What to do in erectile dysfunction?

Erectile dysfunction, impotence, potency disorder – all these terms stand for the same symptoms – the difficulty or inability to achieve or maintain an erection. About 19 percent of all men are affected by erectile dysfunction, or ED for short. But what about erectile dysfunction?

What to do in erectile dysfunction?

Diagnostics – how is ED classified?

Erectile dysfunction (ED) is the name given when a man can not have a satisfying sexual intercourse due to an impaired erection. This is the case when the limb is not erected in most cases, not sufficiently erected or prematurely (usually before penetration) slackens. The frequency of symptoms plays a role here. If there are only occasional erectile problems, this is not yet classified as an ED. Potency is usually present if the symptoms persist for a period of six months or occur in two-thirds of all sexual acts.

Based on various surveys, it is assumed that five million men are affected in Germany alone. In Austria, about 32 percent of the population are affected, which corresponds to about 700,000 men. Thus, a study of the University of Cologne from the year 2000 assumes that every tenth man under 40 and every third man between 60 and 69 years under this problem. The number of unreported cases should be considerably higher, as the erectile dysfunction is still taboo and fraught with many prejudices.

How does an erection come about?

To understand how it can lead to erectile dysfunction, the complexity of the erection process must be understood. It is a complicated interaction of blood circulation, nerve stimuli, messengers and muscles. Especially the blood supply plays a significant role to achieve the appropriate stiffness for penetration.

For an erection, the penis has to fill up with enough blood. The blood is held in the penis by three cavernous bodies. They swell on sexual arousal, the veins are compressed so that the blood can not flow back during the traffic. As a result, the erection is maintained in a healthy man, as long as the sexual intercourse is not over. Through a special enzyme, phosphodiesterase 5 (PDE-5), the blood supply is reduced again after intercourse, and the limb relaxed. The enzyme release is a natural protection process to prevent tissue damage to the penis.

Organic and mental causes of erectile dysfunction

Unless the penis is erected or prematurely deflated, it is often due to organic causes or pre-existing conditions. One of the best known causes is diabetes mellitus. But also coronary heart disease, circulatory disorders of the arteries or neurological problems can cause erectile dysfunction. Less common are malformations of the genitals or surgical procedures, for example after prostate surgery, which are responsible for the problems.

Medications can also affect potency. Especially antidepressants, muscle relaxants or diuretic effects can have a debilitating effect. Since the need for ingestion is linked to the treatment of a pre-existing condition, a normal condition can often be achieved at the end of therapy.

Likewise, mental factors can affect potency and induce erectile dysfunction. Especially in young men are erectile problems due to mental health issues. They suffer from stress, have partnership problems or fear of failure.

In addition, unhealthy lifestyles (increased alcohol consumption, nicotine consumption, unbalanced diet) can contribute to potency disorders. In any case, for erectile problems that persist for more than six months, the doctor should be consulted to identify possible causes of illness in time and treat.

What to do? treatment options

There are a number of treatment options that, depending on the cause, remedy the problem permanently or temporarily. Erectile dysfunction, which is the basis of a disease, usually elapses when the underlying problem has been resolved, ie the treatment of circulatory disorders, heart problems or diabetes has been successfully completed. In an ED that is based on psychological factors such as stress or fear of failure help therapeutic conversations or a sex therapy, in which the partner is included. A change in lifestyle such as diet, alcohol and stress reduction can also be helpful.

PDE5 inhibitor

For an acute treatment also a drug therapy comes into question. If there are acute disorders of blood flow, a doctor may prescribe PDE-5 inhibitors, also known as sexual enhancers. Among the best known preparations are: Viagra, Cialis, Levitra or Spedra.

PDE-5 inhibitors prevent the enzyme phosphodiesterase 5 (PDE-5) from being released prematurely and causing the cavernosum to swell. The funds can be used as needed for a shorter period, but also for long-term use. They work only when the man actually feels a sexual arousal. The duration of action differs depending on the means. This also applies to the side effects that can range from mild headache to severe discomfort.

Difference between Viagra, Cialis, Levitra and Spedra

Accordingly, the various sexual enhancers are all based on the same drug group and the same biochemical principle of PDE5 inhibition and are therefore also called PDE5 inhibitors. However, they contain within the drug group different active ingredients (each with individual dosing), which provide for each a different duration of action and time to onset of action. In addition, the preparations differ in their tolerability or the side effects.

Viagra contains the active ingredient Sildenafil, whose effect begins after about 30 to 60 minutes and lasts for about five hours. It is considered the first and still the best selling sexual enhancer in the world. Cialis uses the drug tadalafil, the effect of which also sets after 30 to 60 minutes, but lasts for up to 36 hours. In addition, the preparation is also applicable in low dosage for a long-term therapy. Vardenafil is used for the remedy Levitra, the effect of which starts after 30 minutes and lasts for five hours. It is considered to be particularly compatible. The youngest sexual enhancer is marketed under the brand name Spedra. Its active ingredient avanafil can develop its potency-enhancing effect after only 15 minutes and lasts for up to six hours.

The fact that they have only in common, if they have been previously formed by sexual stimulation and transmission of nerve stimuli to the penis cyclo-guanosine monophosphate (cGMP).

cGMP is the substance that forms during sexual stimulation by the naturally occurring enzyme guanylate cyclase in the penis and normally disappears again by the enzyme phosphodiesterase no. 5 (see above), so that newly formed cGMP is constantly being broken down again.

So if a man takes a potency agent from this group of drugs, so formed by sexual stimulation cGMP is not degraded immediately and thus remains longer in the penile erectile tissue. The more cGMP in the erectile tissue, the stronger and longer the erection.

Possible side effects in most of these products include blurred vision, headache, stomach ache, heartburn, reddened skin and stuffy nose.

The selection of the corresponding product should be clarified individually with the patient’s doctor.

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