Erections and erectile dysfunction
The inability of a man to attain or keep up erection long enough in sexual intercourse is called Erectile dysfunction.
Under normal circumstances, when a man is sexually stimulated, his brain sends a message via spinal nerves in the penis. Nerve endings in the penis release chemical substances called neurotransmitters that signals the cavernous bodies (two strips of spongy tissue along the penis) to relax and fill with blood. As it expand, the cavernous bodies close other veins that would normally discharged blood from the penis. As the penis becomes filled with blood, it expands and hardens, causing erection. Problems with blood vessels, tissues, or nerves of the penis can cause problems with an erection.
Causes of erectile dysfunction
An estimated 30 million American men suffer from impotence and it affects about half of men aged between 40 and 70 years. Doctors thought that most cases of impotence are psychological origin, but they now recognise that, at least in older men, physical causes may play a major role in 60 % or more of all cases.
Erectile dysfunction can be caused by many psychological and physical reasons.
They are:
diabetes
depression,
prostate cancer,
injury of the spinal cord,
multiple sclerosis,
atherosclerosis and heart disease,
injuries of the penis, that cause nerve, tissue or vascular damage can cause impotence;
It also can occur as a side effect of some medications, including: antihistamines, antidepressants, antihypertensives, antipsychotics, beta - blockers, diuretics, tranquillisers, appetite suppressors, cimetidine and finasteride.
* Among men older than 60 years, a major cause of erectile dysfunction is atherosclerosis, or narrowing of the arteries, which restricts blood flow to the penis.
Smoking, excessive alcohol consumption or use of certain medications can also contribute to impotence in old age.
In some cases, low levels of the hormone testosterone may contribute to erectile failure.
Psychological factors like stress, feelings of guilt or anxiety may play a role, even when the impotence is primarily due to organic causes.
Treatment of impotence
Treatment of the first order and far most used drug is sildenafil citrate. It is estimated that 20 million prescriptions were issued after the U.S. Food and Drug Agency approved the drug in March 1998. Also, treatment with sildenafil citrate is the most effective treatment, with a success rate of over 60 %. The drug increases the levels of a substance called cyclic guanosine monophosphate, which is responsible for widening the blood vessels of the penis.
Sildenafil citrate treats erectile dysfunction, as well as the inability to achieve and / or maintain an erection of the penis adequate for sexual intercourse. The drug was originally developed in 1991 for the treatment of angina or chest pain. It is the first and since the beginning of 2001 and only oral medication approved for the treatment of ED. Sildenafil citrate is a vasodilator, a drug that causes expansion of the blood vessels. He seems to improve blood circulation in the penis and increase the effects of nitrogen monoxide agent that relaxes smooth muscles of the penis and regulates blood vessels during sexual stimulation, allowing the penis to fill and to achieve an erection.
Dosage of medication
The average recommended dose of sildenafil citrate is 50 mg. For men who do not respond adequately to this dose, the dose may be increased to 100 mg. It takes a certain time to absorb the drug in the body to become effective. The drug is taken about an hour before sexual activity and can remain effective for up to four hours. Sildenafil citrate does not increase sexual desire. Sexual stimulation and excitement required for the drug to be effective. Apart its widespread use as a recreational drug, it is not an aphrodisiac and no clinical evidence that it improves sexual performance in men who suffer from ED.
Note: Men should always consult a doctor before beginning treatment with sildenafil citrate!
Expected results
When it is used according recommendations, sildenafil citrate allows men with erectile dysfunction achieve and maintain an erection of the penis when aroused during sexual activity. Double - blind, randomised clinical trials of sildenafil citrate drug has shown that 63-82 % rate of effectiveness in improving erectile activity in men with erectile dysfunction, depending on the administered dose (25 to 100 mg), compared with 24 % improvement in men who received placebo.
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