Erectile Dysfunction or Impotence
Cause
Impotence usually the result of:
Vascular abnormalities
abnormalities persyarafan
Drugs
Abnormalities of the penis
Psychological problems that affect sexual arousal.
The cause of a physical nature is more common in older men, while psychological problems are more common in younger men. Increasing the life of a man, then impotensisemakin often happens, though impotence is not a part of the aging process but is a result of a disease that is often found in the elderly. Approximately 50% of men aged 65 years and 75% of men 80 years of experience impotence.
In order to erect, penis requires adequate blood flow. Therefore vascular disease (eg, atherosclerosis) can cause impotence. Impotence can also occur as a result of a blood clot due to surgery or blood vessels that causes disruption of arterial blood flow to the penis.
Damage to the nerves leading to and leaving the penis can cause impotence. This nerve damage can result from:
Injuries Diabetes mellitus
multiple sclerosis
stroke
Drugs
Alcohol
Lower spine disease
Rectal or prostate surgery.
Approximately 25% of cases of impotence caused by drugs (especially in older men who consume a lot of drugs).
Medications that can cause impotence are:
Anti-hypertension
Anti-psychosis
Anti-depressants
Sedative
cimetidine
lithium
Sometimes impotence occurs due to low levels of testosterone. But the decline in levels of male hormones (which tend to occur due to aging), usually more often causes a decrease in sexual desire (libido).
Some of the psychological factors that can cause impotence:
Depression
Worry
Guilt
Feelings of fear of intimacy
Indecision about sex.
Symptoms: Patients are not able to start and maintain an erection.
Diagnosis
Diagnosis based on symptoms. The physical examination is done to look for any changes in male sexual characteristics, such as breast, testicles and penis size, as well as changes in hair, voice and skin.
To distinguish between a physical or psychological causes, can be seen from sleep erections that are usually found also when you wake up in the morning / morning erection. if when the patient is still experiencing morning erction, meaning impotence is caused by psychological problems, and vice versa, if the patient is not experiencing morning erection, the cause of impotence is physical problems.
To determine abnormalities in the arteries in the pelvis and groin (which supply blood to the penis), measurement of blood pressure in the leg.
Other tests that may need to be done:
CBC
Blood sugar checks for diabetes
The level of TSH
Ultrasound penis.
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