Drugs for the treatment of erectile dysfunction in men. Types of erectile dysfunction. Vascular surgery on the penis to improve erection

Impotence, or sexual impotence,- a serious problem for a man, not only physical, but also psychological. In modern conditions, this term as a diagnosis is not considered correct; instead, urologists and related specialists use the term "erectile dysfunction". This is more accurate and correct from the point of view of medicine, in addition, such a definition of pathology is not so difficult psychologically perceived by the patient himself.

For many men, this is a difficult period in life, but they are embarrassed to seek help from a doctor in such a delicate matter, preferring to search the Internet or on the advice of friends for home remedies and methods for treating impotence. This approach is fundamentally wrong, because dubious methods, various “drugs” often only exacerbate the problem, and self-selected medications can do even more harm, leading to persistent and often irreversible consequences.

Erectile dysfunction: definition and causes

The term erectile dysfunction (formerly impotence) is understood as a condition of a man of any age when he is not able to achieve an erection (the penis is filled with blood and is ready for sexual intercourse). At the same time, even if an erection occurs, it is impossible to maintain it for a sufficient time to conduct a full-fledged sexual intercourse and obtain complete sexual satisfaction for both partners. In addition, the same definition includes dissatisfaction with the quality of sexual intercourse due to potency disorders, premature or early ejaculation, the inability to complete the act before ejaculation (secretion of seminal fluid with orgasm).

Any of the symptoms of erectile dysfunction, occurring episodically or constantly, lead to a decrease in the quality of life due to the inability to have full-fledged intimate relationships, regardless of the factors that caused sexual disorders.

Potency disorders lead to physical discomfort and emotional depression, nervousness and stress, which significantly affects the quality of relationships between sexual partners. Given the special attitude of a man to intimate life, any reason that affects the quality of potency and the duration of sexual intercourse, satisfaction with it, leads to feelings and problems in relationships. The situation is aggravated by the fact that most men who experience difficulties in intimate life do not go to the doctor, considering it shameful and inappropriate, preferring useless and dangerous treatment of erectile dysfunction at home. Treatment does not bring results, leads to disharmony in intimate life and is a reflection of unsatisfactory male health in general.

Causes and conditions for the formation of erectile dysfunction

According to statistics, men in our country are more neglectful of their intimate health than Europeans or Asians. Therefore, potency disorders and various sexual disorders are much more common, they are detected in later and advanced stages.
One of the concomitant conditions for the development of erectile dysfunction is a high degree of traumatism of the genitals, as well as the influence of bad habits (smoking and alcohol).

In addition, in the minds of men, there was a wrong opinion that having this problem, starting treatment for erectile dysfunction is a kind of recognition of the fact that you are already “not on a horse” and cannot satisfy your partner.

The stress that men are exposed to at work or in everyday life has a strong influence on the intimate sphere and potency - depressed mood, manifestations of depression, lack of sleep and fatigue lead to erectile dysfunction.

If we talk specifically about the causes of intimate problems, they are divided according to their origin into two large groups:

• organic pathologies caused by developmental anomalies or acquired defects in the structure of the genitals,
• functional disorders associated with psychogenic or other factors, when the structure of the genitals is normal.

Often, men also have associated problems associated with certain deviations in the structure of the penis and other reproductive organs, as well as functional and psychogenic disorders.

Effective treatment of erectile dysfunction: what is needed for this

For the success of measures aimed at combating erectile dysfunction, it is important to determine the true cause of the disorders, take all measures to eliminate or, if this is not possible, weaken the negative impact. Adequately and fully, in a short time, this can only be done by a doctor, who must be consulted, discarding false shame and doubts. Initially, it can be a urologist or an andrologist, a sexologist, but if necessary, doctors of other specialties can also be involved in the treatment of impotence, depending on the cause that underlies the dysfunction. So, consultation and treatment is often required from an endocrinologist, therapist, cardiologist, vascular surgeon, neurologist, psychotherapist.

Often the problem has a psychogenic origin, in which case it is important to identify and eliminate the root causes. Although men are less emotional than women, various types of psychogenic disorders are also typical for them:

• stressful situations;
• anxiety and neurotic disorders;
• neuroses and neurosis-like disorders (tics, logoneuroses);
• depressive states, up to clinically expressed depression.

The intimate sphere can be significantly influenced by interpersonal relationships and conflicts with a partner, as well as a state of fatigue, feelings. If such "misfires" are rare and irregular, they do not apply to erectile dysfunction. If difficulties in intimate life began to appear constantly, this is a reason to contact a specialist.
The psychological causes of erectile dysfunction cannot be discounted at any age. The disease can be corrected much easier and easier than organic disorders.

Organic causes of erectile dysfunction

Among the reasons of an organic nature that interfere with the normal blood supply to the genitals to achieve a full erection, there are three leading ones:

• hormonal factor (violation of the synthesis of hormones or the perception of hormone signals);
• neurogenic disorders (associated with sensory disorders);
• vascular factor (vascular problems that prevent the penis from filling with blood).

Hormonal imbalance is one of the leading causes of erectile dysfunction. Deficiency of testosterone and androgens, the predominance of estrogen leads to a decrease in sexual desire.

It is the decrease in sexual desire with age that is the first sign of testosterone deficiency, and in this case, the treatment of impotence in men is prescribed by a specialist based on the results of relevant tests.

Violations of the functioning of the brain associated with tumor processes, disorders of innervation as a result of pathologies of the intervertebral discs, vertebral bodies, roots or peripheral nerves in the lumbar region and sacrum can lead to erectile dysfunction. Epilepsy, multiple sclerosis, head and spinal cord injuries, and Alzheimer's disease are also common causes of decreased sexual function in middle-aged and older men.

