Reproductive System
Content
OVARIAN CYSTS An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. Any ovarian follicle that is larger than about two centimeters is termed an ovarian cyst. An ovarian cyst can be as small as a pea, or larger than an orange. Most ovarian cysts are functional in nature and harmless (benign).[1] In the US, ovarian cysts are found in nearly all premenopausal women, and in up to 14.8% of postmenopausal women. Ovarian cysts affect women of all ages. They occur most often, however, during a woman's childbearing years. Some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove cysts larger than 5 centimeters in diameter. SIGNS AND SYMPTOMS •Dull aching, or severe, sudden, and sharp pain or discomfort in the lower abdomen (one or both sides), pelvis, vagina, lower back, or thighs; pain may be constant or intermittent—this is the most common symptom •Fullness, heaviness, pressure, swelling, or bloating in the abdomen •Breast tenderness •Pain during or shortly after beginning or end of menstrual period. •Irregular periods, or abnormal uterine bleeding or spotting •Change in frequency or ease of urination (such as inability to fully empty the bladder), or difficulty with bowel movements due to pressure on adjacent pelvic anatomy •Weight gain •Nausea or vomiting
•Fatigue •Infertility •Increased level of hair growth •Increased facial hair or body hair •Headaches •Strange pains in ribs, which feel muscular •Bloating •Strange nodules that feel like bruises under the layer of skiN DIAGNOSIS Ovarian cysts are usually diagnosed by either ultrasound or CT scan TREATMENT About 95% of ovarian cysts are benign, meaning they are not cancerous.[7] Treatment for cysts depends on the size of the cyst and symptoms. Pain caused by ovarian cysts may be treated with: •pain relievers, including acetaminophen/paracetamol (Tylenol), nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil), or narcotic pain medicine (by prescription) may help reduce pelvic pain.[8] NSAIDs usually work best when taken at the first signs of the pain. •a warm bath, or heating pad, or hot water bottle applied to the lower abdomen near the ovaries can relax tense muscles and relieve cramping, lessen discomfort, and stimulate circulation and healing in the ovaries.[9] Bags of ice covered with towels can be used alternately as cold treatments to increase local circulation.[10] •combined methods of hormonal contraception such as the combined oral contraceptive pill – the hormones in the pills may regulate the menstrual cycle, prevent the formation of follicles that can turn into cysts, and possibly shrink an existing cyst. (American College of Obstetricians and Gynecologists, 1999c; Mayo Clinic, 2002e)[8] Also, limiting strenuous activity may reduce the risk of cyst rupture or torsion. Cysts that persist beyond two or three menstrual cycles, or occur in postmenopausal women, may indicate more serious disease and should be investigated through ultrasonography and laparoscopy, especially in cases where family members have had ovarian cancer. Such cysts may require
surgical biopsy. Additionally, a blood test may be taken before surgery to check for elevated CA-125, a tumor marker, which is often found in increased levels in ovarian cancer, although it can also be elevated by other conditions resulting in a large number of false positives.[11] For more serious cases where cysts are large and persisting, doctors may suggest surgery. Some surgeries can be performed to successfully remove the cyst(s) without hurting the ovaries, while others may require removal of one or both ovaries.[12]
ENDOMETRIOSIS which is a condition involving the presence of ectopic endometrial tissue, can affect the ovaries. Endometriosis can be found as large “chocolate” cysts of the ovary, called endometriomas, or small “blue domed” cysts; both are filled with old, dark brown blood. Tiny implants of endometriosis commonly called powder burns also occur on the surface of the ovaries, on other pelvic peritoneum, and over the Fallopian tubes and uterus as well. Endometriomas of the ovary may be painful, or may rupture and cause diffuse pelvic pain, while the smaller endometrial implants may cause severe pain with menstrual periods, generalized pelvic pain, pain with intercourse, and infertility. SIGNS AND SYMPTOMS
