Impotence: symptoms and treatment
Impotence (erectile dysfunction) determines the urgency for a man of such violations in his sexual functions, in which he is unable to complete the sexual act. Impotence, the symptoms of which indicate an inability to maintain an erection, a level required for sexual intercourse, or an inability to achieve ejaculation, or a combination of both, can be characterized either by total inability to achieve ejaculation or erection, or by a short duration of maintaining an erection.
Impotence as a medical term was introduced in practice in 1655. Nevertheless, the sexual impotence, which she implied, certainly appeared much earlier than was appropriately determined. At the moment, this definition is also obsolete, instead of this name, the term «erectile dysfunction» is now used.
The risk of impotence increases significantly with age. So, in men who have passed the age mark in 60 years, this disorder occurs 4 times more often than in men from 40 years of age. Meanwhile, based on the data of medical statistics on the part of potency disorders, it is known that over 30% of men, whose age is between 18-60 years old, already have violations of the sexual function of one or another degree of its manifestation. Accordingly, the age of impotence in men in each individual case is not subject to strict limits, therefore the definition of specific figures for the manifestation of violations in this area is mainly determined by individual factors and criteria.
Most often, impotence is seen as an erection disorder in men. However, the term is actually more voluminous, and it implies, therefore, any sexual disorders that occur in men (by the way, some researchers hold the view that this applies to women). There are six main criteria on the basis of which a man can be considered impotent:
- A man does not test to a woman of sexual attraction;
- A man can not achieve a sufficient erection with her previous sexual desire;
- A man can not insert a penis into the vagina when he has an erection;
- A man is not capable of making frictional movements for a certain amount of time necessary for them
- A man can not reach an orgasm with such a woman and in such conditions that most men are capable of sexual intercourse.
These criteria for the detection of impotence in a man were provided by one of the authors, and the violation of potency is regarded as an actual pathology when one meets any of the points. Starting points are determined, respectively, as the initial phase of impotence development, because the earlier it will be noted for a man’s compliance with these items, the more serious the consequences will be determined. Violations in the context of a man-specific item determine subsequent deviations for the other specified points (phases).
It is also emphasized that some of the components accompanying impotence not only correspond to the chronology of processes of sexual intercourse, but also act as causative components. The definition of «impotence» must necessarily contain conditions that are relevant to both the specific situation that accompanies sexual intercourse and the sexual partner.
In particular, it can be noted that there are situations in which the commission of sexual intercourse is impossible due to certain physiological circumstances, and therefore attribution to impotence in terms of clinical understanding of this term is unacceptable. Thus, for example, the presence of people in the immediate vicinity (in particular relatives and friends), the threat to life, etc., can be distinguished here. In addition, it can be identified that sexual arousal also occurs in the case of the actuality of the minimum number of erotic stimuli, which, this time, refers to a male sexual partner. In the absence of such stimuli, which, for example, can be considered as an absolute external unattractiveness of the partner, the man, instead of the corresponding possible situation of sexual stimulation, has sexual aversion (which determines the absolute rejection of sexual relations by a man at the psychic level with a relatively healthy state of the body in a sexual relationship ).
Within the clinical point of view, based on the emphasis on the above points (phases), violations related to these items determine such forms of impotence:
- impotence of competitiveness — determines a man’s inability to experience an attraction
- erectile impotence (erectinitis impotence) — determines the erection disorder (ie, erectile dysfunction disorder)
- impotence of the croup (or impotence of immittendi, ejaculatory squash) — determines the inability of a man to insert a penis into the vagina, including a violation in the form of premature ejaculation ;
- erectic breasts — defines erections in a short-term manifestation, which is also combined with the earliest form of male ejaculation;
- impotence of ejaculation in this case, ejaculatory impotence is considered, and with it in particular ejaculation delay in case of its complete absence;
- impotence Satisfactions — considers the inability of a man to achieve sexual satisfaction, his lack of sexual satisfaction.
