Men`s Health Generic Drugs F.A.Q.
What is erectile dysfunction?
Erectile dysfunction or impotence is a chronic inability to achieve and maintain an erection strong enough for complete sexual intercourse. If you encounter this problem once or from time to time, it’s not erectile dysfunction. The diagnosis is made when the situation occurs chronically for at least three months in a row. Besides, the disorder is also commonly accompanied by the lowering of sex drive and ejaculation disorder.
Erectile dysfunction is a very widespread disorder. Around 40% of men develop erection dysfunction by the age of 40 and the number goes up to 70% in men who are older than 70 years.
Severe impotence is rarely found in young men but the disorder affects more and more younger men due to various negative factors such as smoking, alcohol consumption, excess weight, sedentary lifestyle, and so on.
What causes erectile dysfunction?
There are basically two types of erectile dysfunction: psychogenic and organic. The first one accounts for 40% and the second one around 29%. Mixed erectile dysfunction, i.e. caused by a combination of psychogenic factors and physical traumas or diseases, accounts for 25% of cases. In around 6% the cause is undefined.
In the European Association of Urology, the forms of erectile dysfunction are defined in detail depending on the mechanism of their development.
– Damage to the pelvic vessels.
– Neurogenic impotence:
– Degenerative diseases (Parkinson's disease, multiple sclerosis);
– Injuries and diseases of the spinal cord;
– Tumors of the central nervous system;
– Chronic renal failure.
– Anatomic or structural impotence:
– Peyronie’s disease;
– Injury (fracture of the penis or pelvic bones).
– Hormonal impotence:
– Hyper- and hypothyroidism;
– Cushing's disease;
– Drug-induced impotence due to the use of:
– Antihypertensive medications;
– Certain hormonal medicines;
– Psychogenic impotence:
– General (decrease in excitability and sexual disorders, regardless of the circumstances);
– Situational (depends on the partner and circumstances).
The risk factors for the disorder development also include older age, depression, obesity, smoking, use of illicit drugs, alcoholism, vitamin deficiency, metabolic syndrome, disturbances in the lipid spectrum of blood, exposure to external factors (radiation, electromagnetic radiation).
A few decades ago, it had been considered that impotence in men younger than 40 is of psychogenic (mental) nature. However, with the improved methods of diagnosis and understanding of the disease, it had been discovered that around 15-20% of men below 40 who develop the disorder has it due to organic diseases such as atherosclerosis (32.1%), venous pathology (16.7%), neurogenic disorders (12.8%), endocrine diseases, and use of medicines. The main risk factors are considered smoking, elevated blood cholesterol, groin injuries, spinal cord injuries, and drug use. The risk of ED in smokers is 15-25% higher than in non-smokers.
In men older than 40, the main causes are organic diseases such as atherosclerosis, diabetes mellitus, age-related decline in testosterone levels. Besides, the older a man gets, the more combined factors for ED he develops as people in general with age have more health problems than when younger.
In men over 60, besides the above-listed reasons for the dysfunction, there is an additional risk factor – a radical surgery on the prostate in prostate cancer. During surgery, it’s common that nerves are damaged which inevitably causes impotency.
How to know if I have erectile dysfunction?
Usually, the disorder is diagnosed if a man has trouble achieving an erection or maintaining it long enough for intercourse on the course of three or more months. Although it is preferable to pay attention to the cases when you couldn’t achieve an erection, you should not panic. It can be caused by stress, lack of sleep, and other temporary factors. But if the problem reoccurs, it is advised to go to an urologist or andrologist to get a proper diagnosis and find out whether you need the treatment of underlying diseases.
How is erectile dysfunction diagnosed?
To get a proper diagnosis and find out the reason you are suffering from erectile dysfunction, you should visit your physician, urologist, or andrologist. The diagnosis is based, first of all, on the patient’s survey. A doctor asks the patient about the complaints about general health, sexual life in the past and now, stress factors, relationship status, and so on. It is important to establish when the first signs of ED occurred, how often the inability to achieve an erection occurs, and when it occurs.
For the indirect determination of hormonal disorders, the genitals, the skeleton, body hair, and the state of the muscles are examined. Of particular importance is the assessment of the cardiovascular system condition. For example, if a patient with erectile dysfunction has more than three risk factors for developing coronary artery disease, they are asked to undergo an ECG with a load and an ultrasound of the heart. This is due to the fact that in severe pathologies of the heart and blood vessels, sexual life or treatment of impotence may be contraindicated.
A set of laboratory and instrumental diagnostic methods depend on the patient's complaints and the results of the physical medical examination.
Laboratory methods (blood test) include tests for:
– Glucose level;
– Lipid profile;
– Total testosterone;
– Bioavailable and free testosterone;
– Luteinizing hormone;
– Follicle-stimulating hormon;
– Prolactin hormone.
Instrumental methods include:
– Monitoring of nocturnal spontaneous erections (penile tumescence);
– Study with intracavernous administration of vasoactive drugs;
– Doppler ultrasound of the arteries of the penis;
– Research of bulbocavernosus and cremasteric reflexes and evoked potentials;
– Electromyography of the penis.
How is erectile dysfunction treated?
The treatment, first of all, implies the normalization of the lifestyle and exclusion of potential factors that could contribute to ED development. For instance, if you are a smoker, you are highly advised to quit smoking, if you have excess weight – lose it. If you take any medications, you should consult your doctor about whether they could be the reason for the dysfunction development and if they can be replaced.
