Symptoms of impotence and ways to diagnose erection problems

Content:

1. First signs
2. Signs of the disease depending on the type of impotence
3. Symptoms of the disease depending on the cause
4. Neurogenic symptoms
5. Vascular diseases
6. Anatomical reasons
7. Hormonal type
8. Signs of mild impotence
9. Diagnosis and treatment
10. Diagnostic methods
11. Treatment methods
12. Conclusion

Erectile dysfunction is a disorder in which the ability to perform sexual intercourse is partially or completely lost. Previously, this condition was called impotence, and it was attributed to age-related changes in the body, but the number of relatively young men with this diagnosis is steadily growing.

Erectile dysfunction is diagnosed if more than a quarter of sexual intercourses are unsuccessful. Pathology can be both psychological and physiological in nature.

Symptoms and signs of erectile dysfunction help to accurately diagnose and begin effective treatment. After all, the more accurately and earlier the cause of erectile dysfunction is determined, the higher the chance of restoring sexual functions completely.

First signs

Symptoms of erectile dysfunction typically occur in men over 60 years of age. However, the busy rhythm of life, poor environment and bad habits lead to the fact that young and middle-aged people are increasingly suffering from impotence. Signs of the disease are observed in every third man aged 18-60 years. Initial signs of disease development:

Sexual impotence

• Lack of erection. Sexual impotence can be associated with psychology and physiology. If a man lacks not only adequate, but also spontaneous erection, the reason lies in the physiological nature of the pathology. However, if spontaneous erections are present, then sexual impotence is psychological in nature.
• Weak erection. Another initial sign is a decrease in the frequency of erections and the hardness of the penis. This may be due to hormonal, vascular or neurogenic disorders. Weak erections are rarely associated with psychological problems.
• Premature ejaculation. Weak erectile dysfunction also manifests itself in the form of premature ejaculation. This condition is an uncontrolled release of sperm at the beginning of sexual intercourse. This is due to physiological problems, most often with vascular pathologies.

The first symptoms of erectile dysfunction most often occur against the background of psychological problems. It is easier to treat erectile dysfunction if you consult a doctor in time, who will prescribe tests and studies to identify the causes of the pathology.

Signs of the disease depending on the type of impotence

Sexual function in men can be impaired for a number of reasons. The types of impotence have several directions, allowing you to understand the causes of erectile dysfunction. Each type has its own signs and symptoms:

Stress and overexertion at work

• Psychogenic. The cause of dysfunction is stress and nervous tension. Another common reason is a tense relationship with a sexual partner. In this case, symptoms include difficulty having sexual intercourse. However, morning and night erections persist;
• Organic. Pathology is associated with diseases of the reproductive or other body systems. In this case, there is an increase in the symptoms of the pathology associated with the development of internal diseases. In this case, not only psychological therapy is required, but also treatment of the underlying disease. Symptoms also include a lack of spontaneous erections, as well as loss of penile rigidity;
• Mixed. The causes of this pathology are extensive, and the symptoms can combine signs of both psychogenic and organic dysfunction.

Symptoms of the disease depending on the cause

Disorder of male sexual function can be both psychological and organic. It is the latter type that is caused by various diseases and injuries. The cause of the problem can be determined based on the characteristic symptoms.

Neurogenic symptoms

The cause of impotence can be pathologies of the nervous system, injuries to the parasympathetic nerves or the penis. Most often, impotence occurs due to injuries to the lower spine.

May result from multiple sclerosis, diabetic or alcoholic neuropathy. The cause may also be an unsuccessful operation of the pelvic organs, which damages the autonomic fibers.

Symptoms most often include a complete absence of erections.

Dysfunction in old age

Vascular diseases

Occurs when there is a disruption in the blood supply to the penis. The cause is injury or atherosclerosis of the arteries. In this case, the tension in the penis is insufficient or occurs too slowly. Therefore, a full erection does not occur. The reason for a weak erection may be damage to the connective fibers of the penis.

Anatomical reasons

Dysfunction is associated with a violation of the anatomy of the penis, most often with its curvature. Signs of such a pathology may be incorrect position of the penis during sexual intercourse and painful sensations during erection. Anatomical causes also include fibrosis of the corpora cavernosa of the penis, associated with trauma, surgery, or the introduction of foreign bodies into the urethra.

Hormonal type

The reason is a decrease in testosterone levels, which affects the sexual function of men. And its level, in turn, depends on the level of the enzyme responsible for the synthesis of nitric oxide, which causes vasodilation.

