Erectile Dysfunction is defined as, the inability to maintain an erect penis with sufficient rigidity to allow sexual intercourse.
Male sexual dysfunction may be manifested in a variety of ways and the history is critical to the proper classification and subsequent of treatment.
Androgen substances have a strong influence on the sexual desire of men.
Loss of libido may indicate androgens deficiency on the basis of either neurological (hypothalamic and pituitary) and testicular disease.
Blood levels of testosterone and gonadotropine may help localize the site of any disease.
Loss of erection may result instead from vascular, neurogenic or psychogenic causes. Concurrent medical problems may damage one or more of the mechanisms. In addition many medications, especially antihypertensive, are associated with erectile dysfunction.
Centrally acting sympatholitics such as metildopa, clonidine or reserpine can result in loss of erection, while vasodilators, Alfa blockers and diuretics rarely alter erections.
Beta blockers and spironolactone may result in loss of libido.
Use of extreme alcohol or drugs can cause severe erectile dysfunction.
It is very important to establish if the patient has ever had any normal erection such as early morning or during sleep. If this occurs organic cause is unlikely.
Losses of orgasm or premature ejaculation are usually of psychological origin and related to anxiety or stress disorders.
The vast majority of men suffering from erectile dysfunction can be managed successfully with vasoactive therapy:
It is extremely important before using any of these drugs that a diagnostic study is performed and all the risks and the various organic causes are evaluated.
These products can´t be used if the patient is taking nitro-glycerine therapy and must be continuously checked by his doctor.
If you have any medical questions you would like DR Borsani to answer for you or any advice you may need please post your queries to the web express guide or e mail the editor Belinda Regan , she will forward the appropriate ones to the doctor and we shall print the questions and answers in the October edition .