What are the Most Common Male Health Problems?

Erectile Dysfunction

Erectile dysfunction, which is commonly referred to as periodically or accidentally occurring in men problems with an erection, can be caused by endocrine, drug, neurological or local types of causes. Any problems of erectile dysfunction are combined by common symptoms, among which the main one is the man’s inability to achieve / maintain a penis erection, which would allow him to have sexual intercourse. To improve erectile function, you can be offered medication, local therapy, and in rare cases, surgery.

Why is this happening?

What are the causes of erectile dysfunction in men? Previously, it was believed that the main culprits of the pathology are psychological problems and insufficient production of sex hormones. Of course, the importance of these factors cannot be denied, but now they are not put in the first place, but vascular disorders in the subtle mechanism of the occurrence of an erection. In a nutshell, an erection is inherently a vascular reaction, as a result of which a sufficient amount of blood flows into the penis through the arterial vessels to raise the pressure in the cavernous bodies of the penis to a certain level. This pressure level contributes to the blocking of the system of outflow of blood from the cavernous bodies, which leads to an increase in resistance to venous outflow, and as a result, the filling and retention of blood in the cavernous bodies of the penis.

Vascular Erectile Dysfunction

Most often it is vascular erectile dysfunction that occurs. There are two types of vascular disorders that are observed with erectile dysfunction:

  • excessive discharge of blood through the venous vessels of the penis;
  • insufficient arterial blood flow.

Erectile dysfunction The main symptom of erectile dysfunction with impaired venous block is a quick excitation of the penis, a satisfactory but prematurely completed erection. With insufficient arterial blood flow to the penis, an erection occurs hard, for a long time, almost always it is of poor quality.

Psychogenic Erectile Dysfunction

The cause of psychogenic erectile dysfunction is the life problems that a man encounters, frequent stress, dissatisfaction with himself, a feeling of nervousness, depression, and fears. Erectile dysfunction arising on the basis of psychological problems are considered weak erectile dysfunction, which can be eliminated by resorting to the help of a psychologist.

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Erectile Dysfunction Treatments

The main methods of treating erectile dysfunction include:

  1. Local negative pressure therapy (LOT);
  2. Drug therapy (selective type 5 phosphodiesterase inhibitors (PDE5) (sildenafil, vardenafil, tadalafil, udenafil);
  3. Intracavernous administration of drugs;
  4. Vascular operations on the penis;
  5. Endoprosthetics of the penis;
  6. Psychological treatment.

Premature ejaculation

The process of ejaculation is actually an action to eject sperm from the seminal vesicles through the vas deferens and the lumen of the urethra. However, this event (the so-called “phase of exile”) is preceded by the so-called “Emission phase” is the stage when the central nervous system, in response to signals from nerve endings that have become excited as a result of erotic stimulation (both kinesthetic and visual types), sends a signal about the achievement of pleasure.

As the phase of exile approaches, the volitional control over ejaculation gradually loses, which leads the man to the point where the ejaculation process cannot be inhibited or completely stopped by him. Violations of the mechanism of functioning of the genital organs, which lead to uncontrolled ejection of sperm at the very beginning of sexual intercourse (or before it begins) in the general form are called premature ejaculation.

Such pathogenetic mechanisms of development, despite serious work from a scientific point of view, are still of serious interest. And not the last reason for this is the prevalence of such a pathology among the male population of the entire planet.

In the medical literature, the differentiation of premature ejaculation into two types has firmly strengthened:

the relative type, when intercourse lasts more than one or two minutes, but does not contribute to the production of endorphins in both partners;

the absolute type, when the duration of sexual intercourse is less than a minute, or when there is no physical touch of the genitals of partners.

However, modern medical and psychological studies note that premature ejaculation should be called a dysfunction that leads to actual ejaculation during the first minute of penetration (vaginal, anal or oral), accompanied by negative emotional reactions of one or both partners (stress, frustration, rejection, etc.)

Norm variability

The definition of “prematurity” is a symbiosis of the patient’s personal comments and diagnosis by a specialist urologist of the state of sexual function. Here it is necessary to separate the inevitable desire of a man to prolong sexual intercourse.

A sociological survey of 1587 men of reproductive age, according to Professor I. Sosnovsky revealed that the average time of the duration of sexual intercourse among men who do not suffer from diseases of reproductive function is 7.3 minutes, while those who expressed dissatisfaction with their frictional phase of coitus had a value of 1.8 minutes.

The general figure is considered to be the data obtained at the Second International Conference on Sexual Dysfunctions, which indicate that the duration of the friction phase of sexual intercourse is less than 120 seconds can be characterized by the term “premature ejaculation.”

It was noted that there are couples whose coitus duration does not exceed two minutes, and both partners manage to get an orgasm. In these cases, talking about premature ejaculation, of course, is possible, but the fact that it does not cause inconvenience to patients only indicates the incorrectness of the consideration of such cases as “diseases”.

The statistics also provide data on the prevalence of such a pathology among the population: the National Health and Social Life Research Agency, which conducted an analysis among 1,410 men, notes that more than a third of respondents admitted that they have experienced or are experiencing problems characterized by the rapid completion of sexual intercourse and premature ejaculation.

Disease classification

Premature ejaculation can be characterized by several signs. In addition to differentiation according to the period of occurrence (congenital / acquired), there is a division that takes into account the constancy of symptoms (constant / periodic and absolute / selective).