At a young age, the cause can also be various endocrine diseases that affect hormone levels. A decrease in testosterone levels leads to disruption of the veno-occlusive mechanism. Signs of the disease include the complete absence of even spontaneous erections.

In addition, this type of impotence cannot be treated with Viagra or similar drugs.

Signs of mild impotence

Many men with erectile dysfunction try to solve the problem on their own

The manifestation of dysfunction can be either complete or partial. Partial impotence may consist of an inability to achieve an erection or ejaculation every time, as well as a reduction in the period of erection. With a mild form of the disease, the symptoms may disappear on their own, but over time the disease can develop into an advanced form.

However, many men with erectile dysfunction try to cope with it on their own, using widely advertised drugs, dietary supplements and various mechanical devices.

But self-treatment can only temporarily improve the situation.

Therefore, even the initial signs of erectile dysfunction should cause serious health concerns, because the decrease in the frequency of erections occurs in stages, and ultimately leads to a complete inability to perform sexual intercourse.

Diagnosis and treatment

Every man believes that the quality and long-lasting erection is an indicator of his strength and courage.

Therefore, only every tenth man consults a specialist when he develops symptoms of erectile dysfunction. In other cases, men are embarrassed to talk about their problems with their partner or doctor.

But in most cases, with timely consultation with a doctor, sexual disorders can be cured.

Diagnostic methods

It is necessary to pay attention to your health and visit an andrologist in a timely manner. It is this specialist who deals with the problems of erectile dysfunction.

First of all, the doctor must determine whether problems in the sexual sphere are a consequence of the inflammatory process of the bladder or prostate gland. To do this, you will need to visit a urologist.

Additionally, it is necessary to undergo an ultrasound of the pelvic organs, a general blood test to determine the presence of inflammation and a bacteriological smear.

At the first signs of changes, you should consult a doctor

If there are no signs of inflammation, it is recommended to visit an endocrinologist. The doctor will order hormone tests. Their level and relationship with each other may indicate hormonal imbalance - one of the common causes of impotence in older people.

To identify vascular pathologies that can cause sexual disorders, it is necessary to undergo Doppler ultrasound. This research method shows the quality of blood supply to the penis.

Treatment methods

After identifying the cause of the disease, treatment is prescribed, which can be medicinal, psychological, surgical, physiotherapeutic and hormonal.

Taking Viagra

If symptoms of impaired potency occur in men, treatment may consist of taking Viagra. However, this is not a panacea, but only a way to artificially create an erection.

However, the drug has a number of side effects, including headache, exacerbation of cardiovascular diseases or changes in color perception.

In addition, taking Viagra without consulting a specialist is dangerous to life and health.

A safer and more effective treatment method is shock wave therapy. Shock wave therapy is a non-invasive treatment method that involves applying a device that generates special shock waves to a specific area of ​​the penis.

At the same time, fibrosis softens, which impairs blood circulation. By following the doctor's recommendations and completing the entire course of treatment, the mechanisms for restoring potency are activated.

However, in some cases, treatment consists of surgical installation of special prostheses, selection of stimulants, or intracavernosal injections.

If impotence is caused by psychological factors, then treatment consists of consulting a sex therapist and psychotherapist.

Conclusion

Erectile dysfunction can occur in every man, regardless of age, number of sexual partners or social status. At the first signs of pathology, you should consult a doctor who will prescribe appropriate diagnosis and treatment.

The development of impotence can be prevented by giving up bad habits, maintaining normal physical activity and the basics of proper nutrition. It is important to treat inflammatory processes in a timely manner and regularly visit a urologist.

Source: https://funkit.ru/potenciya/erekciya/osnovnye-priznaki-i-simptomy-erektilnoj-disfunktsii.html

Weak erection and poor penis erection: causes of problems, what to do, treatment of weak erectile function

Weak erections can be temporary or permanent. In the first case, the problem is associated with stress, psychological discomfort, and inflammatory diseases of the genitourinary system, which can and should be treated. If the penis is unable to become excited for a long time and maintain the hardness necessary for sexual intercourse, then this may indicate serious pathological processes occurring in the body. Sexual disorders, no matter what the cause, should be a reason to contact a specialist: if you ignore the problem, the outcome may be impotence and infertility.

