What is impotence?
For a long time, the diagnosis of “impotence” was given to all men, without exception, who complained to the doctor about the reduction in the duration and strength of erection. However, in a large number of these patients, an erection is preserved; it simply doesn’t have enough strength to have normal sexual intercourse.
In addition, it turned out that there are much more men with a reduced quality of erection than with its complete absence. So now the term “erectile dysfunction” is more commonly used, i.e. Erectile dysfunction, and impotence – just the extreme degree of these disorders.
There are also secondary impotence, when a normal erection still was before, and primary – in those cases where there was never a normal erection. It is believed that sexual function weakens over time. In fact, it is not. In the absence of diseases that cause erectile dysfunction, every man can have a high-quality sex life in 50 and 60 years.
What causes impotence?
Good sexual health is one of the main factors of a man’s self-sufficiency. But, unfortunately, in recent years, representatives of the stronger sex more often complain of decreased libido and weak erections, and doctors often diagnose “erectile dysfunction” (ED). And not only men aged, but also very young guys.
According to one of the doctors, after 60 years, every third US resident suffers from impotence. But, alas, 25-year-old men are increasingly becoming patients. Experts identify several types of risk areas.
1. The first – non-social people who spend their lives in the virtual world. They do not want to waste time on the conquest of women, watch porn and regularly engage in self-satisfaction. If this process completely replaces normal sexual intercourse, then erectile dysfunction develops over time.
2. The second type – men leading an unhealthy lifestyle, abusing alcohol, and especially beer. And the number of his fans is growing every year.
This drink contains female hormones – phytoestrogens. With its constant use in large quantities in the male body, violations occur, and sex life ceases.
4. The third type – more than others impotence are also men who smoke.
During smoking, carbon monoxide enters the body, which traps oxygen. This clogs the blood vessels, including the thin vessels of the penis. Blood flow to the penis is disturbed and ED develops.
Unhealthy food is also added to everything. People eat a lot of fatty foods, gain weight, as a result, testosterone production is impaired and libido decreases. Compounding the situation is another trend of today – stress.
Problems with potency sometimes appear after injuries or diseases of the spinal cord and brain. Often a broken erection is the first symptom of an infection, injury, tumor, epilepsy, or Parkinson’s disease.
Considerably reduced sexual desire with hormonal disorders. As a rule, this occurs against the background of a lack of male sex hormones or with an excess of female.
Atherosclerosis, congenital defects and other vascular diseases also threaten impotence. The fact is that such disorders prevent the normal flow of blood to the cavernous bodies of the penis.
Impotence can develop as a side effect of medication. An erection is affected by antidepressants, antipsychotics, tranquilizers, drugs that treat hypertension, and those that lower gastric secretion.
Sexual failures sometimes hide inflammatory diseases of the prostate gland, urethra, bladder and testicles. In general, any chronic illness, nervous and physical fatigue is not the best way affect the male strength.
Types of impotence
Impotence can be of several types:
1. Arteriogennye Arteries supplying blood to the penis, do not bring enough blood to cause an erection. This can occur due to narrowing of the arteries, which occurs in older people with diabetes and people with high blood pressure, or because of injury to the genital area. Impotence in such cases is often detected much later, after obvious wounds and fractures have healed.
2. Venogenic Blood from the penis flows through the veins. In the normal case, with a full erection, the veins are almost completely closed and the blood practically does not flow from the penis. This allows blood to accumulate in the sinusoids of the penis, increasing pressure and creating opportunities for its rigidity and hardness. Such impotence is extremely common. It makes up as much as 30-70% of all cases of impotence.
3. Neurogenic Associated with impaired transmission of nerve impulses. Proper impulse work is a major factor in maintaining an erection. It is these nerves that activate the arteries and veins and change the dynamics of the blood flow in them.
- Sometimes they cause back injuries, especially if they are associated with the spine and spinal cord, or injuries of the penis, near the pelvis or perineum.
- A wide range of operations can also cause accidental damage to the nerves of the penis and lead to impotence. These include operations on the rectum, prostate gland, urethra, spine, retroperitoneal space, bladder, etc.
- Another disease affecting the nerves of the penis is diabetes. Impotence is extremely common among diabetics. Impotence in diabetic patients is almost always organic.
- Many drugs also cause neurogenic impotence. Among them are anti-hypertension (lowering blood pressure) and psychotropic drugs. This list is very large.
4. Endocrinological (hormonal) This occurs when there is an imbalance or lack of sex hormones in the blood. It accounts for 5 to 10% of all cases of organic impotence. As a rule, hormonal changes affect libido (sexual desire), and not the quality of erection as such. Various diseases can cause these changes.