Some authors, when considering disorders associated with ejaculation, deny its relationship to sexual impotence, in which it acts as a suitable form. In this case, primary impotence and secondary impotence are allocated. So, primary impotence determines the inability of a man to achieve an erection and to keep it in the state required by the sexual intercourse, as a result of which he can not achieve the emission (the action associated with the introduction of the penis in Vagina partner). Regarding the second option, secondary impotence is relevant for erectile dysfunction in a man, as a result of which sexual intercourse is impossible, but on the condition that before that he had committed at least one sexual intercourse (commissioned), Regardless of its success or «failure.»
In general terms, types of impotence are accepted in such cases as psychological impotence and organic impotence.
Organic impotence defines an erection disorder that causes physiological causes as its conditioning factor, for example, they may include certain types of urological diseases, Endocrine disorders, etc. With this pathology, there is a slow progression. Periodically, a man notices that at the right time an erection does not occur, gradually there is an increase in these failures. And if before such problems with erection did not occur, then as the progress of the disorder for its appearance requires a lot of effort. Organic impotence in a man can be combined with the preservation of sexual desire for a partner, moreover, the appearance of an erection may be accompanied by a subsequent ejaculation. Nevertheless, there is also the likelihood of the fact that during sexual intercourse this violation can cause sudden relaxation of the penis. Symptoms of impotence of this type also consist in the fact that men completely lack spontaneous nocturnal and morning erections.
As for the next option, which is marked by psychological impotence, then, respectively, it is accompanied by psychogenic factors. In particular, these are mental disorders in the form of a neurosis, depression with its accompanying neurotic condition, etc. Signs of psychological impotence, or, as it is customary to define, cortical impotence, consist in the sudden onset of the disease, as well as in the presence of spontaneous nocturnal and morning erections. As for the actual problems with erection, they are predominantly episodic. Implied under this may be situations in which the attempt of a male sexual intercourse is combined with the initial lack of an erection or with its disappearance after a certain time. Treatment of impotence of this type requires the initial identification of the cause, its provoked and, accordingly, the elimination of this cause.
The differential diagnosis of both variants is based on the comparison of manifestations in this version:
- Psychological impotence
- starts suddenly;
- spontaneous erections (night, morning)
- the problem of relations is urgent;
- There are problems with erection in certain types of circumstances in which attempts are made to commit sexual intercourse.
- Organic impotence
- is characterized by its gradual beginning;
- spontaneous erections do not occur;
- Sexual desire and ejaculation normal
- problems associated with impotence arise under any circumstances and circumstances.
In addition, there are some other forms of impotence, consider them below.
Neuroreceptor impotence. This disorder is caused by the actual lesion in the head of the penile receptors, in addition, they can also be affected in seminal vesicles or in the prostate gland.
Spinal impotence. In this case, impotence occurs as a result of the lesion of the corresponding spinal centers (centers of ejaculation and erection).
Spinal organic impotence. In this case, the erection or ejaculation is broken due to the defeat of certain spinal centers concentrated in the lumbar or sacral region, which in particular occurs against the background of actual organic pathology (hemorrhage, trauma, inflammatory or tumor process).
Spinal functional impotence. This term is obsolete, the pathology itself within the current time is often denied in its own existence. The features of the disorder in this case are associated with a persistent type of disorder in the area of the spinal sexual centers against the background of their «overwork» (which, for example, can be accompanied by masturbation, intense sex life, etc.).
The causes of impotence are distributed by specialists to several main groups, which allows us to distinguish the following variants:
- vascular disorders;
- Endocrine Disorders
- Neurological disorders
- drug disorders;
- Local type violations.
These options correspond to the already considered organic nature of the disease in which impotence is the result of deviations in the normal functioning of a particular organ (system) in the body of a man. Of the diseases that cause the development of impotence in men can be identified the following: hypertension, atherosclerosis, low testosterone (hypogonadism), multiple sclerosis, diabetes, spinal cord injury.