Vascular lesions of atherosclerotic origin, hypertension or myocardial infarction with circulatory failure lead to impaired blood filling of the pelvic organs and problems with potency. The narrowing of the lumen of the arteries that carry blood to the penis also causes sexual dysfunction, they progress with age.

Among other pathologies that need to be taken into account in the treatment of the "male problem" - impotence, one can name adenoma and prostate cancer, diabetes mellitus with its progressive lesions of small vessels, as well as liver damage (cirrhosis, hepatitis), scleroderma. Problems also develop as a result of surgical interventions in the prostate, brain or spinal area, as well as various manipulations in the pelvic and abdominal cavity, in the bladder area.

It is worth highlighting the side effects and negative impact on the potency of taking certain medications - antidepressants, drugs against arterial hypertension, antiulcer drugs or alpha-reductase inhibitors, antihyperlipidemic drugs and antipsychotic drugs. If erectile dysfunction occurs during drug treatment, you need to consult a doctor to correct the scheme.

Treatment of erectile dysfunction

It is important to understand that erectile dysfunction is a disease that, with the joint and coordinated actions of the patient's doctor, is successfully treated. Even the treatment of mild erectile dysfunction should be carried out in men under the supervision of a specialist and in accordance with an individually selected therapy regimen.

At the initial stage, all negative changes can be corrected without resorting to taking drugs or surgery, using various instruments and devices. Modern medicine has reached a level where fast and complete treatment of impotence is carried out, effective and safe. You should not practice dubious and untested methods, take various dietary supplements and pills that affect potency, you should undergo a full examination, find out the true cause of erectile dysfunction and, based on these data, take drugs or undergo other treatment.

Many mistakenly believe that the treatment of sexual dysfunction will be expensive and difficult, various painful manipulations or a number of medicines will be needed, but this is not true. Often more effective are just non-drug methods, psychotherapy, changes in lifestyle, nutrition and intimate habits. In each case, the method of impotence treatment is selected individually, based on the age, duration of the disorder, severity and presence of concomitant diseases and complications. Surgical interventions are applicable only in a small percentage of men with serious organic defects.

Erectile dysfunction: treatment methods

Treatment begins with home therapy, including lifestyle changes and the elimination of negative factors that provoke “misfires” in bed. So, it is necessary to provide sufficient physical activity, give up bad habits and correct existing chronic pathologies, evaluate the effect on the potency of the medications taken and, if necessary, replace them with those that do not have similar side effects. No less important is the psychological state of the man. So, the treatment of psychological impotence involves mostly the use of non-drug methods. In the treatment of this type of erectile dysfunction, the support and help of the partner, her participation and tactful attitude to such a delicate problem are more important than ever.

Speaking in general about the treatment of erectile dysfunction, doctors use the following methods of treating impotence:

• non-drug effects (lifestyle change, giving up bad habits, fighting overweight);
• taking medications to normalize sexual functions;
• hormone therapy according to indications;
• physiotherapy techniques;
• the use of various devices to improve erection;
• non-traditional methods of treatment (acupuncture, homeopathy, osteopathic practices, herbal medicine);
• psychotherapy.

Any medication in the treatment of impotence is prescribed only by a doctor, if indicated. Usually these are drugs that affect concomitant somatic pathologies, eliminate latent sexual infections and suppress inflammatory processes in the prostate. With testosterone deficiency, micronized testosterone preparations are prescribed (orally), used according to a special scheme, which allow you to return the brightness of sensations, sexual desire, and restore potency. They are used in courses, only under the supervision of a doctor, with mandatory monitoring of blood counts.

The generally accepted classification of drugs that regulate potency:

1. Means that increase the level of nitric oxide:
   • Selective PDE5 inhibitors: sildenafil citrate, tadalafil, vardenafil;
   • NO-synthase activators;
2. Alpha blockers:
   • Selective alpha2-blockers;
   • Non-selective alpha blockers;
3. Analogues of prostaglandin E;
4. Means of complex composition;
5. Androgens;
6. Myotropic antispasmodics: papaverine.

With testosterone deficiency, micronized testosterone preparations are prescribed (orally), used according to a special scheme, which allow you to return the brightness of sensations, sexual desire, and restore potency. They are used in courses, only under the supervision of a doctor, with mandatory monitoring of blood counts.

Widely advertised non-hormonal drugs for the treatment of erectile dysfunction are used as an additional source of vitamin and mineral components, as well as complexes of plant extracts that have a certain stimulating effect on the synthesis of endogenous testosterone. As an isolated remedy for the treatment of serious problems, these drugs are useless, they are ways to provide a preventive and additional effect that enhances the main therapy.

Physiotherapy for the treatment of impotence in men

In the treatment of erectile dysfunction, a physiotherapeutic effect is used, which, when used systematically, leads to an improvement in blood circulation and microcirculation in the genital area, enhances erection and sensations during sex, improves sperm quality and gives a man confidence.

The most applicable methods are four main areas:

• sedative therapy in the form of transcranial electrical stimulation, electrophoresis with drugs, color therapy, electrosleep;
• techniques that improve the trophism of the tissues of the intimate zone - rectal electrical stimulation, laser therapy, mud treatment, ultrasound exposure, interference therapy;
• effects that activate the synthesis of hormones - ozone therapy, transcerebral UHF method of exposure;
• physiotherapy techniques leading to vasodilation - magnetotherapy, electrophoresis with drugs, LOD-therapy and others.

The combination of psycho-correction with physiotherapy is the best treatment for impotence, leading to stable and pronounced results even without medication.