Research in the field of the reproductive function of the body allows us to distinguish a classification that takes into account the duration of coition as the main feature:

I degree (60-120 seconds / 30-60 frictional movements);

II degree (30-60 seconds / 15-30 frictional movements);

III degree (15-30 seconds / 7-15 frictional movements);

IV degree (up to 15 seconds / several frictional movements);

V degree (the onset of ejaculation before the actual contact of the sexual organs of the partners, the so-called “precoital ejaculation”).

The distribution of this classification among patients is as follows: I degree – 35%, II degree – 26%, III degree – 19%, IV degree – 16%, V degree – 4%.

Diagnosis of premature ejaculation

After a conversation with a specialist urologist (andrologist), during which the psychological and medical history of the patient is clarified, and the history of sexual contacts is reconstructed, in most cases laboratory tests are prescribed to minimize the effect on further treatment of infections in the body, to search for active and latent inflammatory processes, determining the overall hormonal level and tone of the patient.

In addition, the treatment of premature ejaculation involves the appointment of the following hardware examinations:

  • biotheziometry, as a result of which the general coefficient of sensitivity of the penis is determined, and also an increase in sensitivity on various parts of the penis is diagnosed;
  • a vasoactive test to determine the presence or absence of an erection in a patient;
  • Dopplerography or ultrasound examination of the penis;
  • ultrasound examination of the prostate.

Causes of premature ejaculation

To date, a whole list of factors has been formed that somehow become the cause of premature ejaculation:

  1. rapid CNS excitability, characterized by entry into the sexual intercourse of a man with the excitability of neurons located in the center of ejaculation, localized in the spinal cord;
  2. depressed, depressed or depressed state of the central nervous system;
  3. chronic depressive states not suppressed manually or medically;
  4. increased sensitivity of the glans penis;
  5. hormonal disruptions caused by taking medication, increased production of prolactin;
  6. hereditary diseases affecting the reproductive function of the body;
  7. diseases, injuries and injuries of the spinal cord;
  8. psychogenic type erectile dysfunction;
  9. urological diseases of any type (both congenital and acquired);
  10. the use of drugs that affect the central nervous system;
  11. regular use of drugs, systematic abuse of alcohol;
  12. diabetes;
  13. other factors.

As you can see, the spectrum of causes of premature ejaculation is so wide that the same conditions can exclude others and vice versa. This leads to the fact that in medical practice there are cases when patients, trying to hide their problems from the public, begin self-medication, choosing drugs that, at best, do not have a negative side effect on the body, and at worst lead to new pathologies.

Research by Sosnovsky I.B., Tereshin A.T., Morozov F.A. give a broad look at the picture of the causes of premature ejaculation. As noted, the groups of factors are arranged in the following order:

  • organic and pathological factors: 43% of cases;
  • psychogenic factors: 31% of cases;
  • simultaneous presence of factors of both types: 19% of cases.

And only in 6% of cases it was not possible to determine the factor. As for the first group of causes of premature ejaculation, these include lesions of any type of organs of the reproductive system (58% of cases, more than a third of them are inflammatory processes), neurotic organic diseases (22%), psychogenic factors that caused changes at the physiological level ( 7%).

Identifying the problem and first steps

In cases where premature ejaculation is a problem that appeared after a long experience of sexual intercourse, therapists and andrologists andrologists primarily speak of conducting an independent analysis of the causes of this disease. Here are just a few tips.

It is required to identify all possible risk factors. Perhaps they became tensions with a partner, constant quarrels, stressful conditions at work, chronic fatigue. Perhaps the reason was the excess weight gained in the last few months, which negatively affected muscle tone and led to reproductive problems. In addition, it should be noted that cigarette smoking and alcohol abuse are often recognized as negative factors. In all these cases, the adjustment of the daily regimen, an increase in the duration of rest, and a competent balance between working hours and break time are required.

In most cases, the recommendations are unchanged – a healthy lifestyle, proper nutrition and moderate physical activity reduce the chances of risk of diseases of the genital area, which include the described pathologies.

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Treatments for premature ejaculation

Depending on the diagnosis, one or more procedures can be prescribed. As a rule, it is recommended to switch from methods that least affect biological homeostasis to more radical ones.

1. Psychotherapy. The patient is sent for a consultation with a psychologist who, in a few sessions, teaches a man how to control his own body, if there is such a need. Therapy is carried out in several directions: behavioral, sexopathic, psychotherapeutic.

2. Exercise. It is supposed to work with the patient according to a specially developed exercise map, which will strengthen the pelvic muscles, develop flexibility and mobility.

3. The use of gels and lubricants. As a result of using this method, an anesthetic gel (for example, lidocaine) is applied to the glans penis, which is sensitive to suppression of a certain volume of nerve endings.

4. Taking medications. As a result of using this method, the treatment of premature ejaculation is carried out using pharmacological agents of various kinds (antidepressants, drugs for the general tone of the body, drugs to increase potency, improve blood circulation, etc.). In exceptional cases, selective inhibitors may be prescribed to localize the hormone serotonin (sertraline, fluoxetine, dapoxetine). As a rule, to obtain the effect, a systematic intake of small doses of the drug is sufficient, but there is also therapy that prescribes the use of inhibitors only before the onset of sexual intercourse.

6. Microsurgery. It is used if it is necessary to correct the frenum of the penis, open the head to the base, etc.

Thus, it becomes apparent that the vast majority of acquired premature ejaculation is somehow associated with the psychological factors of personality development or with inflammatory processes of the genital organs. Practice shows that surgical intervention is an extreme measure and is used only in cases where a whole range of complex measures did not help to achieve the desired result (according to the patient).