Female sexual dysfunction – Symptoms and causes

Overview

Persistent, recurrent problems with sexual response, desire, orgasm or pain — that distress you or strain your relationship with your partner — are known medically as sexual dysfunction.

Many women experience problems with sexual function at some point, and some have difficulties throughout their lives. Female sexual dysfunction can occur at any stage of life. It can occur only in certain sexual situations or in all sexual situations.

Sexual response involves a complex interplay of physiology, emotions, experiences, beliefs, lifestyle and relationships. Disruption of any component can affect sexual desire, arousal or satisfaction, and treatment often involves more than one approach.

Symptoms

Symptoms vary depending on what type of sexual dysfunction you’re experiencing:

• Low sexual desire. This most common of female sexual dysfunctions involves a lack of sexual interest and willingness to be sexual.
• Sexual arousal disorder. Your desire for sex might be intact, but you have difficulty with arousal or are unable to become aroused or maintain arousal during sexual activity.
• Orgasmic disorder. You have persistent or recurrent difficulty in achieving orgasm after sufficient sexual arousal and ongoing stimulation.
• Sexual pain disorder. You have pain associated with sexual stimulation or vaginal contact.

When to see a doctor

If sexual problems affect your relationship or worry you, make an appointment with your doctor for evaluation.

Causes

Sexual problems often develop when your hormones are in flux, such as after having a baby or during menopause. Major illness, such as cancer, diabetes, or heart and blood vessel (cardiovascular) disease, can also contribute to sexual dysfunction.

Factors — often interrelated — that contribute to sexual dissatisfaction or dysfunction include:

• Physical. Any number of medical conditions, including cancer, kidney failure, multiple sclerosis, heart disease and bladder problems, can lead to sexual dysfunction. Certain medications, including some antidepressants, blood pressure medications, antihistamines and chemotherapy drugs, can decrease your sexual desire and your body’s ability to experience orgasm.

• Hormonal. Lower estrogen levels after menopause may lead to changes in your genital tissues and sexual responsiveness. A decrease in estrogen leads to decreased blood flow to the pelvic region, which can result in less genital sensation, as well as needing more time to build arousal and reach orgasm.

  The vaginal lining also becomes thinner and less elastic, particularly if you’re not sexually active. These factors can lead to painful intercourse (dyspareunia). Sexual desire also decreases when hormonal levels decrease.

  Your body’s hormone levels also shift after giving birth and during breast-feeding, which can lead to vaginal dryness and can affect your desire to have sex.

• Psychological and social. Untreated anxiety or depression can cause or contribute to sexual dysfunction, as can long-term stress and a history of sexual abuse. The worries of pregnancy and demands of being a new mother may have similar effects.

  Long-standing conflicts with your partner — about sex or other aspects of your relationship — can diminish your sexual responsiveness as well. Cultural and religious issues and problems with body image also can contribute.

Risk factors

Some factors may increase your risk of sexual dysfunction:

• Depression or anxiety
• Heart and blood vessel disease
• Neurological conditions, such as spinal cord injury or multiple sclerosis
• Gynecological conditions, such as vulvovaginal atrophy, infections or lichen sclerosus
• Certain medications, such as antidepressants or high blood pressure medications
• Emotional or psychological stress, especially with regard to your relationship with your partner
• A history of sexual abuse

Dec. 17, 2020

Show references

1. AskMayoExpert. Sexual dysfunction in women. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
2. Wein AJ, et al., eds. Sexual function and dysfunction in the female. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Aug. 6, 2018.
3. Shifren JL. Overview of sexual dysfunction in women: Epidemiology, risk factors, and evaluation. https://www.uptodate.com/contents/search. Accessed Aug. 6, 2018.
4. Frequently asked questions. Women’s health FAQ072. Your sexual health. American College of Obstetricians and Gynecologists. https://www.acog.org/Patients/FAQs/Your-Sexual-Health. Accessed Aug. 6, 2018.
5. Fact sheet: Female sexual dysfunction. Hormone Health Network. https://www.hormone.org/diseases-and-conditions/womens-health/female-sexual-dysfunction. Accessed Aug. 9, 2018.
6. Overview of female sexual function and dysfunction. Merck Manual Professional Version. https://www.merckmanuals.com/professional/gynecology-and-obstetrics/sexual-dysfunction-in-women/overview-of-female-sexual-function-and-dysfunction. Accessed Aug. 9. 2018.
7. Shifren JL. Overview of sexual dysfunction in women: Management. https://www.uptodate.com/contents/search. Accessed Dec. 9, 2020.
8. Santoro N, et al. Role of estrogens and estrogen-like compounds in female sexual function and dysfunction. The Journal of Sexual Medicine. 2016;13:305.
9. Cappelletti M, et al. Increasing women’s sexual desire: The comparative effectiveness of estrogens and androgens. Hormones and Behavior. 2016;78:178.
10. Khamba B, et al. The efficacy of treatment of sexual dysfunction secondary to antidepressants. The Journal of Alternative and Complementary Medicine. 2013;19:862.
11. Effective treatments for sexual problems. The North American Menopause Society. https://www.menopause.org/for-women/sexual-health-menopause-online/effective-treatments-for-sexual-problems. Aug. 6, 2018.
12. FDA approves new treatment for hypoactive sexual desire disorder in premenopausal women. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-new-treatment-hypoactive-sexual-desire-disorder-premenopausal-women. Accessed Dec. 9, 2020.
13. Vyleesi (prescribing information). Waltham, Mass.: AMAG Pharmaceuticals, Inc.; 2019. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/210557s000lbl.pdf. Accessed Dec. 9, 2020.