Characteristic symptoms of weak erection

Erectile dysfunction is a problem that can affect not only older but also young men. This is due to the fact that, along with age-related changes, potency is affected by lifestyle, bad habits (the effect of smoking on potency), the presence of various diseases, especially if they are chronic, and taking medications.

A flaccid erection manifests itself in characteristic signs, which include:

1. Periodic lack of erection in the morning (a similar symptom appears in some cases if the reasons for the deviation are quite serious);
2. Premature ejaculation, in which the penis is not erect;

Why do men have problems with erection? More details from immunologist Georgy Aleksandrovich Ermakov:

1. Lack of spontaneous erection and its occurrence only with strong stimulation;
2. Incomplete hardening of the penis during sex;
3. The likelihood of loss of hardness in the penis at any time during sexual intercourse.

Weak erection and impotence are different concepts.

In the first case, a man only partially loses the ability to have a full sexual life: he experiences a general weakening of potency, although the ability to feel arousal remains, and an erection, although not too pronounced, is still present.

With impotence, the penis does not become hard and elastic even under conditions of strong arousal and stimulation. We are talking about the occurrence of such a deviation if the manifestations of erectile dysfunction persist for 3-6 months.

Causes of decreased erectile function

Poor erection, that is, insufficient penis hardness, makes it impossible to have full sexual intercourse. If a healthy man experiences an enlargement of the penis when excited, then for those who suffer from problems of a physiological or psychological nature, an erection may not occur at all or be very weak, despite the intense caresses of their partner.

Combating this phenomenon is important not only to improve the quality of sexual life: experts say that for every member of the stronger sex, failures of a sexual nature cause severe stress, which often leads to suicidal thoughts.

It is possible to explain why the penis is weakly erect by considering the pathological reasons. These include the following:

• Nervous breakdowns, intense mental activity, neuroses, depression. Emotional tension can arise directly during sexual intercourse and cause fear of contracting sexually transmitted diseases during unprotected sexual intercourse or conceiving a child;
• Insufficient distrust of the sexual partner, feeling of discomfort due to incompatibility of sexual preferences;
• Long-term abstinence (what long-term abstinence in men leads to);
• Alcohol abuse, drug use;

• Insufficient physical activity;
• Obesity;
• High blood pressure;
• Work involving prolonged sitting;

• Taking steroid drugs. Similar products are used to build muscle mass. But, while helping to “build” a strong body, steroids stop the process of testosterone production. The result is weak erection, and in the most advanced cases - complete sexual impotence;
• Venereal diseases. Often, sexual dysfunction is observed after gardnerella (read about the treatment of gardnerella in men here);
• Poor nutrition, in which the diet contains insufficient amounts of vitamins and nutrients;

• Diabetes. This disease is directly related to weakening of erection: in diabetes, blood flow in the vessels is disrupted, which reduces the sensitivity of the head of the penis and complicates the process of ejaculation;
• Long-term use of certain medications that suppress testosterone production (antidepressants, diuretics, antihypertensive medications);
• Diseases of the cardiovascular system. In the presence of such pathologies, there is a disturbance in the movement of blood through the vessels. As a result, the penis is insufficiently supplied with blood, so there are no conditions for maintaining a long, strong erection;
• Anomalies of the male genital organ that are congenital in nature (curvature, specific structure);

Urologist Ekaterina Makarova will tell you why male circumcision is done:

• Neurological diseases (epilepsy, Parkinson's disease);
• Circumcision. Problems with erection in this case arise only when circumcision is performed incorrectly or carelessly. If everything was done correctly, then potency only improves: the duration of sexual intercourse doubles, and the erection remains for a long time;
• Spinal injuries;
• Injuries of the penis and pelvic organs;
• Hormonal imbalances associated with dysfunction of the endocrine system;
• Diseases of the genitourinary system (in particular, chronic prostatitis and prostate adenoma).

The causes of poor erection are varied, so it is impossible to identify them on your own, without carrying out appropriate diagnostic procedures. If you notice symptoms that indicate a decrease in sexual performance, you should immediately contact a urologist.

Identifying reasons for deviation

Poor erection is a serious abnormality that you should not be ashamed of. When the first signs of sexual weakness appear, it is necessary to contact a specialist and find out the reason that provoked it. Delay leads to a complete inability to fully engage in sexual activity and a deterioration in general health.

