What is the hardening problem?
The problem of erectile dysfunction in men (impotence) is also known as ' Erectil dysfunctions ', ' impotent ' (Empotans) or ' erection problem '. Erection means the stiffening of the penis, the prick.
For reasons such as business and spouse problems, economic problems, mental tensions, fatigue, other problems in the relationship, etc., every man can face erectile dysfunction in a period of life. This is a natural and usual condition. Because it is not usual to expect adequate erection at all times and under all conditions. But if the erection problem repeats frequently, insists, and often prevents sexual intercourse, this condition requires treatment.
Impotence is not sexual reluctance. It's different from ejaculation problems. And it should not be confused with premature ejaculation or infertility. An impotent male can be an orgasm and a father. This means that a patient with a hardening problem may have sexual desire and can drain smoothly.
The age factor is an important place in the patients with erectile dysfunction. The incidence of males over 40 years of age is increasing.
Men may have troubled periods of hardening throughout their lives, but the problem of permanent hardening under the age of 40 is rare. This rate gradually increases with age and 65% of men in 70 years old have erectile dysfunction problems.
Although a set of age-related changes occur at advanced ages, these changes do not always cause a hardening problem. Most men need more penile stimulation (tactile stimulation of the penis) for stiffness in old age, decreases the degree of stiffness of the penis while erections, and any distraction during intercourse causes a loss of stiffness. The incidence of sexual intercourse has decreased, but the relationship is equally satisfactory. Which is very important for the man to feel better.
Erection, i.e. hardening, is a healthy penis and a natural reflex of the nervous system. This reflex can be damaged in the anatomical structure of the penis or in any difficulties experienced in the nervous system.
How is the anatomy and hardening of the penis?
There are two spongy cylinders called Corpora Cavernosa, which are anatomically parallel to the urinary tract in the penis. When the male is sexually stimulates, the nervous system warns the penis to revive. The muscles of the penis and the arteries from the penis are loosened to fill the sinusoids in the spongy cylinders with blood. This provides an erection with the expansion and hardening of the organ. With the blood filling in the sinusoids, the increased pressure and tension veins in the organ are under pressure and a sort of circulation is prevented and blood flow is adjusted. Adjusting the blood flow in this way ensures the continuity of the erection. In the occurrence of this event, the brain, spinal cord, nerves, blood vessels, penis smooth muscle and hormones take the role. The muscles of the spongy cylinders are administered by the special centers in the brain and spinal cord, and they provide erection and loosework of the penis. These centres are influenced by sexual contact, erotic warnings or fantasies, while the anxiety, distrust, excitement, fear and stress also negatively affect the erection.
What are the causes of the hardening problem?
The hardening problem often has multiple causes. The causes may depend on the combination of psychological, physiological or both. Separation of psychological and physiological causes is important for the selection of treatment. The causes of the hardening problem can be examined in 3 main groups:
1. Psychological reasons
2. Physical causes
3. Psychological and physical causes
1-) Psychological causes:
Stress, constant professional pressure, a sense of failure in the profession and family life, constant problems between spouses, physical antipathy and fear of the woman's conception, fear of failure, misinformation about sexuality, or Discovery, rejection, sadness, etc. Mental distress such as anxiety and depression caused by causes of erectile dysfunction can cause the problem.
Problems with marriage; Disruption of the role balances in the relationship, the dominant character structure of the female spouse, the negativity related to marriage, communication problems, deception or deception can cause hardening problems in men.
Depending on the male, negative perceptions about sexuality, strict, stringent, traditional family structure, strict religious and moral rules, no sexual knowledge can lead to the problem of erectile dysfunction in men. Childhood, sexual traumas experienced during adolescence; Harassment, rape, abuse, incest relationships, poor outcome of the first sexual experience, lack of knowledge and experience can also cause hardening problems in men.
Conflicts related to both unconscious and intrapsification and couples can cause erectile dysfunction. These conflicts are likely to arise when the vulnerable man is about to engage in sexual activity. However, many of the erectile dysfunction we see in the clinic are produced by more simple, much easier-to-fix emotional factors. These are the expectations of performance anxiety, the fear of rejection by the woman, the expectation of impotence due to the experience of erectile dysfunction in the past, the excessive interest of the woman's satisfaction and the culturally induced sexual pleasure A sense of guilt about you.
Consequently, the problem of erectile dysfunction (impotence) We mentioned above is a problem we encounter quite often in all age groups. Since the largest and most functional sexual organ is the brain, long-term ongoing or newly started mental traumas or spiritual traumas experienced in the past may cause a problem of hardening.