Female sexual dysfunction

Female Sexual Dysfunction

Sexual dysfunction is a common problem among women. Almost half of all women have persistent problems with sex, such as little or no sex drive, trouble reaching an orgasm, or pain during intercourse.

Satisfying sex involves your body, mind, health, beliefs, and your feelings toward your partner, among other factors. Here are some possible causes behind problems in your sex life.

Medical or Physical Conditions

Heart disease, diabetes, thyroid disease, nerve conditions such as multiple sclerosis, and even simple fatigue can make sex uncomfortable or painful. They can make it hard for you to get aroused or climax during sex.

Scarring from surgery or radiation treatment in your vaginal opening or in other parts of your genital area also can change your sexual experience. So can infections such as genital herpes.

Other possible causes include hormonal imbalance or physical changes related to:

• Pregnancy (you may have sex less often or find it uncomfortable, especially during the third trimester)
• Childbirth (your genitals may be less sensitive, you may have had a difficult delivery)
• Breastfeeding (low estrogen levels may lead to vaginal dryness, you may lack energy for sex)
• Menopause (vaginal dryness, lack of libido)

Mental and Emotional Issues

The right mood and a healthy, respectful connection with your partner play an important role in sexual intimacy. But there may be factors that leave you feeling self-conscious, fearful, or uninterested. Reasons may include:

Medications, Drugs, and Alcohol

Drinking can make orgasm longer to achieve or feel less intense. Tobacco smoking and long-term use of heroin and other illegal drugs also can lead to sexual problems.

Some medications can make sex less pleasurable, dampen sex drive, or cause vaginal discomfort. Types of medications include:

Treatments and Other Help

A range of therapies can help with your sexual dysfunction. Your doctor will ask about your symptoms, check your health, order blood screens or other tests, and rule out other possible causes.

Medical treatments may include:

• Drugs to raise low libido (desire for sex)
• Kegel exercises to strengthen pelvic muscles to help achieve better orgasm
• Anti-inflammatory drugs to take before intercourse to lower pain

Other advice to improve your intimate experience may include:

• More open communication between you and your partner,
• Making time for sex
• Improving intimacy with your partner
• Healthy habits, such as minimizing alcohol, getting exercise and eating a healthy diet
• Therapy or counseling to help you manage stress or anxiety, or work through feelings of fear or shame in regards to sex
• Vaginal lubricant for dryness or lessen pain during sex
• Vibrators and other tools to enhance arousal
• Techniques on how to reduce distractions and be more present during sex

Erectile Dysfunction: What Women Need to Know – Erectile Dysfunction Center

If you have been struggling with erectile dysfunction, it is a safe bet that your sexual partner has been too.

Experts agree that this sexual issue affects both partners — and that the best way to get erectile dysfunction help is to get help together. In fact, a study published in the International Journal of Impotence Research found that women often experience their own form of sexual dysfunction when coupled with someone who has ED, often due to a lack of intimacy, frustration, or an overall shortage of satisfaction. That means it is not enough to be honest about your erectile dysfunction problems with your doctor; you also need to be open with your partner.

What Women Need to Know

The more you and your partner know about erectile dysfunction, the better you will be able to manage this sexual issue together. Here are important facts you can share to initiate a discussion and relieve the awkwardness:

• Erectile dysfunction is common. Failure to achieve erection about 20 percent of the time is not abnormal. True erectile dysfunction affects about 1 out of 10 men, and up to half of all men over 50 at some time during their lives.
• Erectile dysfunction is not a normal part of aging. Erectile dysfunction does increase with age, though older men may experience a decrease in the quality of their erections and an increase in the time between erections. They may need more stimulation, but they can still have enjoyable sex lives.
• Erectile dysfunction is treatable. In most cases, erectile dysfunction help is both readily available and successful. Treatment options include oral and injectable medications, sex therapy, sexual help devices, and surgery.
• Women also have sexual issues. Up to 70 percent of couples have sexual health issues from time to time. Women may experience loss of desire and arousal problems, and may even experience pain during sex. These sexual issues also need to be addressed.