To determine the course of adequate treatment, the doctor first prescribes a series of tests for the patient. This:

1. Blood composition analysis to determine diabetes mellitus, atherosclerosis;
2. Urinalysis, which detects most inflammatory sugar diseases;
3. Determination of the level of male and female sex hormones in the body, as well as their ratio;

1. Cavernosography, an X-ray examination of the penis in an excited state, which is carried out with the introduction of a contrast agent into the blood;
2. Studying the condition of the vessels passing through the penis area, as well as the blood circulation of the organ as a whole. This is done using Doppler ultrasound and prostaglandin tests;
3. Neurological examination. Such methods make it possible to determine the presence of pathologies of the brain or peripheral nervous system, which could affect the functioning of the male reproductive system.

After the research, appropriate treatment is prescribed.

Restoring erection with the help of medications and folk remedies

Medicine offers several types of measures to correct the condition in which the penis is poorly erect. The therapeutic course depends on the cause that provoked temporary or stable sexual impotence, as well as on the general condition of the patient.

In most cases, the basis of treatment is taking medications that improve blood supply to the pelvic organs, stimulate sexual desire, and suppress inflammatory processes that spread to the organs of the genitourinary system.

The following drugs are used during therapy:

• Phosphodiesterase-5 inhibitors are pills that stimulate blood flow to the penile area. They are used either occasionally, to gain the opportunity to fully complete sexual intercourse, or as a course. Such drugs include Sildenafil, Viagra, Cialis, and Dynamiko. It must be taken into account that such drugs have a number of side effects. That is why they should be used only as prescribed by a doctor and in the indicated dosage;
• “Alprostadil” is a drug that is injected intravenously, directly into the penis, and improves blood flow to the genital organ;
• Hormonal agents that compensate for the lack of testosterone in a man’s body.

Viagra is widely used to combat circulatory disorders, helps restore vascular function and improve erection. Price in pharmacies from 537 rubles.

If a sluggish erection is associated with impaired blood circulation in the penis, which is caused by injuries or congenital anomalies in the structure of the organ, surgical intervention is performed. It may involve cutting pathological vascular plexuses that slow blood flow or installing prostheses that cause an erection.

Unstable erection can also be corrected with folk remedies, before using which you should consult a specialist. The most popular methods of treating sexual impotence at home are:

1. Tonic drink with lemon and ginger. To prepare it, take 100 ml of mint decoction and 2-3 cm of grated ginger root. Add a tablespoon of honey and a slice of lemon to this composition. All components should be poured into a glass of boiling water and drunk instead of tea;
2. Walnuts. It is enough to clean them and use them as an independent remedy. The required rate is 15 kernels per day;
3. A weak decoction of oak bark. Take 20 g of fresh raw materials per liter of water. Take 3 times a day, replacing tea with this decoction.

Dear readers, in this video we will share with you traditional medicine recipes to increase potency:

Traditional medicine can only be used as an aid: to cope with poor potency, more radical methods are required.

Erection problems affect not only the physical, but also the mental state of a man. If they are not addressed, they can worsen and lead to infertility and impotence. Modern treatments help get rid of erectile dysfunction. The sooner a man turns to a specialist, the faster the functioning of the reproductive system organs will improve.

Rate this article: (4

Source: https://VashUrolog.com/potenciya/slabaya-erekciya.html

Erectile dysfunction: diagnosis, what tests to take for neurogenic and other

Based on the characteristics of the pathophysiological mechanisms that are the basis for the occurrence of sexual dysfunction, it is customary to classify its root causes. Pathologies of an organic nature, one way or another related to the functioning of visceral organs and systems, are divided into:

1. vascular. A local decrease in the blood pressure of the blood vessels of the hematomicrocirculatory bed (BPSS) becomes the root cause of insufficient blood supply to the cavernous bodies, and constriction of smooth muscle cells opens the paths through which passive venous outflow occurs. That is, a decrease in erectile function or its complete disappearance can be caused by hypertension, and can also be a symptom of obliterating endarteritis, atherosclerotic lesions of small vessels, diabetes mellitus, heart failure and various types of coronary artery disease.
2. neurological. Pathologies of the parasympathetic pelvic visceral nerves and organic disorders of the nerve pathways can cause discirculatory disorders, a decrease in the pressure of the vessels of the cavernous bodies, and impaired ability to carry out full sexual intercourse. Potency is directly or indirectly affected by neurological disorders observed in pathologies of the peripheral and central nervous systems (in particular, with stroke, lesions of the spinal cord and brain, protrusions and hernias of the vertebrae, as well as with TBI).
3. endocrine. Here we are talking about hyperplolactinemia, hyperestrogenemia, as well as testosterone deficiency.
4. Iatrogenic. The action of some medications leads to a decrease in potency levels. Beta-blockers and antipsychotics showed their worst performance here.
5. toxic. The effect of harmful substances is detrimental to potency.
6. psychogenic causes of decreased “male strength” are associated directly with the central suppression of the physiological mechanism of erectile function.