Pelvic pain A major symptom of endometriosis is recurring pelvic pain. The pain can be mild to severe cramping that occurs on both sides of the pelvis, in the lower back and rectal area, and even down the legs. The amount of pain a woman feels correlates poorly with the extent or stage (1 through 4) of endometriosis, with some women having little or no pain despite having extensive endometriosis or endometriosis with scarring, while, on the other hand, other women may have severe pain even though they have only a few small areas of endometriosis.[3] Symptoms of endometriosis-related pain may include:[4] •dysmenorrhea – painful, sometimes disabling cramps during menses; pain may get worse over time (progressive pain), also lower back pains linked to the pelvis •chronic pelvic pain – typically accompanied by lower back pain or abdominal pain •dyspareunia – painful sex •dysuria – urinary urgency, frequency, and sometimes painful voiding Throbbing, gnawing, and dragging pain to the legs are reported more commonly by women with endometriosis.[5] Compared with women with superficial endometriosis, those with deep disease appear to be more likely to report shooting rectal pain and a sense of their insides being pulled down.[5] Individual pain areas and pain intensity appears to be unrelated to the surgical diagnosis, and the area of pain unrelated to area of endometriosis.[5] [edit]Fertility Many women with infertility may have endometriosis. As endometriosis can lead to anatomical distortions and adhesions (the fibrous bands that form between tissues and organs following recovery from an injury), the causality may be easy to understand; however, the link between infertility and endometriosis remains enigmatic when the extent of endometriosis is limited.[6] It has been suggested that endometriotic lesions release factors which are detrimental to gametes or embryos, or, alternatively, endometriosis may more likely develop in women who fail to conceive for other reasons and thus be a secondary phenomenon; for this reason it is preferable to speak of endometriosis-associated infertility[7] in such cases. In some cases it can take a woman with endometriosis 7–10 years to conceive her first child, to most couples this can be stressful and daunting. [edit]Other •Other symptoms may be present, including: •Constipation[5]
•chronic fatigue[8] In addition to pain during menstruation, the pain of endometriosis can occur at other times of the month. There can be pain with ovulation, pain associated with adhesions, pain caused by inflammation in the pelvic cavity, pain during bowel movements and urination, during general bodily movement like exercise, pain from standing or walking, and pain with intercourse. But the most desperate pain is usually with menstruation and many women dread having their periods. Pain can also start a week before menses, during and even a week after menses, or it can be constant. There is no known cure for endometriosis. [9] There are some additional conditions that are seen in increased frequency among people with endometriosis, but where there is uncertainty whether these are factors that predispose to endometriosis or vice versa. Endometriosis bears no relationship to endometrial cancer. Current research has demonstrated an association between endometriosis and certain types of cancers, notably ovarian cancer, non-Hodgkin's lymphoma and brain cancer.[10][11][12] Endometriosis often also coexists with leiomyoma or adenomyosis, as well as autoimmune disorders. A 1988 survey conducted in the US found significantly moreHypothyroidism, fibromyalgia, chronic fatigue syndrome, autoimmune diseases, allergies and asthma in women with endometriosis compared to the general population.