How a Woman Can Cope With a Partner’s Erectile Dysfunction

If your partner has erectile dysfunction, the most important tip for coping is communication. These steps can help:

• Get educated. Knowing the causes of erectile dysfunction and the treatment options available will lead you to choose something that works best for both of you. Go with your partner to doctor appointments and ask questions. Take an active role in the treatment process.
• Know that it’s not you. Many women, especially older women, may feel that they are part of the problem and take it personally. This is rarely the case. In most instances, there is a physical or emotional reason for erectile dysfunction that does not have to do with you.
• Be positive. The fact that your partner is willing to be open about erectile dysfunction and do something about it is the biggest part of the battle. Don’t be judgmental. Positive feedback is more important than assigning blame.
• Be flexible. Try other ways of having sex and experiencing intimacy. Find sexual techniques that you both enjoy and take the pressure off performance. Don’t assume your partner knows what you want or that you know what he wants.
• Adopt a healthy lifestyle together. One of the best ways to cope with erectile dysfunction is to make positive lifestyle changes. Simple measures like quitting smoking, finding ways to reduce stress, and increasing exercise are good for both of you and are great for decreasing erectile dysfunction symptoms.

Erectile dysfunction is a sexual issue that affects both partners in a relationship, and the best way to manage and cope is to work on finding solutions together. Open and honest communication is the foundation to a good sexual relationship.

Sexual Dysfunction | Male and Female Sexual Dysfunction Types

Sexual dysfunction is a common problem among both men and women. It can be caused by physical problems and medical conditions, such as heart disease and hormone imbalances, or by psychological problems, like anxiety, depression and the effects of past trauma.

There are four main

types or categories of sexual dysfunction

:

Desire disorders

These disorders affect sexual desire and interest in sex, are also known as libido disorders or low libido. Low estrogen and testosterone levels can cause decreased libido, as can hormonal changes, medical conditions (like diabetes and heart disease), relationship problems, sexual inhibitions, fatigue, fear, depression, and anxiety, among other things.

Arousal disorders

These disorders make it difficult or impossible to become physically aroused during sexual activity, can occur in both men and women. The most common type in men is erectile dysfunction. When a person has arousal disorder, he or she may be interested in sexual activity, but be unable to get any physical satisfaction from it.

Orgasm disorders

These involve the absence of orgasm or delayed orgasm, are a common problem with women, but they can also occur in men. Pain during sexual activity, stress, fatigue, hormonal changes and reduced libido can all lead to delayed or absent orgasm.

Pain disorders

These involve pain during intercourse, can affect both men and women. In women, pain may be caused by vaginal dryness, vaginismus (a condition that affects the vaginal muscles), urinary tract infections (UTIs), hormonal changes during menopause, and other conditions. In men, pain may be caused by Peyronie’s disease (physical damage to the penis), infections like UTIs, prostatitis and yeast infections, genital herpes and skin conditions.

If you have signs or symptoms of any type of sexual dysfunction, talk to your doctor. There are treatments available that may be able to help.

Learn more about sexual dysfunction

:

It’s Not You, It’s Not Me, It’s ED

Erectile dysfunction is a common condition that affects men everywhere – but it also affects their partners. In fact, people whose partners struggle with erectile dysfunction or ED (defined as the inability to achieve or maintain an erection to the desired level) may feel hurt, rejected, or suspicious – and some may even blame themselves for the situation.

We wanted to spark honest dialogue about this difficult subject, as well as to understand how ED affects women in relationships with ED sufferers, so we asked 1,000 men and 1,000 women in the U. K. to share their ED-related experiences via a survey. How do women feel when their partners suffer from erectile dysfunction? How do they broach the subject with their partners? And, most important, what helps them navigate this challenging issue in their relationship? See what our male and female respondents had to say on the subject.

To better gauge our survey participants’ understanding of erectile dysfunction, we asked them to define the term. More than 86% of men and women correctly pinpointed the condition as difficulty in getting and/or maintaining an erection to the desired level. Around 7% incorrectly believed erectile dysfunction means that a man can’t control the speed at which he ejaculates, while almost 6% of women and nearly 4% of men said they didn’t know.