If ED is caused by the curable causes, the treatment is started with their elimination. For instance, if a man has no physical health problems, then the reason for the dysfunction is considered to be psychogenic and the help of psychotherapist can be appointed. Another example is when a young man suffers from the disease due to the injury and damage to the arteries in the pelvic area – in their cases, a surgical intervention can solve the problem once and for all. In hormonal imbalance, the use of testosterone in prescribed by endocrinologist dosages can be very helpful.
When the cure of the diseases or conditions that led to ED is impossible, symptomatic measures are used, i.e. those that cannot cure the disorder but can help with erectile dysfunction as a symptom.
– The first and safest treatment method is the use of type 5 phosphodiesterase inhibitors. The group of these medications includes Viagra, Cialis, Levitra, and their generic analogs including Caverta by Ranbaxy. These formulations inhibit the action of a certain enzyme that doesn’t allow the penile muscles to relax. When the muscles are relaxed under the impact of the medications, they allow the blood vessels in the penis to be filled in by the blood which is the main requirement for erection occurrence. Unfortunately, the effect of such medicines doesn’t last long. It is on average 4-6 hours and only Tadalafil can act up to 36 hours. The effect of the pills is noticeable only in the sexual stimulation so you don’t have to worry that you can get an erection at an inappropriate time. The pills are taken one hour to thirty minutes before planned intercourse. They come in different formulations – regular pills, oral jelly, soft tabs, and so on.
– The pump therapy implies the use of a penis pump before intercourse. The penis is inserted in a special tank in which negative pressure is created with the help of a pump. As a result, blood flows to the cavernous bodies of the penis but to preserve an erection it also needed to put a ring on the base of the penis. This method is used by older people who cannot use medications for ED due to health conditions.
– Injections of vessels-widening medications in the penis are also an option. However, due to the inconvenience of their use and such adverse reactions as too long erection and pain in the penis, they are rarely used.
– Surgical treatment of ED. It is the last resort for people who cannot treat the dysfunction with the previously-described methods. To do this, use semi-rigid prostheses or hydraulic implants that mimic an erection are used. Other types of operations are proposed (for example, slowing down of the venous outflow), but their use is questionable today.
During the therapy, it is important to stay in touch with your doctor so that he could assess your response to the used medicines and their safety for your health.
How to prevent erectile dysfunction?
Many of the reasons for ED are eliminable so there are quite effective prevention methods:
– Smoking cessation;
– Regular exercise;
– Maintaining normal body weight;
– If possible, the exclusion of medications that have a bad effect on potency (this always requires the advice of a physician);
– Refusal from large doses of alcohol;
– Recreational drugs withdrawal;
– Control of blood pressure and blood cholesterol levels;
– Avoiding stress if possible;
– Following a balanced diet.
For the prophylaxis of ED, a diet for heart health is recommended. It should include sufficient vegetables, fruits, fish, vegetable oils, and whole grains. It is advised to minimize the consumption of fatty, fried and processed foods.
The increase of physical activity reduces the risk of ED in middle-aged men by 70%.
It is also important to treat all diseases timely especially if you have any heart, vascular, endocrine, or urological infections.
What is premature ejaculation?
Premature ejaculation is an occurrence of lost control over ejaculation. It can happen in 30-60 seconds after an intercourse start or even before penetration. Although it is usually understood as a disorder related to sex, premature ejaculation can also occur during any sexual practice including masturbation.
Some men unreasonably believe that they suffer from the disorder but it’s normal to ejaculate in 4-5 minutes after the start of intercourse – this time is considered an average.
It is a very common disorder that affects one in three men of any age. But not every case of premature ejaculation is considered a sign of the disorder.
If it happens from time to time – it’s normal. But if the problem is persistent and occurs every time you want to have sex – they should seek medical assistance.
There are two types of PE:
– Lifetime (primary): it is present almost always, starting with your first sexual experiences;
– Acquired (secondary): it develops after sexual intercourse and sexual practices that have passed without problems with ejaculation.
What causes premature ejaculation?
To date, the exact reason for the disorder development isn’t found. But it’s considered that PE can be related to the complex interaction of psychological and biological causes.
The psychological reasons can include:
– History of sexual abuse;
– Insecurities related to the body image;
– Erectile dysfunction;
– Troubles in the relationships with the partner;
– Guilt, and others.
The biological reasons include:
– Abnormal hormone levels;
– Abnormal levels of brain chemicals - neurotransmitters;
– Inflammation and infection of the prostate gland or urethra;
How is premature ejaculation treated?
The therapy of the disorder includes behavioral therapy, anesthetics to lower the sensitivity of the penis, and other medicines such as generic Priligy by Sunrise Remedies.
You should keep in mind that it can take some time until your doctor finds an optimal combination of the methods suitable for you.
Doctors commonly recommend consultations including a visit to a therapist and talks with your partner.
Other advised behavioral methods include:
– Masturbation one or two hours before planned intercourse;
– Temporary refusal of conventional sex and its replacement with other practices of intimacy to lower the emotional tension;
– Kegel exercises: stop urinating during the process and remember what muscles were acting. Work on straining them 3 times a day by 10 repetitions for 3 seconds. Do not hold your breath, do not strain the muscles of the abdomen, thighs, and buttocks;
– Use thick latex condoms to lower the sensitivity.
The medications for PE should be chosen by a doctor. They can be topical gels that lower the penis sensitivity or oral tablets that can extend the intercourse time but it’s better to listen to your doctor not to use incorrect medicines that can cause the lack of sensitivity at all.