The most common of these are the following conditions:

• Increased anxiety;
• Lack of sexual arousal;
• Neuroses;
• Psychopathological conditions (depression, schizophrenia).

There are several reasons leading to erectile dysfunction:

• diseases of the cardiovascular system: hypertension, coronary heart disease, atherosclerosis, endatheritis, etc.;
• disruption of the endocrine system: hypogonadism (insufficient amount of testosterone), diabetes mellitus, hypothyroidism, hypo- and hyperplasia of the adrenal glands, tumor in the pituitary gland, etc.;
• pathologies such as deviations in the development of the genital organs, diseases of the prostate gland and bladder, renal failure, etc.;
• neurological failure: depression, epilepsy, Parkinson's disease, multiple sclerosis, consequences of trauma and surgery of the brain and spinal cord, pelvis and perineum;
• side effects of certain medications: diuretics, beta-blockers, antihistamines, etc.

Psychological factors are a common cause of impotence in men. In this case, the patients’ normal sex life is impossible due to psychoneurological problems.

Based on this, we can distinguish the following forms of erectile dysfunction:

1. Psychogenic
2. Endocrine
3. Vascular

Psychogenic factors are a problem in 30% of all cases of impotence. During treatment, the patient attends consultations with a psychotherapist and undergoes physiotherapeutic techniques.

Vascular - account for 70% of cases of men’s inability to perform or complete sexual intercourse. Approximately 1/3 of these cases are associated with impaired arterial function, 1/3 are associated with venous disorders, and 1/3 are associated with mixed arterial-venous forms.

An imbalance of the endocrine system consists of disorders of both psychogenic and vascular factors.

In the scientific world, experts more often use the term “erectile dysfunction.” The word "impotence" is now considered obsolete. The reasons that cause the appearance of this sexual dysfunction are divided into 2 types - psychogenic and physiological.

Psychogenic causes include fear of intimacy, depression, stress, anxiety, excitement, and fear of being unable to satisfy a partner.

Physiological causes of erectile dysfunction:

1. bad habits (smoking, drinking alcohol and drugs). Smoking first causes atherosclerosis. With this disease, the diameter of the lumen of the blood vessels decreases and the flow of blood to the genitals weakens, which causes impotence. In the future, atherosclerosis leads to the appearance of coronary heart disease. Alcohol negatively affects the areas of the brain that regulate the process of erection. Drugs deprive nerve endings of sensitivity and make sex an uninteresting activity;
2. diseases of the cardiovascular system. They are harmful because they disrupt the flow of blood to the cavernous bodies of the penis and impair erection;
3. sedentary lifestyle. The harm to an erection is that blood stagnates in the pelvis, it stops circulating in the genitals;
4. hormonal imbalance. Diseases of the endocrine glands reduce the level of sex hormones;
5. neurogenic diseases. Diabetes mellitus, Parkinson's and Alzheimer's diseases. Thus, in diabetes, the flow of blood to the cavernous bodies is weakened, and in addition, the nerve endings of the peripheral nervous system are damaged. The sensitivity of sexual sensations is weakened;
6. cavernous disorders. This is an anatomical deformation of the genital organ, which makes the onset of an erection impossible.

Instrumental examination

Despite the emergence of new diagnostic methods, their use is limited to particularly complex cases. The most common method of examination is ultrasound to measure the blood flow of the penis, including after the use of drugs.

The computerized system "Rigi-Scan" allows you to assess the frequency and duration of arousal of the penis during the rapid phase of sleep.

Normally, about 5 episodes of approximately 10 minutes each appear per night.

With erectile dysfunction, the quantity and quality of erections decreases; their disappearance is a sign of vascular disease, nervous system disease, and hormonal imbalance. In case of psychogenic impotence they are preserved.

We suggest you familiarize yourself with: Smoking and potency • The effect of smoking on potency

In the absence of a device, rings made of a special elastic material are used. The patient puts them on the penis before going to bed; when an erection appears, they break. This method is indicative and does not allow one to judge the degree of violations.