Resting on impotence, provoked by diseases of the genital organs, we can distinguish three main forms that arise against the background of the influence of the following types of factors: disorders associated with the intrasecretory function of the testicles; The urgency of diseases of the seminal tubercle and prostate gland; Mechanical causes (penile diseases, damage or malformations).
In the first case, the disease endocrine nature of origin, against which the decreased production of the sex hormone testicles leads to a concomitant weakening of sexual desire. Such disorders of the testicles can be congenital in nature (hypoplasia of the testicles), they can also be acquired in childhood (with the transfer of bilateral orchitis or mumps, with scarring and wrinkling in the testicles) or in adulthood (testicular injury, orchitis transfer, age changes , Accompanying the onset of the elderly or senile.)
As for the second form, which deals with the actual disease of the diseased seed tubercle or prostate gland, they, in turn, are related to the presence of deviations from normal sexual life (which implies sexual excesses, actions associated with Artificial prolongation of the sexual intercourse or with its interruption, as well as frequent masturbation), or with external infection (posttrichomonas or postgonorrhoid prostatitis and its other forms). In addition, another type of cause may play a role (prostate adenoma, low-activity lifestyle, sedentary lifestyle, etc.).
Mechanical causes, referred to the third form, determine this type of disease of the penis or its anomaly, in which at the mechanical level there is no possibility of its introduction into the vagina.
However, as also it was noted, most of these violations are rare. Accordingly, this determines that, by its nature, impotence is mainly a psychosomatic scale dysfunction. Early impotence is also considered specifically for compliance with this cause. After eliminating the factor directly associated with the occurrence of such a problem, the erection in men, as well as the ability to commit a full sexual intercourse in full, is subject to recovery.
Isolate certain types of impotence, corresponding to a specific age period. Thus, the noted early impotence is predominantly psychogenic (age up to 30 years). In the middle age (from 30 to 50 years), impotence is predominantly spinal, i.e. Develops against the background of diseases of the seminal tubercle and prostate, as well as against depletion of the corresponding centers in the region of the spinal cord, through which the management of erection and ejaculation is carried out. Impotence in men from 50 years of age and older the nature of pathology is endocrine, it is associated with an age-related decline in the hormonal function of the testicles.
As an aggravating factor in the development of impotence, smoking and alcohol abuse are defined. On the basis of research in particular, it was found that nicotine leads to inhibition of the sexual centers in the brain, due to which, in turn, an erection is subject to erosion. No less negative is the effect of alcohol — here the effect is directed in particular at the sex glands (prostate and testes). Based on experiments conducted on animals, it was revealed that chronic alcoholization causes fatty degeneration of the sexual glands with subsequent atrophy. Such changes, in turn, cause partial or complete extinction in men of sexual potency. In addition, there is also the effect on men of alcohol, at which their feminization takes place (in other words, it is femininity). This is accompanied by hair loss, obesity by the female type, etc. The effect of alcohol is also on the central nervous system, so that impotence can have a subsequent spinal or cortical nature.
The initial stage of impotence determines the corresponding manifestations of this impairment. The first symptoms of impotence in particular are manifested in the form of lack of erection , not occurring when a normal sexual arousal in a man. As the next common sign, there is a weak erection .
There is a decrease in the total number of erections during the day, the elasticity of the penis also changes (which is particularly true for sexual contact). The beginning of impotence is also indicated by premature ejaculation. Meanwhile, the indicated symptom with the appearance of ejaculation before the moment the penis was inserted into the vagina can be a testimony not only of the disorder we are considering, but also act as a sign indicating a venous disorder.
