Erection problems (erectile dysfunction = ED), impotence: Causes and treatments

Impotence, what is it? Definition of impotence

Male sexual impotence, also known as erectile dysfunction, is defined as the permanent inability to initiate or maintain an erection with sufficient rigidity to allow satisfactory sexual intercourse.

Male sexual disorders in general may include erectile dysfunction (impotence) proper, decreased libido, and abnormal ejaculation.

The causes of impotence

The causes of erectile dysfunction can be classified as:

1. Psychological:

  • Depression, anxiety, psychiatric illnesses such as schizophrenia.
  • Anxiety for sexual performance, or forced sexual intercourse.
  • Stress.
  • Relationship problems.
  • Loss of sexual excitement or desire.

2. Organic or physical causes of the body in general:

  • Neurogenic or nervous system: Guillain Barré disease, multiple sclerosis, Diabetes Mellitus or alcoholism with nerve involvement, epilepsy, cerebrovascular disease, Parkinson’s disease, brain trauma, Alzheimer’s disease, infections of the spinal cord, immune diseases of the spinal cord, traumatisms of the spinal column and spinal cord, tumours of the spinal cord, trauma to the pelvis, consequences of surgeries in the pelvic area.
  • Of the hormonal system: Diabetes Mellitus, hyperprolactinemia, acromegaly, hypogonadism, hypo or hyperthyroidism, genetic diseases such as hyperlipoproteinemias, adrenal insufficiency.
  • Vasculogenic or blood vessel alterations: hypertension, atherosclerosis or hardening of the blood vessels, peripheral vascular disease, ischemic heart disease, patients who have received radiotherapy for prostate carcinoma, smoking, Peyronie’s disease, aging, penile fracture.
  • Induced by drugs: alcohol; tobacco; marijuana; cocaine; opioids; amphetamines; antihypertensive drugs (beta-blockers, diuretics, calcium antagonists, methyldopa, clonidine, hydralazine, alpha-blockers, digoxin, amiodarone, others); hormonal drugs (progesterone, estrogens, anti-androgens, ketoconazole, fluconazole, itraconazole, steroids); medicines for psychiatric use (anxiolytics, barbiturates, tricyclic antidepressants, antipsychotics, appetite suppressants); other drugs (bronchodilators, antiallergics, pseudoephedrine, metoclopramide, atropine, heavy metals such as lead).
  • Various causes: Obesity, infections such as prostatitis or urethritis, chronic renal failure, AIDS, liver failure, chronic obstructive pulmonary disease (COPD), scleroderma.

3. Mixed, psychological and organic causes.

Diagnosis : Erectile dysfunction

The diagnosis of any male sexual disorder should begin with a detailed medical history by the doctor, with an interrogation directed at when the difficulty in obtaining or maintaining an erection began, if there is any antecedent or previous associated pathology, and even if there is any environmental or environmental factor that is currently affecting other aspects of your life and generating abnormal stress or anxiety.

After the initial steps, the physical examination should be thorough and complete to cover all body systems, as any organic cause can influence the onset of impotence. Complementary tests such as laboratory tests should also be requested to verify that all levels are in order (hematology, glycemia, hormones, lipid profile, renal and hepatic levels), or if otherwise, there are abnormal parameters that can define the cause of the sexual disorder.

People affected by impotence

Male sexual impotence is a common health problem, the prevalence of which varies between countries and ages, but is constantly emerging.

In a study of the 1990s that is still valid, there was a general prevalence of erectile dysfunction ranging from 10% to 52% of men aged 40 to 70, with an incidence in the West of 25 to 30 new cases per 1000 inhabitants per year.

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In Spain, 18.9% of men between the ages of 25 and 70 have some degree of erectile dysfunction that increases with age.

With these figures so high worldwide, it is evident that it is necessary to have the best diagnostic and therapeutic means to improve a sphere so relevant for men of any age, such as the sexual aspect.

People affected by erectile dysfunction usually have low self-esteem and reduced self-confidence, the impossibility of getting their partner pregnant, and even being at risk of suffering serious psychological disorders such as anxiety or depression.

Risk factors for impotence

Although erectile dysfunction could affect any adult male, there are certain factors that can increase the risk of it. Some of them are:

  • Obesity
  • history of cardiovascular or cerebrovascular disease
  • Elevated cholesterol levels.
  • History of high blood pressure.
  • History of Diabetes Mellitus.
    Exposure to constant stress; other external conditions that tend to anxiety, depression, and other psychological disorders.
  • History of invasive medical treatments, such as prostate surgery or radiation against Cancer.
    Intake of various medications (may be as varied as antihistamines, antihypertensives, antidepressants).
  • Chronic consumption of alcohol or drugs.
  • Advanced age, because the risk of suffering impotence increases with age.
  • Sedentarism, or lack of physical activity.
  • Low self-esteem.
  • Couple conflicts, or poor couple communication.

The symptoms of impotence

If any of these symptoms have occurred, it is time to see your doctor to determine the correct diagnosis and treatment:

  • Decreased sexual desire.
  • Persistent difficulty or inability to get an erection.
  • Persistent difficulty or inability to maintain an erection.

Treatments for impotence

The ideal is to carry out an integral treatment: preventive and causal.

The first step of the treatment is the prevention, primary in improving the statistics and probabilities of improvement. Quitting smoking (if you smoke), losing weight, treating and evaluating together with your doctor other pathological antecedents are some of the initial measures.

Then, as for most disorders, the treatment of erectile dysfunction should be individualized and targeted to the specific cause for each patient.

In case of being due to a psychological cause, the treatment must be directed to psychotherapy as a foundation, as well as to diminish stressing and conflicting factors, both personal and for the couple relationship.