Two processes are studied - blood inflow and outflow. With vascular diseases associated with atherosclerosis of the arteries, the flow of blood into the penis is reduced.

A rapid decline in erection is associated with increased blood outflow through dilated veins.

Arterial pathology is then clarified using angiography, and venous pathology is clarified during cavernosography (filling of the cavernous bodies with blood) using CT or MRI.

Ultrasound of the vessels of the penis

A complete determination of the neurological status is carried out by a neurologist. The andrologist excludes or confirms the neurogenic nature of erectile dysfunction. For this purpose it is determined:

• Bulbocavernosus reflex. Squeezing the tip of the glans penis causes contraction of the anus. The absence of such a reaction occurs in diseases of the spinal cord.
• Vibration, tactile sensitivity (biotesiometry). Reduced when nerve fibers are damaged.
• Vegetative tests - deep breathing and its effect on pulse, pupillary reactions to light. Their disturbances may be a sign of changes in the balance of the sympathetic and parasympathetic nervous systems.

If abnormalities are detected, a more in-depth examination is recommended. It includes:

• study of the function of the perineal muscles (electromyography);
• study of the conductivity of the nerves of the sacral plexus;
• registration of brain function in response to genital irritation;
• electrical stimulation of the cortical centers of the brain and determination of the response of the penis.

The introduction of drugs (Prostaglandin, Papaverine) into the cavernous bodies (filled with blood during erection) of the penis should cause compaction of its tissues. The absence of such a reaction is a sign of the vascular form of impotence.

Administration of drugs into the corpora cavernosa

With its venous variety, an erection appears, but does not last more than 5 minutes; with its arterial type, the blood supply to the penis is initially weakened. Tests can also be carried out with Viagra tablets taken orally against the background of visual stimulation (for example, viewing an erotic magazine).

A radioisotope is injected intravenously and its distribution in the corpora cavernosa of the penis, as well as the rate of excretion, is assessed using a gamma camera. The method allows you to evaluate blood circulation and identify the vascular form of erectile dysfunction.

What tests should men take?

Laboratory diagnostics includes blood testing for:

• Determination of testosterone. If it decreases, you need to find out the level of hormonal imbalance. This requires tests for luteinizing hormone, follicle-stimulating hormone, estradiol, prolactin.
• Thyroid hormones - thyroxine, triiodothyronine and thyrotropin, which controls their synthesis.
• Adrenal cortisol, corticotropic hormone.

It is imperative to determine the risk of developing cardiovascular diseases and diabetes, since erectile dysfunction can be an early indicator of their latent course. If they are present, sexual function will not improve significantly without appropriate treatment.

On the other hand, it is important to understand whether increased sexual activity will be a factor in complications (stroke, heart attack). Patients are advised to study:

• general blood test, urine test;
• blood lipid spectrum - cholesterol, lipoprotein complexes, triglycerides;
• carbohydrate metabolism - fasting blood glucose, after a sugar load (glucose tolerance test), if necessary - glycated hemoglobin, insulin, C-peptide.

If deviations from the norm are detected, it is necessary to undergo an examination by a cardiologist and a consultation with an ophthalmologist.

To determine the causes of erectile dysfunction, it is necessary to carry out a certain number of procedures that will confirm or deny the presence of serious diseases, such as diabetes or hypogonadism. At the same time, the diagnosis of potency in men at 40 years old does not differ from the diagnosis at 20 or 50 years old.

Conversation with the patient

If a man experiences the first symptoms of erectile dysfunction, he should be examined by a urologist. He will ask some questions with which he will draw up a medical record. Here is a sample list of questions:

1. Are you currently taking any medications? These include both synthetic and natural dietary supplements.
2. Do you have psychological problems – fear, anxiety, depression, stress?
3. When exactly did you notice that your erection began to weaken?
4. What is the nature of the erection - frequency, duration, quality.
5. Do you have night or morning erections?
6. Are there problems in your relationship with your partner?
7. How many sexual partners do you have?

Source: https://medicinf.ru/analizy-impotentsii-kakie/

Erectile dysfunction (impotence): causes, diagnosis and treatment

Sexual health is important not only from a medical aspect, but also from a social one, since dissatisfaction with intimate life has a direct impact on the nervous system and human behavior. Sexual incompetence can become relevant for any man.

To prevent the development of impotence, it is important to recognize its first symptoms in time: lack of night or morning erections, recurring problems maintaining the shape of the penis during sexual intercourse, delayed ejaculation.