Complications •Endoscopic image of a ruptured chocolate cyst in left ovary. •Complications of endometriosis include: •Internal scarring •Adhesions[14] •Pelvic cysts •Chocolate cyst of ovaries •Ruptured cyst •Bowel obstruction Infertility can be related to scar formation and anatomical distortions due to the endometriosis; however, endometriosis may also interfere in more subtle ways: cytokines and other chemical agents may be released that interfere with reproduction. Other complications of endometriosis include bowel and ureteral obstruction resulting from pelvic adhesions. Also, peritonitis from bowel
perforation can occur. Ovarian endometriosis may complicate pregnancy by decidualization, abscess and/or rupture.[15] It is the most common adnexal mass detected during pregnancy, being present in 0.52% of deliveries as studied in the period 2002 to 2007.[15] Still, ovarian endometriosis during pregnancy can be safely observed conservatively.[15] Pleural implantations are associated with recurrent right pneumothoraces at times of menses, termed catamenial pneumothorax. DAGNOSIS A health history and a physical examination can in many patients lead the physician to suspect endometriosis. Surgery is the gold standard in diagnosis. Use of imaging tests may identify endometriotic cysts or larger endometriotic areas. It also may identify free fluid often within the cul-desac. The two most common imaging tests are ultrasound and magnetic resonance imaging (MRI). Normal results on these tests do not eliminate the possibility of endometriosis. Areas of endometriosis are often too small to be seen by these tests. Endoscopic image of endometriotic lesions in the Pouch of Douglas and on the right sacrouterine ligament. The only way to diagnose endometriosis is by laparoscopy or other types of surgery with lesion biopsy.[citation needed] The diagnosis is based on the characteristic appearance of the disease, and should be corroborated by a biopsy. Surgery for diagnoses also allows for surgical treatment of endometriosis at the same time. Although doctors can often feel the endometrial growths during a pelvic exam, and these symptoms may be signs of endometriosis, diagnosis cannot be confirmed without performing a laparoscopic procedure. To the eye, lesions can appear dark blue. powder-burn black, red, white, yellow, brown or non-pigmented. Lesions vary in size. Some within the pelvis walls may not be visible to the eye, as normal-appearing peritoneum of infertile women reveals endometriosis on biopsy in 6–13% of cases.[39] Early endometriosis typically occurs on the surfaces of organs in the pelvic and intra-abdominal areas. Health care providers may call areas of endometriosis by different names, such as implants, lesions, or nodules. Larger lesions may be seen within the ovaries as ovarian endometriomas or "chocolate cysts", "chocolate" because they contain a thick brownish fluid, mostly old blood. Often the symptoms of ovarian cancer are identical to those of endometriosis. If a misdiagnosis of endometriosis occurs due to failure to confirm diagnosis through laparoscopy, early diagnosis of ovarian cancer, which is crucial for successful treatment, may have been missed.[40]
If surgery is not performed, then a diagnosis of exclusion process is used.
<nicole pwedeng ito na lang yung explanation khit d na isali sa report masyado kasing mahaba> This means that all of
the other plausible causes of pelvic pain are ruled out. For example, internal hernias are difficult to identify in women, and misdiagnosis with endometriosis is very common. One cause of misdiagnosis is that when the woman lies down flat on an examination table, all of the medical signs of the hernia disappear, but the woman typically has tenderness and other symptoms associated with endometriosis in a pelvic exam. The hernia can typically only be detected when symptoms are present, so diagnosis requires positioning the woman's body in a way that provokes symptoms. [41]
ERECTILE DYSFUNCTION Erectile dysfunction (ED) is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance.A penile erection is the hydraulic effect of blood entering and being retained in sponge-like bodies within the penis. The process is often initiated as a result of sexual arousal, when signals are transmitted from the brain to nerves in the penis. Erectile dysfunction is indicated when an erection is difficult to produce. CAUSES •Drugs (anti-depressants (SSRIs) and nicotine are most common) •Neurogenic disorders (spinal cord and brain injuries, nerve disorders such as Parkinson's disease, Alzheimer's disease, multiple sclerosis, and stroke[4]) •Cavernosal disorders (Peyronie's disease[5]) •Psychological causes: performance anxiety, stress, mental disorders (clinical depression, schizophrenia, substance abuse, panic disorder, generalized anxiety disorder, personality disorders or traits[6]), psychological problems, negative feelings.[7][not in citation given] •Surgery (radiation therapy, surgery of the colon, prostate, bladder, or rectum may damage the nerves and blood vessels involved in erection. Prostate and bladder cancer surgery often require removing tissue and nerves surrounding a tumor, which increases the risk for impotence[8]) •Ageing. It is four times higher in men in their 60s than in men in their 40s.[9] •Kidney failure