In men who suffer from the violation we are considering, there are also personal characteristics, which are typical for him:
- the desire to not be different from other men in their own behavior
- the line of conduct corresponds to the demonstration of «lack» of sensitivity and emotion, in actions coldness and detachment are traced
- there is an ignorance of those needs that are experienced by other people, as well as a tendency to bombast and exaggeration, a belief in one’s own superiority, egocentrism, inability to empathize
- susceptibility to phobias, refusal to perform actions to overcome certain difficulties, self-doubt, impossibility of rapid and complete recovery of the state of equilibrium against the background of previous failures
- the presence of anankast features (manifestations in the form of excessive conscientiousness, obsessive images and thoughts that are destructive for the patient, the urgency of the anxious form of insecurity, the presence of a sense of inferiority and a constant sense of guilt), often combined with excessive impressionability; Constant reflection on the correctness of the acts committed and the desire to see this;
- the presence of deviant features (in particular deviant behavior is defined in sociology in the form of such actions / acts of a person that do not fit the official norms and standards of society), as a result of which the achievement of a normal erection in men is possible only under the conditions for the performance of the corresponding sexual Fantasies or actions.
Based on current research, it is revealed that erectile dysfunction in about 90% of cases is directly related to the relevance of certain psychological factors, while organic violations account for only about 10% of cases of impotence.
In the vast majority of cases, patients refer to sexual relations as a topic of very delicate, so that the appearance of a problem with erection in one form or another causes its attribution to external factors. Quite often, attempts are made to hide it. In almost 95% of cases, this disease is curable through the use of medications, but the ratio indicated to it determines the frequency of treatment to a specialist only in 10% of cases.
For this reason, the main problem accompanying the diagnosis lies in the internal conflict, which can be associated with a man with shame and embarrassment due to a problem, and also because of the expectation that the condition will improve itself. In some cases, active sex life is not important for men, because the appearance of problems with erection as a problem is not considered at all. Sometimes, on the contrary, in an objective identification of the fact that the problem really exists, the trip to the specialist is postponed because of her exaggeration (ie the man thinks that everything is too serious in his case). There are also frequent fears that the result will reveal that no measures can help in eliminating the actual problem.
Based on a number of behavioral signs, it can be assumed that the problems with potency are actual, even in a situation where a man pretends to be all right. As a cause for concern, the following situations are identified:
- Avoidance of sexual intercourse in one way or another (man refers to headache, problems of outside character, fatigue, he comes back late from work, etc.)
- any direct suggestions regarding sex, as well as hints, are ignored by them
- the man initiates sexual intercourse.
A psychological barrier to diagnosing a condition can help a man overcome his sexual partner, otherwise one should rely only on a doctor. The methods of diagnosis include:
- method for testing the innervation of the penis (allows you to determine the state of the nerves of the organ, and a bulbocavernous reflex is tested)
- the method of ultrasound examination (the cavernous bodies of the penis are subject to evaluation, signs of a male atherosclerosis of the vessels, calcification or scarring of the erectile tissue are revealed, the venous outflow is determined, etc.)
- biotesiometry of the penis (vibration test to assess the innervation of the organ and its sensitivity).
Depending on the nature of the disease, the methods of its treatment are determined, which in general can be quite diverse. The main methods of treating impotence are:
- psychotherapeutic treatment (focused on the treatment of psychogenic impotence, as well as on the treatment of the organic form of impotence in the recovery period)
- surgical method (used in the treatment of the organic form of impotence against the background of venous and vascular pathologies in order to increase the influx to the cavernous bodies of blood)
- vacuum method (implies a mechanical method of stimulation of the penis, used as part of a complex therapy for impotence)
- Injection method (treatment involves the injection by injections into the cavernous bodies of injections, against which there is an expansion of the vessels, which, in turn, causes the occurrence of a normal erection)
- drug therapy (determines the possibility of curing impotence without the need for using the above options for methods, has a number of contraindications that require mandatory consultation with specialists on their account, as well as the exclusion of this option as the only one in the treatment of the actual violation).
Impotence, whose popular treatment is considered as an option, should be cured in this way only in consultation with a specialist, because here, again, it is important to start from the nature of the onset of the disease. If you have problems accompanying impotence, you need to contact a urologist, it is possible that you will also need consultation of an endocrinologist, a psychologist and a cardiologist.