The causes for which it appears are diverse. However, there is an isolated factor that has an important impact on erection: age. “As the man gets older he has more erection problems; therefore, risk factor number 1 is considered, “explains Monaca.

Other causes that can cause erectile dysfunction to appear include damage to veins, arteries or nerves; hormonal alterations and psychological causes such as stress, depression or anxiety, for example. “There are psychological factors that can influence and be decisive for the appearance of erection problems, mainly in younger men who have self-esteem problems,” says Monaca.

Regarding hormonal alterations, Javier Romero-Otero, national coordinator of the Andrology Group of the Spanish Association of Urology and responsible for Indology-Reconstructive Surgery at the University Hospital 12 October in Madrid, indicates that testosterone is the male hormone that plays an important role in man to maintain his sexual, mental and physical health.

“One of the causes of erectile dysfunction is that there is a hormonal problem, that is, a testosterone deficit. Without testosterone the architecture of the penis is disturbed and a good erection is not achieved, so that erectile dysfunction can occur as a result of the deficit of this hormone,”says Romero-Otero, who adds that the testosterone deficit can have other consequences on human health such as the appearance of cognitive disorders, problems in language, memory, numerical ability or body composition, among others.

The warning sign of other diseases

One of the peculiarities of erectile dysfunction is that it may be the first symptom of other diseases that, a priori, man will not relate to this problem, hence the importance of seeing a doctor as soon as possible.

Experts point out its link with pathologies such as diabetes (they have between double and triple the chances of developing it), Parkinson’s disease or multiple sclerosis.

However, its relationship with cardiovascular diseases is especially important; erectile dysfunction is related to all cardiovascular risk factors: hypertension, high cholesterol, etc. “It is said that erection problems are sentinel symptoms (first symptoms) of cardiovascular problems. In fact, when you start having an erection problem, many times we are facing cardiovascular problems that are more serious and have not yet manifested,”adds Moncada.

In this line, Romero-Otero remembers that the erectile dysfunction is a window to the integral health of the male to see how that man is. “Think that if a person is over 50 years old, has two or more cardiovascular risk factors and starts with erectile dysfunction, that man has an 80 percent chance of having a coronary event within the next 3 years. It is a very high percentage. ”

The spokesman of the Spanish Association of Urology recommends that men who have erectile dysfunction see it as an opportunity to comprehensively review their health and go to the urologist annually from the age of 45.

In addition, Moncada recalls that man cannot do anything in the face of factors such as age, but can act on the rest of the modifiable risk factors: quitting smoking, controlling and treating high cholesterol, hypertension or diabetes. Acquire a healthy lifestyle, exercise, take care of food and maintain good cardiovascular health.

The couple’s role

Confirmation of the diagnosis of erectile dysfunction causes a very high and serious psychological impact on men’s health in most cases. On the one hand, it can affect self-esteem; on the other, to alter their life as a couple and, finally, it could even cause their life to be less full and satisfying.

The World Health Organization recognizes that sexual health is an integral part of men’s and women’s health. “Men who do not have normal sexual health do not have good health. Erectile dysfunction has a very negative impact not only on your health as an individual but also on your relationship,”adds Moncada.

Hence the importance of having her. “A couple that does not support, that is not for the work, makes the treatment more complex, because normally sexual activity is a matter of two. If one has to follow treatment, but the couple does not pay attention to it, it is much more difficult to handle it. Therefore, the complicity of the couple is essential because it will greatly facilitate the treatment, go to the doctor’s office and make healthier life changes”, emphasizes the head of the Urology Service of the Sanitas-La Zarzuela Hospital of Madrid.

However, many times finding that complicity is complicated, as Romero-Otero points out. “In practice, it would be essential that the couple is involved and that they accompany the male in the diagnosis and treatment of the disease because if one has the help and complicity of his partner, everything is easier. The problem with all this is that many times they have become accustomed to not having sex, not touching and losing that intimacy and when they want to recover it becomes weird. ”

In addition, Romero Otero adds that to this difficulty to recover complicity and sexual normality another obstacle is added in heterosexual couples. If over the years the main problem at the sexual level in men is sexual dysfunction, in women there is a loss of libido, the desire to have sex. “So that hunger is joined with the desire to eat: a man who begins to have problems with a woman who in turn begins to have a less sexual appetite.”

In these situations, experts insist on the importance of communication, of speaking things, being honest and avoiding feelings of guilt.

What treatments are there?

Regarding treatments, both highlight that there is currently a range of options that allow you to effectively treat erectile dysfunction.

“The first step is lifestyle changes. If the patient has another disease such as diabetes, obesity or hypertension, he must keep it under control and from there lead a healthy life. I recommend including aerobic sport on a day-to-day basis (adapting it to the characteristics and limitations of each one) and choosing activities such as running, swimming, cycling or elliptical and not lifting weights. All this helps to improve the vascular function of patients and also erectile dysfunction,”recommends Romero-Otero.

The next step would be drug treatment. “The initiation therapy recommended by specialists consists of taking oral drugs, phosphodiesterase 5 (PDE5) inhibitors, a less invasive, less aggressive treatment that can return sexual function for a while,” says Moncada, who recalls that men continue to age even if they are being treated, so in some cases, when the years go by the medication stops responding.

This first step of treatments also includes topical creams that are applied to the penis or shock waves that are increasingly being used and that appear to have a beneficial effect on blood circulation.

When this first line of treatments does not work, specialists move on to the second line: intracavernous injections of substances that cause vasodilation of the arteries of the penis and favor erection. “Sometimes the injections are not effective or end up losing their effectiveness or there are many men who do not want to puncture the penis, because it makes them sick or because it bothers them, makes them uncomfortable or scares them,” says the expert.

In these cases, specialists opt for the last alternative almost one hundred percent effective: implants of a penile prosthesis, an option that requires surgical intervention. “Patients who have had surgery are very happy because they recover normal sexual function,” he concludes. For more information visit: True Libido

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