Disturbances of the erection (limb stiffening) often have a psychological and/or physical (physical) cause. But there are many options available for erectile dysfunction treatment in Delhi.
Erectile dysfunction (ED) literally means a problem in erection (limb stiffening). One understands this as the permanent inability to achieve or maintain an erection sufficient for a satisfactory sexual activity. Among other things, it is clear from this definition that the diagnosis also depends on the subjective assessment by the person concerned and that an occasional absence of the erection does not yet signify ED.
Erectile dysfunction is colloquially also referred by the best sexologist in Delhi as potency disorder or impotence. However, this is partially correct, because both terms also include the inability to normal ejaculation (ejaculation), the inability to produce ( sterility ) and the lack of urge to sexual activity (lack of libido = “desire”).
In undisturbed libido and normal hormonal position, in erotic situations under the influence of the mental state of the man certain areas of his brain are excited, for example, by visual impressions, touch, odors or ideas. Through special centers in the spinal cord and nerve fiber plexuses around the bladder and prostate, the impulses then reach the penis. There they leave the musculature of the supplying blood vessels (arteries) and the cavernosumslacken, causing an increase in the diameter of the afferent arteries. Thus, the blood supply increases in the cavities of the cavernous, so that they expand and high pressure in the erectile tissue.
This pressure, in turn, squeezes the laxative blood vessels (veins), the blood no longer drains from the erectile tissue, the high pressure remains and the penis becomes large and stiff. The cavernous bodies have a stable connective tissue envelope, which limits their extent (tumescence) and together with the balance of inflow and outflow of the blood determines the hardness (rigidity) of the erection.
The afferent blood vessels (arteries) are barrier arteries whose width can be regulated by the musculature of the arterial wall. Emptying of the cavernous bodies is also under the control of the brain via nerve impulses. These control the smooth muscles of the barrier arteries, the arteries occlude and thus the pressure falls in the erectile tissue. The low pressure is no longer sufficient to squeeze the laxative vessels. As a result, the bloodstream is released, the erectile tissue empty, the penis relaxes again.
Frequency of Erectile Dysfunction
Many men are affected by a more or less pronounced erectile dysfunction, in India alone up to 6 million. The incidence increases with age, according to studies to more than 50%. However, only 10-25% of them can be treated, although up to two-thirds of men are sexually active even at a high age.
The unreported number is so high. Shame probably prevents many sufferers from going to the doctor (or fear of not being a real man). Often the partnership is burdened by this. This, in turn, builds up psychological pressure, which only aggravates the problem.
Causes of Erectile Dysfunction
It can be seen from the process of erection described above that it can be organically (physically) disturbed in a variety of ways. However, the psyche (eg fear of failure, stress at work, partnership conflicts) also plays a significant role in erectile dysfunction (ED). It can trigger and amplify problems.
Physical causes include, for example:
- Supply of pleasure poisons (eg alcohol, nicotine) or drugs.
- Cardiovascular diseases, eg coronary heart disease, hypertension, arteriosclerosis (“vascular calcification”).
- Metabolic diseases, eg diabetes mellitus (diabetes), lipid metabolism disorders, thyroid diseases.
- Taking medicines, such as blood pressure and blood lipids, heart medication, anti-inflammatories, psychotropic drugs, tranquilizers, and strong painkillers, appetite suppressants, hormone preparations (including antiandrogens and LH-RH analogs for the treatment of prostate cancer).
- Benign Prostate Syndrome (benign prostate enlargement).
- Diseases of the brain or spinal cord, eg multiple sclerosis, stroke.
- Nerve damage, eg by poisons or in prostate cancer by radical prostatectomy or
- Changes in hormone levels due to diseases of the pituitary gland, testes or adrenal glands.
- Malformations, injuries or penile diseases.
As major risk factors for ED as well as for cardiovascular diseases are: lack of exercise, obesity, smoking, hypercholesterolemia (elevated blood lipid levels) and the metabolic syndrome (a combined metabolic disorder in diabetes mellitus).
Investigation of Erectile Dysfunction
The basis is the detailed collection of the anamnesis (previous history) in order to limit the number of possible causes. This includes questions about taking medication, the psychological situation and sex life.
Then follows the physical examination, including the measurement of blood pressure and pulse as well as a DRU. Whether laboratory tests are carried out depends on the results so far. Further investigations can be: the determination of blood sugar, blood fats, and sex hormones, if necessary also further ones like the PSA value.
Because the cardiovascular risk of sexual activity among those affected by ED is increased, the diagnosis also aims to assign the affected person to a corresponding risk class, possibly with the help of a cardiologist or internist. Thus, in the case of high risk (eg unstable angina pectoris = “chest tightness”), the intake of PDE-5 inhibitors is generally prohibited. At low risk, however, a trial with these drugs may be considered without further investigation.
Only rarely are special examinations, such as the cavernous injection test (SKIT) and sonography (ultrasound examination) of the penile vessels required. The measurement of nocturnal erections, musculoskeletal muscle activity measurements (CC-EMG, corpus cavernosum electromyography), X-ray contrast imaging of cavernous bodies or blood vessels, and functional tests of nerves or hormone control circuits are only available in particularly complicated cases and are usually only carried out by specialized institutes.
Erectile Dysfunction Treatment
In erectile dysfunction treatment in Delhi, first and foremost are the removal of the risk factors (eg through physical training, weight loss, smoke stop) and the treatment of possible causes (eg adjustment of blood pressure and blood sugar, switching to other drugs, hormone replacement, surgery of malformations, psychotherapy).
At the same time – or if this is not enough or not possible – symptomatic measures (directed against the symptoms, ie the ED) can be used.
The selection depends on the cause of the ED, the findings and the individual needs and expectations of the affected couple. Success, satisfaction and adverse effects should be reviewed regularly and therapy should be adjusted as necessary.