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Erectile dysfunction, loss of desire, premature ejaculation: treatments for men's sexual problems
Erectile dysfunction, loss of sexual desire and premature ejaculation: these are the main sexual problems faced by men. But do they have a solution? Yup. The explained the best solutions according to the root of the problems.
Until recently, commercials sold the solution to "impotence." Doctors warn that the word is no longer used because it is considered pejorative.
Erectile dysfunction is the main sexual problem experienced by men. Dr P K Gupta, , explains what the disease is:
"The definition of erectile dysfunction is the persistent inability to produce or maintain an erection sufficient for satisfactory sexual intercourse for at least six months."
But what can lead to the problem? According to Dr Gupta, "the penis works like a blood vessel."
"What is bad for a blood vessel will also be bad for the health of the penis. Increased cholesterol, sedentary lifestyle, smoking, diabetes, obesity, are some of the risk factors for erectile dysfunction."
separate causes into two types: organic and psychological. Dr P K Gupta, an expert in the field, says that the root of the dysfunction is emotional.
"Insecurity in relation to erection is the problem that most affects men", he evaluated.
The psychological factors are varied, such as fear of pregnancy and depression. There is also situational erectile dysfunction, when the patient has a normal erection with his wife but not with his lover, and vice versa. Job loss and widowhood can also cause it.
In these cases, the most recommended treatment is specialized psychotherapy. According to , it is possible to solve the problem momentarily with the use of medicines, but only the recovery of security is what brings the definitive cure.
"The ideal is to be able to treat the emotional cause and take medicine. If the first part is not done [going to a psychologist], the patient will need to take the medicine forever. Psychotherapy is the only treatment that really cures", he explains.
There are also organic causes: it is very common for men to undergo pelvic surgery. says that 1 in 7 men will have prostate cancer, one of the treatments being surgery. This can damage one of the nerves that make an erection impossible.
Viagra and Variations
The says that the great evolution in occurred with the discovery of drugs that guarantee erection, such as Viagra, 20 years ago. They work in the following way: the man produces a substance inside the penis called cyclic GMP (cyclic guanosine monophosphate) and it is this that starts the erection mechanism. There is also an enzyme that destroys cyclic GMP.
"Let's assume that the man has '10 pellets' of cyclic GMP. The enzyme goes there and destroys eight. The drug reduces this action to facilitate erection", explains Dr Gupta.
Treatment with drugs and psychotherapy is called first-line, according to Dr Gupta. He points out that there are other ways out for the 30% or so who don't respond to pills like Viagra.
The second line consists of injections into the corpus cavernosum of the penis. "We teach the patient how to do a penile injection and he will be able to have sexual intercourse normally," he said.
Dr P K Gupta says that while the injection is done to not cause too much pain, many patients can't get used to it. A small portion does not have the expected result.
"Then we go to a third line of treatment, the penile prosthesis. It is the implantation of silicone rods inside the cavernous body. This keeps the penis erect, with a malleable and semi-rigid prosthesis", he explains.
Reduction of sexual desire
Doctors are clear: a lack of sexual desire among men is increasingly common.
Libido is linked to the levels of testosterone, a male hormone, also found in women, which peaks in adolescence. It is natural for rates to drop after age 50 and there is a reduction in attraction.
"It's not just hormonal. Men can also have libido problems for psychological reasons. In the so-called hypoactive male sexual desire, he has all the normal tests, but for some unknown reason he has no sexual desire. It's no use giving Viagra, it's no use giving hormone", explains .
Dr Gupta points out that psychological causes are also linked to depression, pressure at work and stress.
"Today I think that lack of desire is the second biggest cause of male sexual health problems. Hormone replacement is for those who need hormones. Often the root is emotional. This story of giving testosterone to everyone is wrong", he recalled. .
In these cases, when there is no hormone dysregulation, the solution is specialized psychotherapy. The available remedies do not resolve the issue, since the erection is only "activated" with the man's arousal.
There is disagreement regarding the definition of . Some medical institutions define it as the inability to maintain an erection for more than two minutes inside the partner's vagina. Others ejaculate in a minute.
"I believe it's 'when a man doesn't have voluntary control of ejaculation, such that he ejaculates before he wants to," said. He just thinks he has it.
"It involves three concepts: a quick ejaculation, a feeling of lack of control and a nuisance in the couple", evaluates .
According to the , a survey that lasted 10 years showed that the normal median time for men is five minutes.
In this disease, the causes are psychological. There are some cases in which suspicions arise for organic reasons, such as a hypersensitivity of the glans (the "head" of the penis), but not with considerable frequency.
"It is very prevalent because it affects men of any age, although there is a greater predominance in young people under 25 years old. It causes major problems in terms of quality of life", says Dr Gupta.
Anxiety to satisfy the partner and insecurity are the most recurrent causes. In these cases, treatment is also done with specialized psychotherapy.
The drugs used to prolong erection in India are antidepressants. says that one of the effects is to slow down the process and, with smaller doses, you can lessen the side effects.
"The antidepressant drug will increase serotonin in the Central Nervous System and that delays the trigger of ejaculation."