Various devices for the treatment of erectile dysfunction

The method of vacuum massage (LOD-therapy) in the penis area is considered to be quite effective. It helps to stimulate an erection and eliminates circulatory disorders. The mechanism of action is simple, due to the special design of the device, a rarefied atmosphere is created around the penis, stimulating artificial blood flow to the area of ​​the cavernous and spongy body, which leads to an erection. During the session, in addition to decompression, the exchange of oxygen between blood and tissues is also activated, the transport of metabolic products and fluid is normalized. This improves tissue nutrition and eliminates dystrophic processes in the genital organ.

Additionally, against the background of decompression, irradiation with a monochrome light spectrum (red area) is performed, which irritates the penis receptors that are involved in the formation and further maintenance of an erection. Due to the effect on blood flow, the blood filling of the organ improves and its functions are normalized.

Additional remedies for the treatment of erectile dysfunction

In addition to the main ones, as additional, auxiliary methods, you can use acupuncture and the impact on biologically active points with massages, as well as homeopathic medicines and manual therapy, osteopathy is used as a method of soft and delicate exposure, relieving spasms and clamps in the lumbar region and small pelvis.
Full-fledged psychotherapy and support of a partner, close people and normalization of relations in a couple are extremely important, which together leads to a quick and irrevocable elimination of the problem.

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Erectile dysfunction, or, as it is popularly called, impotence, is the inability to achieve and maintain an erection until the completion of a full-fledged sexual intercourse. Periodically, this condition can occur in any man, regardless of age. And if you do not treat this problem properly, it can really end in complete impotence (sexual impotence). Statistics show that more than 40% of men after 35 years of age in one way or another experience problems with erection. If a similar problem lasts more than 3-6 months, doctors may talk about erectile dysfunction.

Impotence - signs. Treatment with folk remedies. The reasons

The signs of erectile dysfunction, depending on the cause that caused it, may differ somewhat, but they have the same essence - a weakening of an erection or its complete absence. Consider several reasons why an erection can become unstable:

1. Gradually, over the years, the erection becomes weaker and occurs less frequently, and at some point completely disappears - this may indicate that the reason lies in a slowly progressing physical problem, for example, in the development of some kind of chronic disease (diabetes mellitus, epilepsy , atherosclerosis, etc.).
2. If a good erection occurs at the right time, but disappears at the very beginning of sexual intercourse, then everything is in order from a physical point of view, and the problem lies in increased anxiety about sexual possibilities. This happens in especially emotional men. In this case, a man is advised not to think about what impression he will make on his partner, but to switch to his feelings (think less with his head), and, most likely, the problem will disappear on its own.
3. Another option: an erection perfectly occurs when necessary, but may gradually disappear a few minutes after the onset of sexual intercourse - this means that the blood from the cavernous bodies of the penis has returned to the systemic circulation. On the physical side, everything is in order, and the fact that ejaculation did not occur does not mean anything. It’s just that the body doesn’t need it at the moment, or the psycho-emotional state of the man is to blame.

morning erection

Normally, during the phase of REM sleep (dream phase), men have an erection. This can happen 2-4 times a night, of course, it is impossible to feel it in a dream, but if a man woke up in this particular phase of sleep, he will feel an erection. If a morning erection occurs quite often, this indicates that everything is in order with the man in physiological terms. If there is a problem with potency in this case, you should pay attention to the psycho-emotional state. But if an erection is not observed in the morning for quite a long time, it is necessary to undergo an examination, perhaps there is a disease that needs to be treated. In a neglected case, the problem of impotence may develop. Treatment with folk remedies will help to cope with temporary problems of erectile dysfunction, and is also a method of its prevention.

What factors can lead to impotence?

Erectile dysfunction is not only a problem of a sexual nature, sometimes it is a symptom of some other serious illness, emotional fatigue and constant stress at work or in the family, as well as a side effect of a drug. It can be:

• endocrine diseases (diabetes mellitus, pituitary tumor, hypogonadism - insufficient testosterone production);
• local changes in the tissues of the male genitalia (sclerosis);
• side effects of antibiotics;
• infection of the genitourinary system (urethritis, prostatitis);
• sexually transmitted infections (syphilis, etc.);
• violation of the blood supply to the vessels of the erectile mechanism;
• operations in the pelvic area;
• hypertension;
• atherosclerosis;
• neurological diseases (multiple sclerosis, epilepsy, etc.);
• psycho-emotional states (stress, depression, mental disorders).

Types of erectile dysfunction

Depending on the cause that caused sexual weakness, experts distinguish two types of erectile dysfunction: organic and psychogenic.

Organic dysfunction is associated with the development of a disease (diabetes mellitus, hypertension, atherosclerosis, etc.), which caused sexual weakness. In this case, it is necessary to treat not impotence, but the disease that caused it.

Psychogenic erectile dysfunction is much more common and is caused solely by the psycho-emotional state of a man. A good rest will help to cope with the problem.

If there are inconveniences associated with a violation of potency, and even more so if they are repeated regularly, you should contact a specialist who will help to cope with the problem of impotence. Treatment with folk remedies in combination with medication will help to achieve positive dynamics in treatment.

Nutrition for erectile dysfunction

The best treatment is to prevent the onset of the disease, i.e. its prevention. The disease is easier to prevent than to cure. This fully applies to erectile dysfunction. Proper therapeutic nutrition will help at the first signs of sexual disorders in men.

It is unacceptable for food to be taken on the run, which is characteristic of very busy people. It should be complete and, of course, dinner should not be late, but at least 3-4 hours before bedtime.