Timely diagnosis of erectile dysfunction will help restore a man not only to physical health, but also to self-confidence.

Content

• Classification and reasons
• Diagnostics
• Treatment

Classification and reasons

A confident erection is the result of the coordinated work of the nervous, endocrine, circulatory systems, as well as the groin muscles.

During sexual arousal, nervous stimulation occurs in the walls of the corpora cavernosa and adductor arteries of the penis to release nitric oxide, as a result of which they relax and increase in volume. The muscles tense to maintain an erection.

The efferent venules contract and retain blood in the corpora cavernosa of the penis until orgasm and ejaculation. Depending on which link the failure occurred, one or another type of erectile dysfunction develops (Table 1).

Table 1. Types of erectile dysfunction

Type of dysfunction Provoking factors Consequences, symptoms

Psychogenic	Chronic stress, depression, discord with partner, deliberate mindset for failure	Decrease in libido, nitric oxide synthesis in cells is slowed down
Organic	Vascular arteriogenic	Smoking, excess weight, high blood pressure, high blood lipids (hyperlipidemia), diabetes	Delayed erection due to insufficient and untimely blood flow
Vascular venogenic	Peyronie's disease, general exhaustion, dysfunction of the cavernous bodies (cavernitis, priapism)	Inability of the penis to maintain its elastic shape
Neurogenic	Injuries and pathologies of the brain, spinal cord and peripheral nerves	The generation of nerve impulses is impaired, their transmission to the corpora cavernosa is difficult
Hormonal	Diabetes mellitus, hyperprolactinemia, hypogonadism	Decreased libido and the amount of nitric oxide produced by cells
Mixed	Chronic renal failure, diabetes mellitus, old age, smoking, metabolic disorders	Characteristic symptoms are neurogenic and vascular in nature

In 80% of cases, organic type dysfunction is diagnosed.

In every 4th patient, erectile dysfunction is caused by taking medications: non-selective beta-blockers, blood pressure lowering agents, a number of antidepressants, thiazide diuretics.

There is a simple way to determine impotence of one type or another on your own. To do this, you need to pay attention to the condition of the penis in the early morning and analyze night sensations and dreams.

If, after waking up, an erection is observed, erotic dreams occur, accompanied by stimulation of the genital organ and even wet dreams, then the physiology is normal, and the dysfunction is psychogenic or neurogenic in nature.

In the latter case, damage to peripheral nerves is excluded.

Causes of impotence in women and treatment methods

Diagnostics

Diagnosis and treatment of erectile dysfunction are necessary in cases where the problem persists for 3-4 months. You should contact a urologist or andrologist.

It is important to describe in detail to the doctor the nature of the problem: premature or delayed ejaculation, episodic disorders or complete absence of erection, whether attraction to women is present in the same volume.

Be sure to inform about all existing diseases and medications taken.

In order to systematize and objectify complaints, the doctor will ask you to fill out special questionnaires, which will reveal the index of erectile function. Based on the results, it can be determined whether the patient has a normal erection or whether there really are problems.

This is followed by an examination of the external genital organs for anatomical pathologies and other disorders.

To clarify the overall picture of the man’s physical condition, you will need to undergo basic tests: blood, urine and scraping from the urethra.

They determine the presence of inflammatory processes, sexually transmitted infections, signs of systemic diseases and the level of sex hormones. If a man is over 50 years old, then it is advisable to take a blood test for the tumor marker PSA.

Instrumental diagnostics

If a psychogenic or neurogenic nature of the dysfunction is suspected, then for more accurate monitoring of nocturnal erections, the doctor can suggest several methods:

• wrap a ribbon of standard postage stamps around your penis overnight (in the form of a closed ring). As the volume of the organ increases, a rupture will occur;
• Snap-Gage test. This is a tape made of three strips of different densities that are worn on the penis; breaking each one requires some effort. In this way, you can determine the approximate strength of the erection, the tone (rigidity) of the penis;
• "Rigi-Scan" test. It is a small device that is fixed on the thigh, from which two elastic loops extend. They wrap around the penis at the bottom and top. When an erection occurs, an accurate measurement and dynamics of the increase in volume are made.

Causes and methods of treatment of psychological impotence

Doppler ultrasound examination is highly accurate in diagnosing impotence - Doppler ultrasound to assess the condition of the arteries and hemodynamics in the penis area.