•Diseases such as diabetes and multiple sclerosis (MS). While these two causes have not been proven they’re likely suspects as they cause issues with both the blood flow and nervous systems. •Lifestyle: smoking is a key cause of erectile dysfunction.[10][11] Smoking causes impotence because it promotes arterial narrowing. [12] See also Tobacco and health. •A few causes of impotence may be iatrogenic (medically caused)
Signs and Symptoms Erectile dysfunction is characterized by the regular or repeated inability to obtain or maintain an erection. There are several ways that erectile dysfunction is analyzed: Obtaining full erections at some times, such as when asleep (when the mind and psychological issues, if any, are less present), tends to suggest the physical structures are functionally working. Other factors leading to erectile dysfunction are diabetes mellitus (causing neuropathy). TREATMENT Treatment depends on the cause. Exercise, particularly aerobic exercise is an effective treatment for erectile dysfunction.[25][better source needed] When pharmacological methods fail, a purpose-designed external vacuum pump can be used to attain erection, with a separate compression ring fitted to the penis to maintain it. These pumps should be distinguished from other penis pumps (supplied without compression rings) which, rather than being used for temporary treatment of impotence, are claimed to increase penis length if used frequently, or vibrate as an aid to masturbation. More drastically, inflatable or rigid penile implants may be fitted surgically. Medications carry risk of priapism. All these mechanical methods are based on simple principles of hydraulics and mechanics and are quite reliable, but have their disadvantages. Medication Phosphodiesterase type 5 inhibitors The cyclic nucleotide phosphodiesterases constitute a group of enzymes that catalyze the hydrolysis of the cyclic nucleotides cyclic AMP and cyclic GMP. They exist in different molecular forms and are unevenly
distributed throughout the body. One of the forms of phosphodiesterase is termed PDE5. The prescription PDE5 inhibitors sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) are prescription drugs which are taken orally.[26] They work by blocking the action of PDE5, which causes cGMP to degrade. Alprostadil Alprostadil in combination with the permeation enhancer DDAIP has been approved in Canada under the brand name Vitaros as a topical cream first line treatment for erectile dysfunction.[27] Another treatment regimen is injection therapy. One of the following drugs is injected into the penis: papaverine, phentolamine, and prostaglandin E1.[28] Surgery Main article: Penile prosthesis Often, as a last resort if other treatments have failed, the most common procedure is prosthetic implants which involves the insertion of artificial rods into the penis.[29][unreliable source?] Devices Main article: penis pump The device helps draw blood into the penis by applying negative pressure. This type of device is sometimes referred to as penis pump and may be used just prior to sexual intercourse. Several types of FDA approved vacuum therapy devices are available with a doctor's prescription. Alternative medicine The FDA does not recommend alternative therapies to treat sexual function.[30][clarification needed] There are many different products advertised as "herbal viagra" or "natural" sexual enhancement products, but there are no clinical trials or scientific studies that support the effectiveness of these products for the treatment of erectile dysfunction, and synthetic chemical compounds similar to sildenafil have been found as adulterants in many of these products.[31][32][33][34][35] The United States Food and Drug Administration has warned consumers that any sexual enhancement product that claims to work as well as prescription products is likely to contain such a contaminant.
•Fatigue •Infertility •Increased level of hair growth •Increased facial hair or body hair •Headaches •Strange pains in ribs, which feel muscular •Bloating •Strange nodules that feel like bruises under the layer of skiN DIAGNOSIS Ovarian cysts are usually diagnosed by either ultrasound or CT scan TREATMENT About 95% of ovarian cysts are benign, meaning they are not cancerous.[7] Treatment for cysts depends on the size of the cyst and symptoms. Pain caused by ovarian cysts may be treated with: •pain relievers, including acetaminophen/paracetamol (Tylenol), nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil), or narcotic pain medicine (by prescription) may help reduce pelvic pain.[8] NSAIDs usually work best when taken at the first signs of the pain. •a warm bath, or heating pad, or hot water bottle applied to the lower abdomen near the ovaries can relax tense muscles and relieve cramping, lessen discomfort, and stimulate circulation and healing in the ovaries.[9] Bags of ice covered with towels can be used alternately as cold treatments to increase local circulation.[10] •combined methods of hormonal contraception such as the combined oral contraceptive pill – the hormones in the pills may regulate the menstrual cycle, prevent the formation of follicles that can turn into cysts, and possibly shrink an existing cyst. (American College of Obstetricians and Gynecologists, 1999c; Mayo Clinic, 2002e)[8] Also, limiting strenuous activity may reduce the risk of cyst rupture or torsion. Cysts that persist beyond two or three menstrual cycles, or occur in postmenopausal women, may indicate more serious disease and should be investigated through ultrasonography and laparoscopy, especially in cases where family members have had ovarian cancer. Such cysts may require