5. Mixed Sometimes one patient may have more than one factor. Such patients usually have systemic diseases. Illustrative examples are diabetes mellitus, renal failure, and liver failure.
6. Psychogenic In the absence of an organic factor, the problem lies exclusively in the mind. Then it is referred to as psychogenic impotence. But before making such hasty markings, it is necessary to prove that no physical reasons exist.
Male impotence. Modern methods of treatment of impotence.
In rare cases, the doctor prescribes a single method of treatment, focused on the elimination of the pathological factor. Much more often, especially with the “neglected” form of impotence (when the patient did not immediately seek advice) and for men of mature age, an integrated approach is effective. It is characterized by a combination of therapeutic techniques and is aimed not only at the rapid recovery of sexual function, which initially led to the disease, but also at the struggle with self-doubt that develops in most patients.
1. The first way is psychotherapy – in a situation where an erection is not always present, but only during sexual intercourse, doctors talk about the psychogenic nature of impotence. In this case, arousal can be achieved during masturbation or during sleep. Often, in order to help the patient, it is not necessary to prescribe pharmaceutical preparations or medical procedures, it is enough to visit a qualified psychotherapist (sometimes with a partner). The specialist will help you understand your emotions and advise effective techniques aimed at restoring sensuality, overcoming clips and creating a romantic atmosphere in the bedroom.
2. The second method currently, drugs such as Viagra (Sildenafil), Levitra (Vardenafil) and Cialis (Tadalafil) are successfully used to combat impotence. The effectiveness of drugs is undoubted, but they can cause a lot of side effects. Modern medical drugs (the so-called sexual doping), used in clinical practice, can achieve a higher efficiency of treatment, which reaches 70-80%. These drugs are distinguished by the presence of side effects, such as a minor headache, a sudden reddening of the face and neck, hyperemia of the nasal cavity, a change in color sensation and visual acuity.
3. The third method is intracavernous injection of vasoactive drugs – the essence of the method consists in microinjections of vasoactive drugs directly into the penis before sexual intercourse. The method of intracavernous injections of vasoactive drugs has become the most common and most effective among conservative methods of treating erectile dysfunction. For treatment, prostaglandin alprostadil is used, both as monotherapy and in various combinations. The combination of drugs is used to reduce the side effects of each of them by reducing the concentration. An integrated programmatic approach to the prescription of intracavernous therapy allows us to make the use of this method effective and safe.
4. The fourth method is intraurethral impotence therapy – for intraurethral applications, various drugs are used, such as alprostadil. From the urethra, the drug is absorbed and from the bloodstream enters the cavernous body, where reactions occur that cause an erection. This method is similar to the previous one, but it eliminates the injection into the penis. Currently, this therapy is not widespread due to the high cost of drugs and adverse reactions (burning sensation in the urethra), as well as the need for mandatory use of a condom.
5. The fifth method of intraurethral impotence therapy – the essence of the method is to create negative pressure in the corpus cavernosum of the penis using a vacuum cylinder and a pump, which causes blood flow and an erection held by a special compressive ring at the base of the penis, which restricts venous outflow. Thus, it becomes possible to perform sexual intercourse, lasting no more than 30 minutes. The effectiveness of the method is 40-50%. The disadvantages include the practical use of the device (it is impossible to hide from a partner, etc.), painful ejaculation (ejaculation) caused by a compression ring, hemorrhages on the penis, numbness of the penis, etc.
6. The sixth method massage – massage of the perineum and pelvic organs is an important method that is used in the complex treatment of erectile dysfunction. Improving blood circulation in this area contributes to the activation of metabolic processes, the expansion of blood vessels and increase the effectiveness of the used drugs. The psychological component is also important: sessions of apparatus massage increase the sensitivity of the genital organs, relieve stress.
7. The seventh method of surgical treatment of impotence – surgery has recently been used less frequently due to the high effectiveness of drug therapy. Surgical methods are used in extreme cases, when conservative treatment does not give the desired results and for certain indications.
Surgical treatment of venous insufficiency of the penis is performed in case of a defeat of the vasoapillary mechanism of the penis. Despite the great age of this method, its effectiveness is about 50%. However, even with relatively low results, venous surgery of the penis is still used in clinical practice, as an adjunct to other previously cited methods, which allows to achieve high results.
Surgical treatment is indicated in the case of insufficient arterial blood flow to the penis. An arterial microvascular shunting is performed, the effectiveness of which ranges from 30 to 50%. This operation shows high efficiency only in young patients.
Prosthetic penis is currently the main method of restoring rigidity of the penis. Implantation of prostheses is the final stage of treatment of impotence, when all previous methods of treatment have failed.
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