Protein-rich foods must be present in the diet: cottage cheese, milk, cheese, eggs, meat (preferably low-fat), fish (preferably sea) and legumes. Slow carbohydrates have a very positive effect on health, in particular, on men's too. These are cereals from various cereals, grain bread, potatoes.

It is better to limit fast carbohydrates at least for the duration of treatment. These include pastries, cakes, sweets, etc. The exception is chocolate, which contains at least 70% cocoa, it increases the level of endorphin (the hormone of happiness), which has a positive effect on mood, and if dysfunction is caused by stress, it can serve as a medicine . Vegetables, fruits and especially fresh herbs have a beneficial effect in the treatment of impotence. Onions, garlic, cilantro, spinach - each product on this list has always been known as a folk remedy for impotence. It is very good to use spices, ginger, hot and sweet peppers for the male diet.

Vegetarianism for impotence

Since ancient times, switching to a vegetarian diet has been used as an effective treatment for erectile dysfunction. Folk remedies for the treatment of this disease have been used before and now. Parsnip root is added as a spice to various dishes, and the seeds of this plant are infused and drunk for disorders associated with dysfunction.

Vegetarian dishes contain all the necessary vitamins and minerals. The protein found in plant foods has an identical effect on the body, like an animal. A large amount of protein is found in legumes and nuts.

Especially good for men's health is the presence in the diet of nuts (walnuts or peanuts), pumpkin seeds and honey. Connoisseurs of traditional medicine claim that taking carrot juice with the addition of honey for a month completely cures erectile dysfunction at the initial stage.

If the body weight is much higher than normal, this can have a bad effect on potency. With proper nutrition, weight can be normalized. normally ranges from 23 to 25.

Medicines for the treatment of impotence

The problem is successfully treated. In addition to medical methods, the treatment of erectile dysfunction with folk remedies has long been used. Collections of medicinal plants are effectively used for the treatment and prevention of impotence. Here is some of them:

1. Prepare a mixture of dry medicinal herbs from stinging nettle, mint and flax seeds. All ingredients must be taken in equal amounts. Pour two tablespoons of this collection into a thermos and pour two glasses of boiling water. It is better to prepare the infusion in the evening, then by morning it will be ready. Drink one glass in the morning and evening, regardless of the meal. The course lasts 21 days. Break - from one week to two months. Sometimes a couple of courses are enough. This collection helps men avoid premature ejaculation.
2. The following collection includes only 2 ingredients: - 2 parts, calendula flowers - 1 part. Pour one tablespoon of this mixture with a glass of boiling water. Infuse should be until cool, preferably without access to light, for example in a ceramic teapot. Take 1 tbsp. spoon 3-4 times a day, you can between meals. The course can last up to 30 days, then a break - 30 days. This folk remedy for impotence is quite effective. In some cases, only 2-3 courses may be needed.
3. Yarrow is quite affordable, it is sold in every pharmacy. A decoction is prepared from it, which helps to cope with dysfunction. To do this, pour 200 g of dry yarrow herb with a glass of water, boil for no more than 20 minutes on very low heat. Cool and strain. This decoction is taken 1 tablespoon 3-4 times a day.

Herbs for impotence give no less effect than drugs, and provide a lasting result. In addition, they do not have any side effect.

Alcohol tinctures for impotence

Alcohol tinctures are also known for the treatment of sexual weakness in men. They are indicated for use only if the man does not intend to drive, otherwise there may be trouble with the representatives of the traffic police.

It should be borne in mind that alcohol tinctures are prepared precisely from vodka or diluted alcohol (up to 40 degrees), since if the degree is higher, healing substances will not pass from raw materials to tincture. They are simply preserved in the original raw material.

Folk methods of treating impotence with alcohol tinctures suggest making them from the rhizomes of plants. The method of their preparation is the same. One part of the raw material is poured with 3 parts of vodka and infused for two weeks in a dark place. The container with tincture should be shaken periodically. Take 25-30 drops after meals. To prepare the tincture use:

• ginseng root;

The use of these funds for impotence gives a lasting result.

What is the difference between the use of medicinal herbs and drugs for impotence?

The use of plant materials has a beneficial effect on the entire body, so not the disease disappears, but its cause. While some drugs for erectile dysfunction act on the body like a whip on a driven horse.

The only drawback in the treatment of impotence with folk remedies is that recovery comes gradually. You have to stock up on patience. Sometimes it will take more than one course of taking the drug, but 2-4, and in some cases, treatment can last 6-12 months.

This mushroom got its name from its ability to grow in the cold. In fact, this is a kind of honey agaric. Its healing properties allow you to deal with the problem of impotence. Treatment with folk remedies is possible not only with herbs, but also includes the use of mushrooms (winter mushroom, shiitake).

The winter mushroom is quite edible, you can cook dishes from it or make healing alcohol tinctures from dry raw materials. The recipe for its preparation is the same as described above.

Conclusion

Problems associated with sexual weakness have been known since ancient times, even when there was no official medicine. With the development of this science, a purely medical approach to the problem of impotence appeared. Treatment with folk remedies, carried out in parallel with medication, appointed by a specialist after an examination of the patient, will help get rid of erectile dysfunction and get a lasting effect.

Treatment of impotence implies a complex event, including etiotropic (when the cause itself is affected) and pathogenetic (restoring the normal functional state of the gonads) therapy. Modern drugs for the treatment of erectile dysfunction in men purposefully and effectively eliminate the disease. The main thing is to choose the right therapeutic course.