surgical biopsy. Additionally, a blood test may be taken before surgery to check for elevated CA-125, a tumor marker, which is often found in increased levels in ovarian cancer, although it can also be elevated by other conditions resulting in a large number of false positives.[11] For more serious cases where cysts are large and persisting, doctors may suggest surgery. Some surgeries can be performed to successfully remove the cyst(s) without hurting the ovaries, while others may require removal of one or both ovaries.[12]
ENDOMETRIOSIS which is a condition involving the presence of ectopic endometrial tissue, can affect the ovaries. Endometriosis can be found as large “chocolate” cysts of the ovary, called endometriomas, or small “blue domed” cysts; both are filled with old, dark brown blood. Tiny implants of endometriosis commonly called powder burns also occur on the surface of the ovaries, on other pelvic peritoneum, and over the Fallopian tubes and uterus as well. Endometriomas of the ovary may be painful, or may rupture and cause diffuse pelvic pain, while the smaller endometrial implants may cause severe pain with menstrual periods, generalized pelvic pain, pain with intercourse, and infertility. SIGNS AND SYMPTOMS
Pelvic pain A major symptom of endometriosis is recurring pelvic pain. The pain can be mild to severe cramping that occurs on both sides of the pelvis, in the lower back and rectal area, and even down the legs. The amount of pain a woman feels correlates poorly with the extent or stage (1 through 4) of endometriosis, with some women having little or no pain despite having extensive endometriosis or endometriosis with scarring, while, on the other hand, other women may have severe pain even though they have only a few small areas of endometriosis.[3] Symptoms of endometriosis-related pain may include:[4] •dysmenorrhea – painful, sometimes disabling cramps during menses; pain may get worse over time (progressive pain), also lower back pains linked to the pelvis •chronic pelvic pain – typically accompanied by lower back pain or abdominal pain •dyspareunia – painful sex •dysuria – urinary urgency, frequency, and sometimes painful voiding Throbbing, gnawing, and dragging pain to the legs are reported more commonly by women with endometriosis.[5] Compared with women with superficial endometriosis, those with deep disease appear to be more likely to report shooting rectal pain and a sense of their insides being pulled down.[5] Individual pain areas and pain intensity appears to be unrelated to the surgical diagnosis, and the area of pain unrelated to area of endometriosis.[5] [edit]Fertility Many women with infertility may have endometriosis. As endometriosis can lead to anatomical distortions and adhesions (the fibrous bands that form between tissues and organs following recovery from an injury), the causality may be easy to understand; however, the link between infertility and endometriosis remains enigmatic when the extent of endometriosis is limited.[6] It has been suggested that endometriotic lesions release factors which are detrimental to gametes or embryos, or, alternatively, endometriosis may more likely develop in women who fail to conceive for other reasons and thus be a secondary phenomenon; for this reason it is preferable to speak of endometriosis-associated infertility[7] in such cases. In some cases it can take a woman with endometriosis 7–10 years to conceive her first child, to most couples this can be stressful and daunting. [edit]Other •Other symptoms may be present, including: •Constipation[5]
•chronic fatigue[8] In addition to pain during menstruation, the pain of endometriosis can occur at other times of the month. There can be pain with ovulation, pain associated with adhesions, pain caused by inflammation in the pelvic cavity, pain during bowel movements and urination, during general bodily movement like exercise, pain from standing or walking, and pain with intercourse. But the most desperate pain is usually with menstruation and many women dread having their periods. Pain can also start a week before menses, during and even a week after menses, or it can be constant. There is no known cure for endometriosis. [9] There are some additional conditions that are seen in increased frequency among people with endometriosis, but where there is uncertainty whether these are factors that predispose to endometriosis or vice versa. Endometriosis bears no relationship to endometrial cancer. Current research has demonstrated an association between endometriosis and certain types of cancers, notably ovarian cancer, non-Hodgkin's lymphoma and brain cancer.[10][11][12] Endometriosis often also coexists with leiomyoma or adenomyosis, as well as autoimmune disorders. A 1988 survey conducted in the US found significantly moreHypothyroidism, fibromyalgia, chronic fatigue syndrome, autoimmune diseases, allergies and asthma in women with endometriosis compared to the general population.
