Impotence / erectile dysfunction, i.e. the inability to maintain an erection for satisfactory sexual activity, affects many men at some point in their lives. Kamagra or Viagra are officially approved tablets for the treatment of declining sexual performance.
Epidemiological data indicate that 5 – 20% of all men show moderate to severe erectile dysfunction. Other studies have pointed out that about 50% of all men over the age of 40 report varying degrees of erectile dysfunction. The symptoms often affect the quality of life as well as the physical and psychosocial health negatively – both for the patient and his family. Erectile dysfunction may be an early sign of general vascular insufficiency, which is why cardiovascular examination may be indicated for these patients.
Erectile dysfunction is divided into four main groups:
- Endocrine diseases
- Vascular insufficiency
- Neurological dysfunction
- Psychogenic impotence
Some medicines (cardiovascular) can also cause impotence. However, most patients are observant and register themselves if erectile dysfunction occurs in connection with the introduction of medication. Antidepressants and neuroleptics can cause erectile and ejaculation disorders.
Hormonal insufficiency (Decreasing testosterone levels)
There is no set lower limit for S-testosterone because it varies from person to person. Values less than 8 nmol/l should be considered as testosterone deficiency. A gray zone exists between 8 and 12 nmol/l. Values above 12 nmol/l indicate a low likelihood of testosterone insufficiency. Blood tests are taken prior to substitution to rule out prostate cancer, assess primary or secondary hypogonadism, and act as a baseline for Hb and hematocrit: PSA, LH, Hb, EVF.
Table of Contents
Vascular insufficiency
Inflow problems
The blood flow to the penis must increase about 25 times for a useful erection to occur. This places great demands on the vascular system.
Three out of four men with suspected somatic impotence have some type of vascular disease. The most common is arteriosclerosis with decreased blood flow to the penis. Many of these patients are diabetics or smokers.
Trauma to the small pelvis can result in vascular injury and erectile dysfunction, especially in young men. In certain circumstances, surgical revascularization can be helpful.
Outflow problems
Pathological leakage through the venous system is a less common cause of erectile dysfunction. Patients with venous leakage usually respond poorly to usual treatment. Surgery is usually necessary. Examination takes place at a urologist with so-called cavernosometry.
Neurogenic Causes of Erectile dysfunction
- Patients with spinal cord injury usually do not have a normal erection ability (depending on the location and extent of the injury). Nowadays, these patients can often be successfully treated by a urologist.
- Patients who have lost their ability to get an erection after major pelvic surgery can also be successfully treated with oral therapy or intracorporeal injections.
- Patients with juvenile diabetes often suffer from erectile dysfunction already at the age of 40.
- Patients with neurodegenerative diseases (eg MS) often suffer from impotence.
Psychogenic causes of Erectile dysfunction
It is not unusual for erectile dysfunction to have a simultaneous psychogenic component. The fact that the patient is young, has fluctuating sexual aptitude, and has maintained a night / morning erection strengthens the suspicion of pure psychogenic impotence. Performance anxiety is frequently present in the picture, implying that the patient is terrified of “failure.” In most cases, these patients can be treated by a medical practitioner, but a referral to a sexologist is recommended.
Treatment of Erectile Dysfunction
Kamagra is the Best Erectile Dysfunction Medicine on the Market
Oral treatment presents the first choice in the treatment of impotence. The smooth muscle relaxation in the corpora cavernosa and its supplying blood vessels is mediated by nitric oxide which increases the amount of cGMP in the tissues. Normally, cGMP is broken down by the enzyme phosphodiesterase V. Large studies have shown that up to 80% of patients with impotence respond well to ED drugs like Viagra or Kamagra that inhibit phosphodiesterase V (PDE5).
Sildenafil Citrate, the main compound of Kamagra inhibits PDE5 and hence improves erection. Kamagra is a cheeper Viagra generic, with identical results and effects, produced by the Indian pharmaceutical firm Ajanta Pharmaceutical. Thanks to its better price, Kamagra has become quickly more demanding than Viagra. Kamagra medicine starts within 30 to 60 minutes with effective treatment time from 4– 6 hours. When taking Kamagra, avoid large or fatty meals and alcohol, since it will also reduce this medicine effectiveness. Kamagra might cause some mild side effects but these are usually connected to dehydration and quickly diminish by increasing water intake.
This Erectile Dysfunction drug can be taken 30 minutes before sexual activity, however, Kamagra only works following sexual stimulation.
Surgical treatment
Penis implants (prostheses) and surgical vessel reconstruction are performed on some selected patients. Such treatment is now uncommon due to successful treatments with oral and intracorporeal drugs. If after taking oral treatment and you’re still experiencing impotence or your system doesn’t respond to oral treatment, consulting an urologist should be considered.