According to medical statistics, in 75-80% of cases, erectile impotence develops against the background of another somatic pathology: diabetes mellitus, peripheral atherosclerosis, hypercholesterolemia, kidney and liver diseases, hormonal imbalance, thyroid disorders. And it is important to take this into account in the course of therapy, including in the process of selecting medications.

Phentolamine ("Vazomaks", "Dibazin", "Regitin")

The agent belongs to the imidazoline group and is a competitive inhibitor of alpha-adrenergic receptors (found in large quantities in small arteries and arterioles). Settling on these receptors, the substance prevents vasospasm in, and also enhances endogenous relaxation effects.

With the introduction of the drug into the cavernous bodies of the penis, its maximum concentration in the peripheral blood is reached by the 30th minute, after which it sharply declines. Phentolamine is intended only to improve erection, it does not affect ejaculation and libido.

Contraindications to the drug are:

1. Severe course of heart disease (heart failure, ischemic disease).
2. Acquired and congenital heart defects.
3. Anomalies and malformations of the main vessels.
4. Allergic reaction to the main active ingredient.
5. Tendency to hypotension and fainting.

Since phentolamine slightly lowers blood pressure, its use is acceptable in men suffering from hypertension. Available in tablet form of 25 mg (pack of 30 pieces) and in injection form (1 ml contains 10 mg of the substance). The price is acceptable and varies from 300 to 600 rubles, depending on the manufacturer.

Take tablets after meals in a single dose - 50 mg (that is, 2 pieces) 3 times a day. The course of treatment is 3-4 weeks. Perhaps intracavernous administration, in this case, the dose is selected individually.

Alprostadil (Alprostan, Vazaprostan)

Refers to analogues of prostaglandin (a substance that is formed from fatty acids, in particular from arachidonic). This medicine contributes to the rapid relaxation of smooth muscle cells and vascular walls in the cavernous bodies, which ultimately leads to an increase and improvement in local hemocirculation. In addition, alprostadil protects cells and tissues from the harmful effects of free radicals and enzymes, activates protein synthesis, and reduces the concentration of cholesterol in the blood.

It is indicated as a therapy for vascular or mixed erectile dysfunction.

1. Severe heart failure.
2. History of myocardial infarction.
3. Bronchial asthma.
4. Heart rhythm disturbances.
5. Stomach ulcer.
6. Individual intolerance to the components of the drug.

Alprostadil exists in the form of a solution and suppository, which are applied only topically. are introduced into the urethra through its external opening, located on the head, using a special plastic applicator. Before use, it is advisable to empty the bladder so that the remaining small amount of urine in the urethra helps the drug dissolve faster.

Also, in case of impotence, it is possible to inject the drug when the syringe needle is inserted into the spongy tissues of the penis. It is recommended that this procedure is carried out by a medical professional, and the individual dose is selected by a doctor.

Due to their mechanism of action, they release nitric oxide, which leads to relaxation of the vascular wall and the muscular component of the cavernous bodies. As a result, blood flow increases in the penis and is achieved.

Any of the presented drugs of the group is prohibited for men with:

1. Unstable angina and uncontrolled arrhythmias.
2. A history of ischemic stroke.
3. lactase deficiency.
4. Impaired kidney function.

The drug is prescribed in one tablet (from 5 to 100 mg, depending on the active substance), preferably at the same time of the day and on an empty stomach. The action begins in 30-60 minutes and lasts from 3 to 72 hours. The course is selected by the doctor individually.

You can buy this kind of pill at any pharmacy for an approximate price of 100 to 800 rubles per 1 piece (the specific cost depends on which drug is chosen). Numerous reviews of men say that the best drug for the treatment of erectile dysfunction in this category is.

A new drug for the treatment of erectile dysfunction based on natural ingredients, related to.

It includes:

• long-leaved eurycoma;
• creeping palm;
• extract from the leaves of Damiana.

Regular intake of the drug effectively stimulates the hormonal function of the male gonads, enhances the production of seminal fluid and.

Take Ali Caps one capsule in the morning with plenty of water for 30 days. A second course of therapy can be completed after two weeks.

Not recommended for men suffering from insomnia, heart rhythm disturbances, and atherosclerosis. The pricing policy is quite loyal, since the cost of the drug does not exceed 1900 rubles, and the reviews say that Ali Caps course intake really helps to cope with the disease.

Impaza is a homeopathic remedy

The scheme of treatment of erectile dysfunction in men with drugs

There are three consecutive lines of treatment for erectile dysfunction, which differ from each other by groups of drugs and the method of their administration.

The first drug treatment regimen for erectile dysfunction involves the use of selective phosphodiesterase-5 inhibitors (Udenafil, Sildenafil and Vardenafil).

Their appointment is subject to the following conditions:

• preserved libido.
• The presence of sexual stimulation during the period of accumulation of the main substance in the blood plasma.
• Normal in peripheral blood.

If the first line was ineffective, the doctor switches to drugs from the second line:

• Papaverine. Antispasmodic, which expands the cavernous bodies to a certain level and contributes to their increased blood supply.
• Prostaglandins. Restore the functions of the cavernous bodies and gonads, which in turn has a positive effect in the treatment of erectile dysfunction.
• Phentolamine - blocks alpha receptors, which ultimately improves local blood circulation in.

They are injected directly into the urethra or into the cavernous bodies. Complex application is considered relevant, due to which the effect is achieved faster.

The third line includes surgical reconstruction of the arteries of the penis using balloon plastics or dorsal vein ligation.

Treatment of erectile dysfunction (impotence) pursues the following goals - to achieve the quality of erections that is necessary for a full-fledged sexual intercourse. The patient should be informed about the possible methods, their effectiveness and negative properties.