If an organic cause is determined, one should seek to treat it directly: supplement drugs taken for other pathologies that may be causing impotence, reduce cholesterol levels, glycemia and others that act as risk factors, seek treatment for any underlying disease, and other measures.

The most important step, without a doubt, is to adjust, together with the doctor, the individualized treatment for each patient with the adequate medication to resume a fair sexual performance. The treatment modalities can be: oral medications (such as Cialis, Levitra, Viagra, Tadalafil, etc.); sublinguals (apomorphine); transurethrals (Vitaros or alprostadil in cream); intracavernosal, and topical. There may even be combinations of these active principles.

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The best treatments against impotence:

Cialis : Cialis (Tadalafil) is a medication for erectile dysfunction, with onset of action at 30 minutes and duration of up to 36 hours. It belongs to the group of drugs inhibitors of phosphodiesterase 5, which act by increasing blood flow to the vessels of the penis getting an erection satisfactory.

Available presentation: Film-coated tablets of 2.5 mg, 5 mg, 10 mg, 20 mg and 40 mg, in boxes containing from 10 to 360 tablets.

Advantages:

  • Cialis has a rapid onset of action, taking only 30 minutes to an hour before sexual activity.
  • It is the only medication in its group that guarantees the duration of the effect of up to 36 hours.
  • Many patients prefer it for its duration, and do not have to take it daily or expose themselves to annoying side effects.
  • He has years of market experience to back him up.
  • It has a successful penetration rate after taking more than 70%.

Price: The price per tablet may vary depending on factors such as the concentration of the tablet, and the number of tablets present in the box.

Cialis price of 2.5 mg: Prices ranging from € 1.19 to € 2.89 per tablet, in boxes from 10 to 360 tablets.

Price of Cialis 5 mg: Prices ranging from € 1.82 to € 3.46 per tablet, in boxes from 10 to 360 tablets.

Price of Cialis 10 mg: Prices ranging from € 1.91 to € 4.54 per tablet, in boxes from 10 to 360 tablets.

Price of Cialis 20 mg: Prices ranging from € 2.10 to € 6.36 per tablet, in boxes from 10 to 360 tablets.

Price of Cialis 40 mg: Prices ranging from € 3.57 to € 6.45 per tablet, in boxes from 10 to 120 tablets.

Viagra : Viagra (Sildenafil) is a drug used to treat erectile dysfunction, marketed and widely distributed since 1998 with resounding success among men who wish to treat these disorders of sexual performance. Its onset of action is usually 30 minutes to an hour after taking. It belongs to the group of phosphodiesterase 5 inhibitors, which act by increasing blood flow to the vessels of the penis getting a satisfactory erection.

Available presentation: 25 mg, 50 mg and 100 mg oral tablets.

Advantages:

  • Commercialized and issued since 1998, it was the first medicine of its kind to be used for erectile dysfunction. It has much more experience in the market, and testimonials of efficacy that endorse its effects.
  • Its onset of action can be from 30 minutes of ingestion, but on average taking it an hour before the sexual encounter guarantees a satisfactory erection.
  • It only works with sexual stimulation, and does not produce spontaneous erections.
  • Its effectiveness, although similar to the drugs in its group, has been shown to be slightly higher than others.
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Price: The price per tablet may vary depending on factors such as the concentration of the tablet, and the amount of tablets present in the box.

Price of Viagra 25 mg: Prices ranging from € 2.97 to € 13.36 per tablet, in boxes from 4 to 120 tablets.

Price of Viagra 50 mg: Prices ranging from € 13.40 to € 14.41 per tablet, in boxes from 2 to 8 tablets.

Viagra price of 100 mg mg: Prices ranging from € 3.58 to € 9.35 per tablet, in boxes from 4 to 120 tablets.

Spedra : Spedra (Avanafil) is a new drug indicated for the treatment of male erectile dysfunction, the most innovative and best tolerated in the group of phosphodiesterase 5 inhibitors. It has a start of action that can even be as early as 15 minutes after taking.

Presentation available: film-coated oral tablets for oral intake, 50 mg, 100 mg, and 200 mg, in boxes containing 10 to 120 tablets.

Advantages:

  • It has an innovative and more modern formula, with respect to the medicines of its group.
  • It is very well tolerated by patients, for the selectivity of its components and fewer side effects associated with taking.
  • It has a very fast onset of action of only 15 minutes.
  • High rates of effectiveness and successful penetration.

Price: The price of Spedra per tablet may vary depending on the quantity of tablets in the box, whether Spedra is purchased online or if Spedra is purchased in a pharmacy.

Price of cheap Spedra 50 mg: prices ranging from € 3.48 to € 4.12 per tablet.

Price of cheap Spedra 100 mg: prices ranging from € 3, 75 to € 4.58 per tablet.

Price of cheap Spedra 200 mg: prices ranging from € 4.15 to € 5.23 per tablet.

Prevent impotence :

Although erectile dysfunction could affect any man, there are certain measures that could help prevent its onset. Some may be:

  • Attend a medical consultation to diagnose and treat underlying diseases such as Diabetes Mellitus, Hypertension, heart disease, and other chronic conditions; as well as seek their control if they are pre-existing.
  • Regular exercise or physical activity.
  • See your doctor for periodic evaluations and check-ups.
  • Reduce exposure to stressful situations.
  • Avoid couple conflicts, and work on improving communication if they are present.
  • Seek psychological help in case of anxiety, depression or other situations that may affect mental and emotional health.
  • Stop smoking.
  • Reduce or eliminate the intake of alcohol and/or illegal drugs.