Complications •Endoscopic image of a ruptured chocolate cyst in left ovary. •Complications of endometriosis include: •Internal scarring •Adhesions[14] •Pelvic cysts •Chocolate cyst of ovaries •Ruptured cyst •Bowel obstruction Infertility can be related to scar formation and anatomical distortions due to the endometriosis; however, endometriosis may also interfere in more subtle ways: cytokines and other chemical agents may be released that interfere with reproduction. Other complications of endometriosis include bowel and ureteral obstruction resulting from pelvic adhesions. Also, peritonitis from bowel
perforation can occur. Ovarian endometriosis may complicate pregnancy by decidualization, abscess and/or rupture.[15] It is the most common adnexal mass detected during pregnancy, being present in 0.52% of deliveries as studied in the period 2002 to 2007.[15] Still, ovarian endometriosis during pregnancy can be safely observed conservatively.[15] Pleural implantations are associated with recurrent right pneumothoraces at times of menses, termed catamenial pneumothorax. DAGNOSIS A health history and a physical examination can in many patients lead the physician to suspect endometriosis. Surgery is the gold standard in diagnosis. Use of imaging tests may identify endometriotic cysts or larger endometriotic areas. It also may identify free fluid often within the cul-desac. The two most common imaging tests are ultrasound and magnetic resonance imaging (MRI). Normal results on these tests do not eliminate the possibility of endometriosis. Areas of endometriosis are often too small to be seen by these tests. Endoscopic image of endometriotic lesions in the Pouch of Douglas and on the right sacrouterine ligament. The only way to diagnose endometriosis is by laparoscopy or other types of surgery with lesion biopsy.[citation needed] The diagnosis is based on the characteristic appearance of the disease, and should be corroborated by a biopsy. Surgery for diagnoses also allows for surgical treatment of endometriosis at the same time. Although doctors can often feel the endometrial growths during a pelvic exam, and these symptoms may be signs of endometriosis, diagnosis cannot be confirmed without performing a laparoscopic procedure. To the eye, lesions can appear dark blue. powder-burn black, red, white, yellow, brown or non-pigmented. Lesions vary in size. Some within the pelvis walls may not be visible to the eye, as normal-appearing peritoneum of infertile women reveals endometriosis on biopsy in 6–13% of cases.[39] Early endometriosis typically occurs on the surfaces of organs in the pelvic and intra-abdominal areas. Health care providers may call areas of endometriosis by different names, such as implants, lesions, or nodules. Larger lesions may be seen within the ovaries as ovarian endometriomas or "chocolate cysts", "chocolate" because they contain a thick brownish fluid, mostly old blood. Often the symptoms of ovarian cancer are identical to those of endometriosis. If a misdiagnosis of endometriosis occurs due to failure to confirm diagnosis through laparoscopy, early diagnosis of ovarian cancer, which is crucial for successful treatment, may have been missed.[40]
If surgery is not performed, then a diagnosis of exclusion process is used.