Treatment should be etiological and pathogenetic. First of all, this concerns diabetes mellitus, arterial hypertension, metabolic syndrome. A stable cure for erectile dysfunction (impotence) can be expected in cases of psychogenic erectile dysfunction (rational psychotherapy), post-traumatic arteriogenic impotence in young men, and hormonal disorders (hypogonadism, hyperprolactinemia).

Surgical interventions on the vessels are indicated for patients with occlusive lesions of the arteries supplying the pelvic organs. Ligation of the veins draining the corpus cavernosum is sometimes used in young patients with impaired venous occlusion.

The treatment of impotence that has arisen against the background of androgen deficiency can be very effective by restoring the physiological concentrations of androgens in the blood serum by prescribing the latest generation of testosterone preparations.

In situations where a comprehensive examination did not reveal the underlying disease, the treatment of erectile dysfunction is carried out according to certain standards, taking into account the effectiveness of the method, safety, and invasiveness. material costs and patient satisfaction.

Before starting treatment, the patient is advised to exclude factors that adversely affect erection (see above), as well as to normalize lifestyle and sexual activity. Consideration should be given to the possibility of canceling or replacing medications that the patient is receiving that can adversely affect erection.

Treatment of erectile dysfunction requires adherence to the principle of the phased use of therapeutic measures.

Hospitalization is indicated only for complex invasive studies and / or surgical interventions.

Erectile dysfunction treatment: first line

Oral drugs for impotence: phosphodiesterase type 5 inhibitors.

The development and availability of phosphodiesterase type 5 inhibitors has revolutionized the treatment of erectile dysfunction. The mechanism of their action is as follows: during sexual stimulation, nitric oxide (N0) is released from the nerve structures of the cavernous bodies. activating the enzyme guanylate cyclase, which leads to an increase in the content of cyclic guanosine monophosphate in the cells of the cavernous bodies. The result is a decrease in the content of free calcium in smooth muscle cells, their relaxation, a sharp increase in blood flow and expansion of the cells of the cavernous bodies. By blocking phosphodiesterase-5, which is involved in the breakdown of cyclic guanosine monophosphate, these drugs contribute to the emergence and maintenance of an erection during sexual activity.

Currently, three drugs of this group are used in the world: sildenafil, talalafil and vardenafil, produced in tablet form and in different doses. Their distinguishing feature is high efficiency in all forms of impotence and good tolerability. Phosphodiesterase-5 inhibitors are used occasionally (if necessary) for a certain time before sexual intercourse, while sexual activity is necessary for the onset of the effect. The advantages of sildenafil include, first of all, the greatest experience of its use. Vardenafil is distinguished by a rapid onset of action, as well as less dependence on fatty foods and alcohol. The peculiarity of tadalafil is the duration of action. component 36 h.

Key pharmacokinetic parameters for phosphodiesterase type 5 inhibitors (based on US Product Information)

Clinical efficacy of phosphodiesterase type 5 inhibitors (data of drug registration in Europe - EU Summary of Product Characteristics)

In comparable studies, an improvement in the ability to achieve an erection during therapy with sildenafil was noted by 84% of patients, during therapy with vardenafil - 80%, during therapy with tadalafil - 81%.

Apomorphine is used sublingually as needed in a dose of 2-3 mg, the effect develops after 10-20 minutes against the background of sexual stimulation. The drug is relatively safe, but significantly inferior in effectiveness to phosphodiesterase-5 inhibitors.

Yohimbine hydrochloride is an a2-adrenergic blocker and has the ability to activate penile hemodynamics and erection. Both episodic and course reception are possible. A single dose is 5 mg orally, daily - up to 15-20 mg.

Vacuum constrictor method

The essence of the method is to create a negative pressure in the cavernous bodies of the penis using a vacuum device. An increase in blood flow causes an erection, to maintain which a special compressive ring is placed on the base of the penis, which limits the venous outflow. Approximately 30% of patients refuse metol due to the occurrence of pain, subcutaneous hemorrhage, difficult ejaculation and decreased sensitivity.

Psychosexual Therapy

Whatever the cause of erectile dysfunction (impotence), psychosexual therapy should be a mandatory component of treatment. In all cases, the physician must use his influence to normalize or improve the interpersonal relationships of sexual partners. It is highly desirable that the sexual partner be involved in the treatment process, optimally as a co-therapist.

Impotence treatment: second line

In the absence of effect from the use of oral drugs and vacuum constrictor devices, intracavernous injections of vasoactive drugs can be used. The effectiveness of this treatment is about 85%. For intracavernous administration, several drugs can be used as monotherapy or in combination (alprostadil, phentolamine, papaverine). The initial dose of alprostadil (prostaglandin E1) is 10 μg, injected into one of the cavernous bodies after dissolution in 1 ml of sodium chloride (sodium chloride isotonic solution for injection 0.9%). If necessary, the dose can be increased to 20 mcg. Erection occurs 5-15 minutes after drug administration; its duration depends on the dose, on average - about 90 minutes. After selecting the dose of the drug and appropriate training, the patient is transferred to perform autoinjections with a frequency of no more than 2 times a week.

This treatment of erectile dysfunction (impotence) has a number of contraindications and side effects. The patient should be warned that if an erection persists for more than 4 hours, he should consult a doctor. Erection should be resolved by puncture of the cavernous bodies and aspiration of blood, and if necessary, the introduction of minimal doses of adrenomimetic drugs.

Treatment of impotence: third line (prosthesis of the penis)

In cases where drug treatment of erectile dysfunction did not work or the patient insists on a radical solution to the problem of this problem, phalloendoprosthetics are used with a semi-rigid prosthesis or devices that mimic an erection.