The reactions of men to erectile dysfunction (impotence) are the form of embarrassment, guilt, confusion, self-confidence shaking, closeness, fatigue. Increasing performance pressure prevents spontaneous (spontaneous) occurrence of hardening. Instead of focusing on the feeling of gratification and sexual contacts with the male, sexual partner, "If I am not erect (not hardened)", "will my penis be hardened?", "is my hardening going to last until the end of the relationship?", "Does my hardening disappear again?", "into the vagina may have to struggle with questions like "conscious or unconscious. These negative thoughts can turn into a fear of inability to succeed, lead to a loss of motivation and performance in the next sexual intercourse, and put a man in a vicious circle. So the most important psychological factor in the emergence or continuation of the hardening problem is negative expectations and thoughts about performance. The expectation that the individual's performance will be insufficient, and the thoughts on problems that may arise as a result of insufficient performance are concerned about the intense concern and avoiding sexual intercourse, sexual reluctance, or even depressive symptoms .
Premature ejaculation, orgasm disorders and a decrease in sexual intercourse can also cause a problem of hardening in connection with each other.
2-) Physical causes:
A.) Diseases involving vessels
• Cardiovascular diseases
• Hypertension (high blood pressure)
• Diabetes Mellitus (diabetes)
• Hyperlipidemia (blood cholesterol, elevation of triglycerides etc.)
• Serious surgery for the pelvis area
• Receiving beam therapy (radiotherapy) for the pelvis region
B.) Neurological disorders affecting the nervous system
• After paralelects
• Trauma, impact, accidents and spinal cord diseases affecting the spinal cord
• Diseases leading to brain degeneration (Parkinson, multiple sclerosis, etc.)
• Brain neoplasms
• Type 1 or type 2 diabetes that holds the nerves (Diablo)
• Chronic renal failure
• Nerve incision during surgery for the pelvic (pelvis) region
C.) diseases that cause structural impairment in the anatomic or penis
• Hypospadias, Epispadias
• Micropenis (small penis)
• Peyronie's disease
• Congenital penile curvatics
D.) Diseases due to Hormonal disorders
• Hypogonadism (impairment of the male hormone called testosterone in the blood)
• Hyperprolactinemia (The high prevalence of prolactin hormone in men)
• Hyper-Hypo thyroidism (high or low thyroid hormones)
• Hyper-Hypo cortisolism (such as Cushing's disease)
E.) Erectile dysfunction due to drug use
• Medications used to treat some high blood pressure
• Some antidepressant medications
• Antiandrogenic Drugs (drugs that suppress male hormone testosterone)
• Alcohol and drug use (heroin, cocaine, marijuana etc.)
F.) Trauma (penis ruptions, penis fractures, etc.)
What are the risk factors for the hardening problem?
1. Cardiovascular diseases are the leading Risk factors. The following risk factors leading to heart disease are also the risk factors for the hardening problem:
• No regular workouts
• High blood cholesterol level
• Metabolic syndrome
2. Chronic diseases are identified as an important risk factor. At the beginning of these diseases are diabetes, hypertension, chronic renal failure.
3. Continuous drug use for chronic diseases is also assessed among the risk factors.
4. Some surgeries: Being undergoing a surgical treatment of prostate cancer such as radical prostatectomy
5. Radiation therapy (radiotherapy or brachytherapy) to the pelvic area (pelvic area) and the organs of the pelvis, especially the prostate
To investigate the presence of physical (organic, structural) factors, men who have a hardening problem should be evaluated primarily by a specialist urologist.
How to diagnose hardening problem?
The evaluation begins by taking the patient's story. In the story part, risk factors are questioned. Diabetes, high blood pressure and heart disease must be questioned. It is important that the patient does not undergo surgical intervention and is exposed to radiation therapy. Serious accidents, smoking and alcohol consumption, use and information about the medications it uses over the past year should be obtained.
The patient should be asked whether the penis is hardened or not, or if deformity, curvature develops. If these troubles exist, Peyronie's disease should come to mind. Psychological reasons should also be questioned. The next step in the story is physical examination. Attention should be given to the Genital area. Vascular and nerve functions should be tested. It should also be investigated for Peyronie's disease. The rectal examination can be done by finger to obtain information about the prostate.
You need to do some blood and urine tests. Testosterone and sugar levels in the blood should be measured. The level of blood fats should be known. Color Doppler utrasonography is a responsive test that provides information about the veins of the penis with the help of sound waves. The injection of drugs that provide hardening (papaverin) into the penis and the response of the penis tissue to this application can be observed. If there is no problem with blood flow, the hardening occurs. In some patients, further examinations may be necessary. The first is a bulbocavernous reflex measurement, which is a neurological test. During this test, the doctor places a finger on the rectum and squeezes the penis head with the other hand. In Normal conditions, the muscles around the breech are contruned. Thanks to another test, information about the presence and degree of hardening during sleep is obtained. Each male experiences 3 – 4 times of hardening (nocturnal erection) during sleep. If the problem is physical, the frequency and degree of hardening decreases. In the presence of psychological causes, the patient continues to experience these hardening. This test provides important information to the doctor in the separation of psychological and physical causes.
The problem of erectile dysfunction in men (impotence, exertion, hardening, erection problems) is possible in today's treatment. If the hardening problem persists for more than 3 months, a professional support should be taken. Your knowledge of the treatment of erectile dysfunction will help your treatment very well.