Thursday, 28 November 2013

Erectile dysfunction

Erectile dysfunction
The complaints related to sexual dysfunction are very common. From the infertile couple visiting hospital, 6o% men complain off some Problem.

Premature ejaculation
Premature ejaculation is common at earlier age , but some men has sustained problem after several years and is more common in men with habitual masturbation.This can be effectively treated with medications .

Failure to attain erection
Many patients attribute this to heavy workload and increased stress levels. Medical problems can cause difficulty in erection.
  1. Neurologic diseases like stroke
  2. Surgery damaging nerves.
  3. Kidney failure
  4. Diabetis and high cholesterol
  5. Medications like antihypertensives
  6.  Ageing and psychological causes are also quite common.
Failure to sustain erection/failure to ejaculate  
Normal physiological time for erection to ejaculation is few minutes in men. whereas, the average time for females to achieve orgasm can be much longer (e.g. Half hour or more).
So a disparity between the couple is common, and conditions like diabetes make it difficult to sustain erection for longer time. This can be corrected medically with medicines like sildanafel (Viagra).

  1. Diabetics properly treated will have improved sexual function.
  2. Psychological problems can be solved with proper counseling.
  3. Medications like sildanafel (Viagra), vardenafil and tadalafel has been successfully used, in selective cases.
  4. Herbal remedies have been boosted, but proper scientific evaluation is incomplete to prove evidence.
  5. Vacuum devices,  injectables, and implants are occasionally used by urologist.
  6. Electroejaculator or vibrator can be used to collect semen sample, in case of difficulty for the purpose of IUI or ICSI.
  7. Premature ejaculation can be treated with Dapoxetine to increase the duration.  
General management for male fertility
  1. Increase in fruits, vegetables and nuts, will provide sufficient vitamins which are vital in fertility.
  2. Diet and exercise together will help in maintaining weight and proper blood circulation.
Erection is maintained only by pooling of blood in penis.
  • Extreme heat and travelling long distance should be avoided. Proper hydration is necessary with 4 liters of water daily.
  • Wearing loose cotton clothes helps in reducing scrotal temperature and helps sperm motility.   
  • Stopping smoking and alcohol consumption has huge advantages.
  • Reduction of stress, avoiding heavy work load and excessive strenuous exercise will help.
  • Have a good laugh, humour has proven to improve vascularity and thus sexual function.
  • Avoid abstaining for prolonged periods, as more prostatic infections noted leading to liquefaction problem in semen.
  • Avoid unprotected intercourse with unknown partners, as it can cause STD.       

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