Advantages and disadvantages of various treatments for impotence

It is possible to restore erectile function at almost any age. Treatment of erectile dysfunction should be comprehensive. In order for therapy to be effective, the root cause of the pathology should be initially identified.

ED can be of mixed, psychogenic or organic origin. In 90% of cases, the violation of potency is psychogenic in nature.

Impotence is treated mainly in a conservative way. The patient is prescribed a diet, certain medications, exercises, physiotherapy.

What are the causes of impotence?

Impotence is a disease that can have a different etiology. Often the disease is psychological in nature, especially in middle-aged and young men. The reason for the lack of erection is the syndrome of anxious expectation of sexual failure.

The syndrome develops due to stress, sexual failures, experiences before sexual intercourse, depression. Psychogenic ED is the easiest to treat, in most cases it is enough for a man to visit a psychoanalyst and a sex therapist.

They also distinguish organic and mixed impotence. The organic form is observed in patients suffering from any diseases of the genitourinary, endocrine, nervous, cardiovascular or musculoskeletal systems.

Mixed ED is the result of psychological instability and organic disorders. This type of impotence is the most difficult to treat, however, it is possible to normalize the “riser” with mixed ED.

We highlight the main causes of impotence in men:

• Diabetes. Moreover, the lack of a quality erection is observed both in insulin-dependent and non-insulin-dependent forms of diabetes.
• Diseases of the cardiovascular system. Very often erection is disturbed due to hypertension and atherosclerosis.
• Injuries of the spine, spinal cord, perineal organs.
• Diseases of the prostate gland and other organs of the genitourinary system.
• Unhealthy Lifestyle. Many addictions have a negative impact on male strength and the health of the genitourinary system as a whole. Urologists say that patients who regularly consume alcoholic beverages are at risk of "earning" impotence. No less detrimental effect on the potency of smoking and drug addiction.
• Disorders in the work of the thyroid gland.
• Passive lifestyle.
• Recent operations on the pelvic organs.
• STD.
• Prolonged sexual abstinence. By the way, excessive sexual activity is no less dangerous for male power.
• Diseases/injuries of the spinal cord.
• Allergy to contraceptives. It happens that a man's penis falls after putting on a condom. This may indicate an allergy to latex.
• Diseases of the central nervous system.
• Peyronie's disease, penis fractures.
• Hormonal disorders. The lack of male androgens leads to a decrease in libido and potency. The symptoms of feminization are not excluded, including gynecomastia and female-type visceral obesity.

Even in medicine there is such a thing as "iatrogenic impotence". It develops as a result of the use of any drugs. So, sedative drugs, hormone-based drugs, antihypertensive and hypoglycemic agents, cardiac glycosides, and tranquilizers can cause erectile dysfunction.

With iatrogenic impotence, it is enough to stop taking the remedy that caused a decrease in sexual strength. If this is not possible, it is recommended to select an analogue group that has a less significant effect on the “riser”.

Before starting therapeutic measures, the physician must without fail establish the root cause of sexual impotence in the patient.

How is the diagnosis carried out?

The examination begins with an oral questioning. The doctor finds out in what period the man's erection decreased, and what concomitant symptoms occurred. For example, with psychogenic ED, potency disappears abruptly, but at the same time, regular spontaneous erections take place.

With organic and mixed impotence, the “riser” worsens gradually, and at the same time there is a lack of spontaneous erections even in the morning. Also, with organic and mixed genesis of sexual impotence, there are any secondary symptoms of diseases of the central nervous system, cardiovascular system or other life support systems of the body.

In general, to make a diagnosis, a patient should:

1. Get an ultrasound of the pelvic organs.
2. Take a blood test for low and high density lipoproteins, triglycerides.
3. Get a digital prostate exam.
4. Take a blood test for sugar and glycated hemoglobin.
5. Complete the Caverject Test.
6. Pass a general and biochemical analysis of urine.
7. Take a blood test for the level of free and total testosterone, prolactin, estradiol, FSL, LH.
8. Pass ultrasound of the heart and kidneys, ECG. These activities can be recommended for hypertensive patients.
9. Submit a spermogram.
10. Get monitored for nighttime erections.
11. Take a blood test for PSA - prostate specific antigen.

Based on the data obtained, the physician makes a final diagnosis and selects the optimal treatment regimen. If organic pathologies have become the cause, then initially it is necessary to eliminate them, and only then proceed to the treatment of ED.

For some organic disorders, including BPH, prostate cancer, etc., surgery may be recommended.

Preparations for the normalization of sexual power

With impotence of any origin, the doctor may recommend specialized preparations to the patient to normalize sexual strength. Tinctures, gels, injections, tablets can be used.

The sale of most medicines is carried out in pharmacies without a prescription, that is, anyone can buy medicine. By the way, some means to increase sexual strength can be taken even for prevention.

Consider tablets and capsules for internal use. To date, pharmacology offers us a variety of various means of natural and synthetic origin. Most effective:

• Phosphodiesterase inhibitors. These drugs are included in the list of the most popular and effective. PDE-5 inhibitors stimulate blood flow to the penis by enhancing the relaxing action of nitric oxide. The list of the best medicines in this group includes Cialis, Viagra, Sildenafil, Levitra, Avanafil, Zidena, Maksigra, Sildenafil SZ. The disadvantages of such drugs are a large number of contraindications and side effects, a short effect, and a high price. With a limited budget, you can use generics (cheap analogues) of known PDE-5 inhibitors. For example, Stendra, Vidalista, Vilitra, etc. have proven themselves well.
• Homeopathic preparations. The Russian Federation declared that homeopathy is a pseudoscience. Nevertheless, for many men, it was homeopathic remedies that helped to return the former “riser”. To date, the Russian drug Impaza has been recognized as the most effective drug in this segment.
• Herbal remedies. For the treatment and prevention of impotence, you can use herbal medicines. Verona, Tribestan, Tribulustan, Yarsagumba Forte, Parity, Vuka-Vuka, Lovelas Forte, Peruvian Maca are recognized as the most effective. These drugs are recommended to take long courses - at least 20-30 days.

