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Health

Erectile Dysfunction

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  1. Symptoms: the vascular reflex mechanism in the penis fails; sufficient blood is not pumped to the penis to make it erect; occurs any time prior to orgasm; some have trouble achieving an erection during sexual foreplay; occurs in one of two ways:
    1. Difficulties in obtaining an erection long enough to accomplish intercourse
    2. Difficulties in maintaining an erection long enough to satisfy themselves and their partners during intercourse
  2. Diagnosis: Symptoms must occur for at least six months and lead to marked distress in the person that experiences them; diagnosis made by experienced therapists who would take into account persons age, the context of a person’s life, and whether the person experienced stimulation that would ordinarily be expected to lead to sustained arousal and orgasm
  3. Course and Outcome: Sexual disorders such as erectile dysfunction are well understood and there are several treatments that good results to cope with the disorder
  4. Frequency of Disorder: in men 18 to 24, 6% reported erectile problems; men 55 to 59, 20% reported erectile problems; erectile problems increase with age, they achieve erection slower, but can maintain it for a longer period of time; older men find it more difficult to regain an erection if lost before orgasm
  5. Etiology:
    1. Biological factors:
      1. Hormonal impairments: Men with inadequate levels of sex hormones (testosterone) have a lower sexual appetite
      2. Vascular impairments: effects the amount of blood reaching the penis
      3. Neurological impairment: epilepsy and multiple sclerosis; lacking spinal reflexes; diabetes
      4. Drugs: cigarettes, alcohol, marijuana
    2. Psychological Factors: beliefs and attitudes towards sexuality; anxiety; negative emotions in the presence of erotic stimuli
  6. Treatment(s):
    1. Psychological procedures: focuses on activities of sensate focus and scheduling, education and cognitive restructuring, and communication training
    2. Biological treatment:
      1. Medications: phosphodiesterase-5 (PDE-5) inhibitors that facilitate an erection by increasing blood flow to certain areas of the penis: Sildenafil citrate (Viagra), tadalafil (Cialis), vardenafil (Levitra)
      2. Surgical: inserting a penile implant (or prosthesis):
        1. semi-rigid silicone rod that the man can bend into position for intercourse
        2. hydraulic that can be inflated for the purpose of sexual activity
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