<nicole pwedeng ito na lang yung explanation khit d na isali sa report masyado kasing mahaba> This means that all of
the other plausible causes of pelvic pain are ruled out. For example, internal hernias are difficult to identify in women, and misdiagnosis with endometriosis is very common. One cause of misdiagnosis is that when the woman lies down flat on an examination table, all of the medical signs of the hernia disappear, but the woman typically has tenderness and other symptoms associated with endometriosis in a pelvic exam. The hernia can typically only be detected when symptoms are present, so diagnosis requires positioning the woman's body in a way that provokes symptoms. [41]
ERECTILE DYSFUNCTION Erectile dysfunction (ED) is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance.A penile erection is the hydraulic effect of blood entering and being retained in sponge-like bodies within the penis. The process is often initiated as a result of sexual arousal, when signals are transmitted from the brain to nerves in the penis. Erectile dysfunction is indicated when an erection is difficult to produce. CAUSES •Drugs (anti-depressants (SSRIs) and nicotine are most common) •Neurogenic disorders (spinal cord and brain injuries, nerve disorders such as Parkinson's disease, Alzheimer's disease, multiple sclerosis, and stroke[4]) •Cavernosal disorders (Peyronie's disease[5]) •Psychological causes: performance anxiety, stress, mental disorders (clinical depression, schizophrenia, substance abuse, panic disorder, generalized anxiety disorder, personality disorders or traits[6]), psychological problems, negative feelings.[7][not in citation given] •Surgery (radiation therapy, surgery of the colon, prostate, bladder, or rectum may damage the nerves and blood vessels involved in erection. Prostate and bladder cancer surgery often require removing tissue and nerves surrounding a tumor, which increases the risk for impotence[8]) •Ageing. It is four times higher in men in their 60s than in men in their 40s.[9] •Kidney failure
•Diseases such as diabetes and multiple sclerosis (MS). While these two causes have not been proven they’re likely suspects as they cause issues with both the blood flow and nervous systems. •Lifestyle: smoking is a key cause of erectile dysfunction.[10][11] Smoking causes impotence because it promotes arterial narrowing. [12] See also Tobacco and health. •A few causes of impotence may be iatrogenic (medically caused)
Signs and Symptoms Erectile dysfunction is characterized by the regular or repeated inability to obtain or maintain an erection. There are several ways that erectile dysfunction is analyzed: Obtaining full erections at some times, such as when asleep (when the mind and psychological issues, if any, are less present), tends to suggest the physical structures are functionally working. Other factors leading to erectile dysfunction are diabetes mellitus (causing neuropathy). TREATMENT Treatment depends on the cause. Exercise, particularly aerobic exercise is an effective treatment for erectile dysfunction.[25][better source needed] When pharmacological methods fail, a purpose-designed external vacuum pump can be used to attain erection, with a separate compression ring fitted to the penis to maintain it. These pumps should be distinguished from other penis pumps (supplied without compression rings) which, rather than being used for temporary treatment of impotence, are claimed to increase penis length if used frequently, or vibrate as an aid to masturbation. More drastically, inflatable or rigid penile implants may be fitted surgically. Medications carry risk of priapism. All these mechanical methods are based on simple principles of hydraulics and mechanics and are quite reliable, but have their disadvantages. Medication Phosphodiesterase type 5 inhibitors The cyclic nucleotide phosphodiesterases constitute a group of enzymes that catalyze the hydrolysis of the cyclic nucleotides cyclic AMP and cyclic GMP. They exist in different molecular forms and are unevenly
distributed throughout the body. One of the forms of phosphodiesterase is termed PDE5. The prescription PDE5 inhibitors sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) are prescription drugs which are taken orally.[26] They work by blocking the action of PDE5, which causes cGMP to degrade. Alprostadil Alprostadil in combination with the permeation enhancer DDAIP has been approved in Canada under the brand name Vitaros as a topical cream first line treatment for erectile dysfunction.[27] Another treatment regimen is injection therapy. One of the following drugs is injected into the penis: papaverine, phentolamine, and prostaglandin E1.[28] Surgery Main article: Penile prosthesis Often, as a last resort if other treatments have failed, the most common procedure is prosthetic implants which involves the insertion of artificial rods into the penis.[29][unreliable source?] Devices Main article: penis pump The device helps draw blood into the penis by applying negative pressure. This type of device is sometimes referred to as penis pump and may be used just prior to sexual intercourse. Several types of FDA approved vacuum therapy devices are available with a doctor's prescription. Alternative medicine The FDA does not recommend alternative therapies to treat sexual function.[30][clarification needed] There are many different products advertised as "herbal viagra" or "natural" sexual enhancement products, but there are no clinical trials or scientific studies that support the effectiveness of these products for the treatment of erectile dysfunction, and synthetic chemical compounds similar to sildenafil have been found as adulterants in many of these products.[31][32][33][34][35] The United States Food and Drug Administration has warned consumers that any sexual enhancement product that claims to work as well as prescription products is likely to contain such a contaminant.