Tinctures help not only increase potency, but also get rid of asthenic syndrome. The disadvantages of such drugs are low efficiency, many contraindications and side effects, the inability to be taken by elderly patients who have abnormalities in the liver and cardiovascular system.

In addition to tinctures and tablets, ointments and gels on a natural basis can be used to increase potency. Of course, they are less effective, but safer. Not bad help to cope with sexual impotence Maksoderm, Nitroglycerin ointment, Heparin ointment.

In a separate category can be attributed to injectables. To increase sexual strength, you can use Papaverine or Caverject. These funds should be injected into the cavernous bodies of the penis.

Injections are highly effective, but they are quite harmful and contraindicated in the presence of diseases of the genitourinary / cardiovascular system. In addition, drugs are difficult to administer, and the injections themselves are painful.

It was noted above that hormonal disorders can provoke ED, so some patients may be recommended drugs based on testosterone or dihydrotestosterone.

Hormonal drugs are available in the form of:

1. Tablets - Metadren, Andriol, Proviron, Striant.
2. Injections - Nebido, Testosterone Cypionate, Testosterone Propionate, Testosterone Enanthate, Omnadren, Sustanon.
3. Kremov - Androgel, Andraktim, Andromen.
4. Transdermal patches - Testoderm, Androderm.

The duration of HRT and the dosage of the drug are chosen strictly individually. Lifelong HRT may be recommended.

Devices for the normalization of erection

Many men do not want to use synthetic pharmacological agents and dietary supplements. In this case, you can use specialized devices. Of course, they will not help to completely cure impotence, but with the help of devices, you can maintain an erection more stable and lead a full sex life.

A good way is to use an erection ring. This item must be worn on the base of the erotic penis. The ring blocks the flow of blood from the penis, as a result of which the erection remains stable for a longer time.

These devices are made of latex, metal, plastic. Doctors recommend using latex rings as they are the safest. It is worth noting that the ring should be on the penis no longer than 20-30 minutes.

If this rule is neglected, you can “earn” yourself hematomas and other disorders in the work of the vascular system. By the way, erection rings are absolutely not suitable for the category of patients who have anatomical deformities of the phallus.

In addition to rings, vacuum pumps can be used. These products are safer. Vacuum pumps should be used as follows:

• Wash the pump flask.
• Lubricate the edges of the flask and the penis with lubricant.
• Insert the penis into the flask.
• Evacuate air from the flask using a pump.
• Hold the penis in the product for 3-5 minutes.

As you can see, the technique is quite simple. By the way, the use of a vacuum pump will help not only improve erection, but also lengthen the penis. These products can be used permanently.

It is advisable not to use vacuum pumps in the presence of STDs, diseases of the genitourinary and cardiovascular systems.

Folk remedies for impotence

Many adult men want to restore an erection without the help of drugs, and in the hope of a positive result, they turn to alternative medicine.

Is it efficient? It's impossible to say for sure. Doctors say that folk remedies for erectile dysfunction are ineffective, and at best can act only for auxiliary purposes.

Nevertheless, it was folk recipes that helped some men to find a good “riser”. Consider the most effective remedies for sexual disorders:

1. Alcohol tinctures based on ginseng, eleutherococcus, leuzea flowers. The base (dried plant components) is mixed with alcohol in a ratio of 1:15, respectively. Then the tincture settles for 30 days, after which it is filtered through several layers of gauze. Traditional healers recommend using infusions at a dosage of 10-20 drops 2-3 times a day for a month.
2. A mixture of red wine, honey and dried fruits. The ingredients are mixed and taken orally 2-3 times a day.
3. A decoction based on willow-tea, lemon balm, calendula, ginseng or yarrow. Plants are poured with a liter of warm water, after which the resulting mixture is boiled and filtered. Take decoctions in a dosage of 100-200 ml 3-4 times a day.
4. A mixture of honey and walnuts.
5. Ointment from honey, dead bees and pork fat.

It will be possible to normalize potency only with an integrated approach. No matter how strong the drugs are, they will not be effective if the patient does not reconsider his lifestyle.

A good boner and an unhealthy lifestyle are diametrically opposed concepts, that is, they are not compatible.

That is why all men, without exception, are strongly recommended:

• Give up alcohol. The maximum is to consume 50-100 ml of red wine per week.
• Full rest, sleep at least 7-8 hours a day.
• Do not smoke.
• To live an active lifestyle. It is advisable to walk more, play sports, do Kegel exercises.
• Do not use drugs.
• Eat properly. It is advisable to consume as little fatty, fried and sweet foods as possible. If you are obese, then a low-carbohydrate diet is the best option.
• Do a prostate massage. This procedure will help to avoid congestive prostatitis, improve erection and normalize the outflow of secretions from the prostate.

Patients are also encouraged to undergo physiotherapy. They will be an excellent addition to conservative therapy. Physiotherapy will help improve the conduction of nerve impulses, strengthen the immune system, and normalize the functioning of the vascular system.

With impotence, acupuncture, electrophoresis, SMT-phoresis, LOD-therapy, rectal electrical stimulation are most effective. Mud therapy has also proven itself well.

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