certain conditions, such as after prostate surgery or diabetes.
The general rule for all such drugs is that you can use them once a day.
Viagra was the first FDA-approved drug for the treatment of ED in 1998. The main active ingredient is sildenafil. Initially, it focused on the treatment of angina pectoris. But during clinical tests, it became clear that the drug copes with this function poorly. And then its positive effect on male potency was discovered. In 84% of cases, the user got a lasting erection after application.
The optimal dose of sildenafil is 50 mg. If there is no effect, you can increase the dosage to 100 mg. The higher dosage tablets should be divided into several parts. The duration of action is about 4 hours (this is also the half-life of the substance from the body). The effect – a very hard erection – appears 40-50 minutes after administration. You can drink alcohol only an hour after taking the drug. In extremely rare cases, the medicine can cause side effects, such as slight redness in the face and neck.
After the huge triumph of sildenafil, scientists continued to develop new drugs for impotence. Vardenafil was approved by the FDA in 2003. Levitra starts working after less than an hour. Most users also note its milder effect on the body.
The optimal dose is 10 mg, the maximum recommended dose is 20 mg. The duration of the effect reaches 12 hours. The effect on the body is similar to Viagra – a very hard erection occurs within half an hour after ingestion. A distinctive feature of the drug is its compatibility with alcohol. Side effects were detected only in 3% of cases.
The last of the three ED drugs was Cialis. It is based on the substance tadalafil, which has a very long period of action. In 2003, Cialis was approved for medical use in the United States. This is the only remedy that can be used daily. It is often used to treat benign prostatic hyperplasia.
The recommended dose is 10 mg, the maximum dose is 20 mg.
Cialis is a medicine with the longest action. The action can last up to 36 hours. The effect is observed within 15-20 minutes after administration. You can drink alcohol 15 minutes after using the product. Side effects were found in only 2% of cases.
Risk Factors for Erectile Dysfunction
A man’s erection depends on a number of mental, neurogenic, hormonal, vascular and anatomical factors. Accordingly, the causes of ED may be as follows:
- Mental disorders and diseases
Popular causes of psychogenic erectile dysfunction are strict upbringing, religious beliefs, fear of sex life, sexual perversions (perversions), depression, fear of aging, physical disabilities, a certain sexual preference of a partner, conflict with a partner, negative first sexual experience, an expectation of failure in contact with a partner, mental illness and some other conditions;
- Neurogenic factors
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, vascular diseases of the brain can lead to erectile dysfunction due to suppression of libido or excessive inhibition of spinal erection centers or nerve conduction disturbances at the site of the lesion that is involved in the emergence and maintenance of an erection necessary for sexual intercourse. Osteochondrosis, herniated disc, tumors, multiple sclerosis, the innervation of the penis can be disrupted, which also leads to erectile dysfunction;
- Endocrine factors
Endocrine diseases are most widespread and often detected in patients with erectile dysfunction. Patients with diabetes mellitus are most often treated. The causes of erectile dysfunction, in this case, are vascular problems and damage to peripheral nerves. Tumors of the hypothalamus and pituitary gland can also lead to a decrease in libido, a change in the level of hormones that are responsible for an erection. In a certain percentage of cases of the thyroid gland, it is directly and indirectly reflected in the man’s ability to have sexual intercourse. Recently, male aging has become relevant because with age, many physiological functions of a man fade away, and many of this group of patients want and have the opportunity to live a full sexual life. One of the first terms that appeared to describe age-related changes in men is the term “male menopause”, which is currently used quite widely as a description of a complex 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, hot flashes and sweating, sleep disturbances and other symptoms. But men do not have a clear age period for a decrease in the production of sex hormones, unlike women. Therefore, the use of the term male climax is not correct because this condition has a blurred and gradual beginning in men. Therefore, the term male menopause should be considered as age-related androgen deficiency;
- Cardiovascular disorders
Pathology of the arteries and veins of the small pelvis, arteries and veins that supply the penis with blood can lead to poor blood supply to the corpora cavernosa. Arterial pathology is most often caused by stenosis or atherosclerotic lesions of the arterial wall, as a result of which blood perfusion through the cavernous bodies of the penis decreases. Patients with arterial insufficiency most often note a weak erection and difficulty maintaining it. With pathological venous outflow, patients also note the weakness of an erection soon after its onset;
- Use of certain medications
Sometimes certain medications can lead to erectile failure. Most often these are sleeping pills, sedatives, antidepressants, hormones and anabolic steroids, blood pressure-lowering drugs (diuretics, beta-blockers, ACE and Ca-channel inhibitors), and other drugs. Therefore, such patients need to correct prescriptions by canceling or replacing drugs.
Methods for Detection and Diagnosis
- Organic forms are treated by urologists, psychogenic – by psychiatrists and/or sexologists. In most cases, a urologist examination can help to choose the treatment tactics;
- Physical examination. Examination, palpation of the penis and testicles, testing of nerves for sensitivity;
- Blood and urine tests. These tests are needed to check the state of the cardiovascular and endocrine systems, diabetes, or other diseases;
- Ultrasound procedure. It is sometimes combined with an injection of special drugs into the penis to stimulate blood flow. Thus, the blood supply to the organ is assessed;
- Psychological test. It helps to identify depression or other possible psychological causes of the disease.
Measures for the general prevention of erectile dysfunction include:
- balanced and rational nutrition, rich in vitamins and trace elements, essential amino acids, and polyunsaturated fatty acids;
- observance of the work and rest regime; first of all, it’s proper sleep;
- physical activity, sports, including in the fresh air;
- absence of prolonged stressful situations at work and at home;
- refusal from alcohol abuse (including beer), from smoking and taking narcotics;
- timely prevention and treatment of diseases leading to erectile dysfunction (hypertension, atherosclerosis, diabetes mellitus, obesity, etc.).
Separately, it is necessary to name food products that improve erectile function and can be used as ED prevention: food rich in fat and water-soluble vitamins (olive and sunflower oil, nuts, rose hips, currants, fresh vegetables and fruits, cereals and legumes), sources omega-3 polyunsaturated fatty acids (fish oil, sesame, corn oil) and essential amino acids (milk and fermented milk products, quail eggs, meat, and fish). Of course, these are only natural ingredients, not genetically modified products. You should remember that overeating is also a direct path to potency disorders.
Erectile dysfunction is often the result of some disease or disorder in the regulation of the erection process. Violations rarely occur instantly. Therefore, if you notice the first symptoms of erectile dysfunction, you should immediately consult a doctor. It’s important not to miss the moment to start a timely, effective and safe treatment.