Synonyms

Erectile dysfunction, impotence,
medical: Erectile dysfunction (ED)

definition

Erectile dysfunction occurs in men if, within a certain period of time, he does not or only rarely succeeds in inserting his penis into the necessary fully erect (stiff) To bring a state or to maintain this state. However, if this is only the case sporadically or for a short time, one does not speak of erectile dysfunction.
Has erectile dysfunction Nothing to do with a reduction in male fertility. With an existing impotence, the ability to ejaculate and to produce semen remains with a few exceptions.

Epidemiology

According to studies, the incidence rate is (Incidence) erectile dysfunction in Germany and internationally approx. 20%. For men over 70, however, it is already 70%which shows that this disease is highly age dependent. In men aged 40, this disorder is about 5% complete and about 17% moderate. Furthermore, recent studies show that 20-70% of all patients with diabetes (Diabetes mellitus), high blood pressure (hypertension) or Lipid metabolism disorders one time you have an erectile dysfunction that requires treatment.

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Erection Basics

Several systems work together so that an erection can occur in men. Functional blood vessels are important for their development, annoy, certain parts of the penis and a healthy initial psychological situation. Important to understand the erection and thus also their disorder is the knowledge of their physiology, as well as an idea of ​​the anatomy of the penis:
The penis owns three so-called cavernous bodies (Corpus cavernosum), which can swell up and down. Your filling with bloodand with it the condition of the penis, is controlled by blood vessels that run along the penis. An important blood supplying vessel is that Arteria dorsalis penisthat runs in pairs under the top of the penis. From there, small branches go into the two large cavernous bodies and fill them with blood if necessary. Inside these two cavernous bodies there is another vessel, the Deep penis arterythat does the same job.
The third erectile tissue encloses the urethra and is fed by its own artery. However, all three vessels are connected to one another. When the penis is flaccid, they supply it Arteries oxygen, the blood flowing into it is transported away again by the associated veins without the cavernous bodies being able to fill. This is achieved by small muscle fibers that hold the fluid (Sinusoids) surround the erectile tissue. So you can think of it as similar to a sponge.
These muscles are tense when they are flaccid, so the arteries are narrow in diameter and there is not much room for blood in the caverns of the erectile tissue.
Certain nerve impulses slacken the muscle fibers when there is one erection should come. This causes the arteries mentioned above to increase in diameter and thus to pump more blood into the erectile tissue. This then collects in the Caverns (Sinusoids), causing the veins that carry it away to narrow in diameter. They have a far softer wall than the arteries. So there is a so-called positive feedback: the more blood flows in, the more the cavernous bodies fill, the less blood flows out.
The penile shaft becomes longer, it increases in diameter and becomes stiff.
The nerve impulses necessary for this come from the autonomous (vegetative, involuntary) Nervous system, more precisely from the so-called Parasympathetic nervous system. This is particularly active when we are sleeping, digesting, or generally relaxed.

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Types of erection

There are basically three types of erections:

  • Reflexogenic erection: It occurs through the stimulation of the genital area and the associated nerve connections in the lower spinal cord.
  • Psychogenic erection: It is triggered by erotic stimulation of the brain, for example through thoughts or images. The impulses for this are controlled centrally in the brain and passed on via the parasympathetic nervous system.
  • Nocturnal erection: It is practically automatic because the parasympathetic nervous system is most active at night. Therefore, if there is an existing nocturnal erection, a psychologically induced erectile dysfunction can be ruled out.

Erectile dysfunction prophylaxis

To the impotence To prevent this as early and as effectively as possible, the general lifestyle should be adjusted accordingly. Risk factors like tobacco, cholesterol (animal fats) and too much sugar should be avoided. Regular physical activity is also a useful preventive measure for erectile dysfunction. Is there already a vascular disease or a Diabetes mellitusso should be on a well-monitored and meaningful basis medication Care should be taken to avoid impotence as a long-term consequence of the disease. An open partnership relationship can also have a positive effect on sex life, so that psychological triggers caused by partnership can be avoided.

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Erectile dysfunction prognosis

It depends on the number and severity of the underlying factors. Furthermore, the prognosis is influenced by whether the possibly existing underlying disease can be treated and how well the patient responds to the therapy used.
The earlier and more effectively the problem is treated, the better. This is not always easy to do, as most patients are ashamed of their potency problems and therefore wait on average over a year before even going to the doctor.

Summary erectile dysfunction

The Erectile dysfunction is a disease that is as widespread as it is secretive in men. Despite its frequency, it is still a socially taboo topic. It particularly affects those over 50 years of age; however, men under the age of 40 sometimes have problems with potency.
Often it is based on chronic diseases that affect the metabolism Hormones, the annoy- or that Vascular system affect. Well-engineered and good diagnostics in the field of urology enable an exact determination of the triggers of the erectile dysfunction and create the basis for an efficient and largely side-effect therapy (see: Erectile dysfunction therapy). There are several different approaches that can be individually adapted to the patient. The last few years in particular have produced many new findings that have been able to improve the therapeutic effects and patient comfort.

An important, non-invasive and in many cases indicated option for the treatment of erectile dysfunction is psychotherapy. However, their possibilities are often underestimated, especially by men, and their methods are viewed as rather unpleasant and shameful, which makes them fall behind drug or technical-assisted therapy in their popularity. The prognosis of erectile dysfunction ranges from very good in mild and easily treatable cases to rather poor in the case of multifactorial genesis and serious underlying diseases.
In summary, it can be said that for the prevention and better therapy of erectile dysfunction, the education of both male and female society about the spread and development of potency problems should significantly improve.

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