If necessary, a clarifying examination is carried out - a test with intracavernous (injections into the penis) administration of vasoactive substances (prostaglandin E1, papaverine hydrochloride). Injections, in consultation with your doctor, can be replaced with a Viagra or Cialis tablet.

As a result, a drug-induced erection occurs, against which the arteries and blood flow are clearly visible, areas of pathological venous drainage are noticeable, due to which the erection is unstable or sluggish.

You can also check the speed of blood flow using laser Dopplerography. This method effectively detects vasospasms, which are often the cause of erectile dysfunction in diabetics and smokers.

If it is necessary to clarify the location of venous blood leakage, cavernosometry is performed. During the procedure, two thin needles are carefully inserted into the penis.

One for administering drugs (first a vasodilator, and after 10 minutes a contrast agent). The second serves to measure the pressure required for an erection, as well as blood flow.

Then cavernosography is performed - a series of x-rays are taken to record the fact of venous leakage.

In order to study the arteries, cavernous bodies of the penis and the quality of blood flow, radioisotope phalloscintigraphy and selective pharmacoangiography are also used. If there is a suspicion of the neurogenic nature of erectile dysfunction, electromyography (testing muscle response) and biothesiometry (assessing the sensitivity of the head) are performed.

If there are problems with ejaculation, then it is necessary to evaluate the condition of the urethra, seminal tubercle, orifices of the vas deferens. For this purpose, urethroscopy (urethrocystoscopy) is used - examination of the urethra and bladder from the inside using a thin and flexible endoscopic device (cystoscope). It also allows you to detect inflammation of the prostate gland.

Treatment

The goal of treatment is to restore erectile function of the penis. Depending on the diagnosed cause of the developed disorder, medication, physiotherapeutic and surgical techniques are used.

Medicines

Pharmaceuticals are prescribed for sexual impotence of vascular, psychogenic and neurogenic origin. The most effective are phosphodiesterase type 5 inhibitors, which include Viagra, Cialis, and Levitra. 80% of patients experience noticeable improvements when treated with these drugs. The following may also be prescribed as part of complex treatment:

• yohimbine (adrenergic blocker);
• neuroleptics;
• androgens;
• dopamine receptor antagonists;
• serotonin uptake blockers;
• plant adaptogens (ginseng, eleutherococcus).

The main causes of potency problems in men aged 30

If oral therapy is not possible, then an option is injection or intraurethral administration of vasodilators into the cavernous bodies of the penis (papaverine, prostaglantin E1). For anatomical defects, this method is contraindicated.

Mild forms of erectile dysfunction can be corrected with the help of ointments, gels, dietary supplements, as well as folk remedies (propolis, beaver stream).

Physiotherapy

Physiotherapeutic methods help restore nerve conduction, blood flow, and muscle reflexes. For erectile dysfunction the following are used:

• electrical stimulation of the corpora cavernosa;
• magnetic therapy;
• LOD therapy (vacuum);
• reflexology (impact on points in the groin and shaft of the penis);
• ILBI (laser irradiation of blood inside the veins);
• ozone therapy.

Physiotherapy is usually designed for a long course and is an effective addition to drug treatment.

Surgical methods

Surgical interventions are carried out to restore blood flow in the penis, as well as to correct its anatomical defects. In some cases, vein ligation is used to prevent excessive blood outflow; anastomoses are applied connecting the inferior epigastric artery and dorsal vein.

Indications for penis replacement include removal of the prostate and other types of surgical interventions in the pelvic area, irreversible pathological changes in the corpora cavernosa.

The essence of the operation is to introduce balloons with a constant or adjustable volume into the corpora cavernosa.

After penile replacement surgery, orgasm and ejaculation are completely preserved.

To prevent erectile dysfunction, it is enough to follow three rules:

• regular physical activity (preference to cardio training at a moderate pace) to prevent stagnation and strengthen the cardiovascular system;
• good nutrition, vitamins;
• to give up smoking

Any sexually transmitted diseases must be treated completely to avoid inflammatory cicatricial changes in the genitourinary tract. It is also important to promptly stop orchitis, epididymitis, and the development of varicocele.

Modern medicine makes it possible to cure or correct erectile dysfunction of almost any origin: from mild cases of psychogenic disorders to pathologies of the anatomical structures of the penis. However, timely and complete diagnosis for persistent erectile dysfunction is necessary, since this may be a consequence of a more serious disease.

Source: https://potencia.online/impotentsiya/diagnostika-i-lechenie/