Erectile dysfunction is also known as impotence. It is defined as the persistent inability in men to attain a hard and stiff erection. There may be some who can manage a descent erection but cannot maintain it long enough to perform a satisfying sexual intercourse.
Occasional inability to achieve erection may cause unwarranted stress and result in performance worry, which affects future performance and creates a cycle of impotence. Occasional impotence is common; this is usually situational and is not considered dysfunctional.
Causes
Erectile dysfunctions can be attributed to either psychological or physical conditions or both.The causes may include drugs, alcohol, diabetes, Parkinson’s disease, multiple sclerosis, HIV, other diseases, cycling and spinal cord lesions. Performance anxiety is often associated with Erectile Dysfunctions. Sometimes the problem may have psychological underpinnings such as stress, depression or sexual boredom.
Treatment
It is important to inform the partners about the risks involved in some treatment approaches. Consequently, treatment depends on the cause of the dysfunction and include:
• Intracavernosal injection
• intraurethral pellets
• oral medications
• hormonal augmentation
• surgical interventions
• psychologicaltherapy
Erectile dysfunctions are sometimes tackled through the use of vacuum that involve placing the penis is a plastic tube with suction, thus drawing venous blood into the penis to create an erection. Once the penis is erect, a rubber constriction ring is placed at the base of the penis to prevent the erection from being lost, thus allowing sexual intercourse.
Sunday, February 3, 2008
Erectile Dysfunction / Impotence
Premature Ejaculation
Premature ejaculation affects a man such that he repeatedly ejaculates without much sexual stimulation. He may climax before or shortly after penetration and finds it hard to control it. The man is unable to apply any voluntary control on his ejaculatory response and is unaware of erotic sensations leading to ejaculation. Premature Ejaculation is most common among younger men and men with limited sexual experience. The condition is often associated with performance anxiety.
Causes
Premature Ejaculation can rarely be attributed to physical condition. At times infections in the urethra and prostate, neglected gonorrhea, and overly tight foreskin have been considered as possible physical causes.In Premature Ejaculation, the affected man has not learned to recognize the sensory feedback that indicates ejaculation is imminent.
Treatment
Treatment may include psychological approaches aimed at reducing anxiety, special techniques to improve ejaculation (such as the “pause and squeeze” technique), and drug therapy with the use of formulations that delay ejaculation, thereby improving sexual satisfaction in the patient and his partner.
Anorgasmia
Anorgasmia is another condition typical to women as characterized by a continuous or repeated delay in or lack of orgasm following a normal sexual excitement stage.In this case women may have intense sexual desire or arousal or even enjoy penetration but is unable to climax.Remember a woman is not anorgasmic if she can achieve orgasm through means other than penile-vaginal stimulation.
Causes
Causes of anorgasmia is characterised by rage and hostility toward one's partner, unproductive sexual technique, nervousness, familial or religious teachings that encourage sexual avoidance, and strong fear of loss of control over feelings and behavior. In men the cause is rarely physical and is usually associated with a traumatic sexual experience, hostility, loss of control, or lack of trust.
Anorgasmia is often experienced where communication between partners is lacking and where the sexual or emotional needs of the anorgasmic partner are not fulfilled.
Treatment
Refer the patient to a sex therapist, where possible. The treatment method involves individual where focus is on treating the fear of orgasm or loss of control, resolution of conflicts, and increasing stimulation. Couple work involves sexuality education, addressing sexual myths, and developing a greater understanding of the anorgasmic partner’s needs.
Vaginismus
Vaginismus again affects women and is marked with difficulty or pain during penetration due to involuntary contractions of vaginal muscles. It can get so worse at time that women dread any sexual contact; others may have satisfying sexual experiences through extensive foreplay leading to orgasm without penetration.
Causes
It is seen that Vaginismus is often the result of physical or sexual abuse that induces a phobic reaction at the prospect of genital penetration. Other causes may include a painful first intercourse, relationship problems, fear of pregnancy, rape victim, religious orthodoxy, or the woman’s belief that her vagina is too small.
Treatment
Refer the patient to a doctor with a background in sex therapy or psychology, if possible. The treatment involves “cognitive behavioral” therapy, consisting of a program with specific exercises designed for soothing the muscles around the vagina and systematic desensitization of the vagina. The woman learns to have greater control over her vaginal muscle spasm while gently introducing inserters of gradually increasing size into her vagina. This regime is successful once a women is comfortable with her partners penetration.
Dyspareunia
Dyspareunia affects women and can differentiated by repeated vaginal pain during sexual intercourse. Pain usually occurs with penetration but can occur even without penetration due to vaginal stimulation.
Dyspareunia is marked with pain at the vaginal opening or deep inside. Such repeated pain can lead to avoidance of sexual activity, loss of desire and arousal.
Symptoms
Burning, itching, stinging, and feeling swollen, in any area of the perineum are some of the symptoms of Dyspareunia.
Causes
There are many causes of dyspareunia that can be psychological or physiological.The main causes are vulvovaginitis, herpes, atrophic vulvitis, urethral troubles, episiotomy, radiation vaginitis, sexual trauma, inadequate lubrication and topical irritants such as latex. Sometimes deep pelvic pain is often ascribed to ovary injury during intercourse with the partner hitting an ovary during sexual intercourse, pelvic or abdominal surgery, postoperative adhesions, genital or pelvic tumors, irritable bowel syndrome, urinary tract infection, and ovarian cysts.
Treatment
Physical nature of dyspareunia can be identified and treated accordingly. If the dyspareunia is of a psychological nature, refer the patient to a doctor with a background in sex therapy or psychology, if possible.