Couples who struggle with erectile dysfunction are far from alone. We asked survey respondents to estimate the percentage of men aged 40 to 70 who experience ED. Surprisingly, the vast majority – 88% of men and 85% of women – underestimated the percentage of men who suffer from ED. The truth? Studies show that ED affects more than half of men, and while the risk can increase with age, it is increasingly recognised that young men may also suffer from it. Less than 15% of women and 12% of men correctly identified how common ED really is.

As with any health condition, the first question that many people affected by erectile dysfunction ask is a simple one: why? In a multiple-choice question, we asked survey participants to identify factors they believe contribute to ED. Anxiety/stress/lack of sleep takes first place, followed by alcohol and drug use and the belief that ED signals an underlying health problem.

In reality, all conditions listed on the survey can cause ED. Erectile dysfunction can stem from many physical and/or psychological causes – from cardiovascular disease to depression. To make matters more confusing, ED can be a self-fulfilling prophecy, as anxiety about getting an erection can prevent men from getting one.

“We got stressed from trying to do things that wouldn’t happen, or doing things and then having to stop part way through,” one woman wrote in our survey.

For men struggling with erectile dysfunction, pressure to perform can be stressful – so it makes sense that some might come up with excuses to avoid sex. We asked women to identify excuses they thought their partners had used – and asked men to come clean about which reasons they provided. Almost 19% of women believe their partner has claimed to be too tired for sex, nearly 14% think he’s used the standby “not in the mood” excuse, and about 12% think he said he had drunk too much. Which excuses did men say they used? Interestingly, their top three answers mirrored the women’s responses: Nearly 21% have said they were too tired, almost 16% said they weren’t in the mood, and almost 15% cited alcohol consumption.

Though erectile dysfunction is a problem unique to men, there’s no doubt the experience affects their partners – and oftentimes, emotions run high. What did our survey participants have to say about their initial feelings about their partner’s ED?

Only around 20% of respondents categorised ED as a medical condition they couldn’t control. The brunt of response reflect women’s tendencies to take erectile dysfunction personally: nearly 23% said they believed the ED had something to do with them, while more than 19% cited feelings that their partners might not find them attractive, and nearly 14% said their confidence suffered.

“[It] made me feel like I wasn’t attractive and put me off initiating sex,” one woman wrote. Another admitted she became suspicious: “[It] made me doubt his attraction to me and his fidelity – was he getting affection elsewhere?”

Erectile dysfunction can test even the strongest of relationships. “We hardly ever got close,” one woman wrote. “[It] felt like living with a friend rather than a partner.”

Nearly 60% of the women we asked said their partner’s ED did not affect their relationship, while more than 35% said it did. This positive outlook is reflected in some of the respondents’ comments: “It made us closer,” one woman wrote, “to find a way to solve the problem.”

To see if people’s experiences with erectile dysfunction vary in different areas, we mapped our survey participants’ responses. When asked if they’d ever had a partner with ED, no was the top answer in Scotland and the North East, women in the North West said yes, and women in Wales preferred not to answer.

When asked about their initial thoughts on their partner’s ED, women in the West Midlands reported their confidence levels suffered and worried their partners didn’t find them attractive, while women in the East Midlands chalked it up to a medical condition. Scottish women worried their relationship wouldn’t be as strong, while those in Yorkshire and the Humber felt the diagnosis had something to do with them. Women in Northern Ireland predominantly marked the other category, while women in Wales reported thinking “nothing” on the subject.

For couples struggling with ED, for many, the next logical step is to seek help. However, more than 40% of the women we surveyed said they didn’t take any steps to find answers or treatment. The good news? Nearly 23% turned to their GP for assistance. Another 19% went online to perform research – not surprising, given the sensitive nature of the subject. Very few respondents turned to friends, family, and pharmacists.

We wanted an honest answer – which resources truly help couples dealing with erectile dysfunction? The women who did seek assistance shared their experience: Around 45% said their GP was helpful, and another 35% found online research beneficial. Interestingly, the third-most helpful resource was a woman’s own partner: Nearly 1 in 10 women said he was a source of support.

Seeking solutions during difficult situations can offer untold benefits. Many of the women we surveyed turned to others for support with their partner’s experience with erectile dysfunction, and we wanted to know how they felt afterwards. Around three quarters of women felt more positive after seeking assistance. Overall, nearly a quarter felt optimistic that a solution could be found, and another 20% reported feeling better knowing it wasn’t about them. The relationships benefited as well: 16% said seeking help empowered them to better support their partner, and 13% reported improvements in their relationship. Only around 21% said seeking help didn’t make a difference in their feelings.

Conclusion

Any couple who has ever struggled with erectile dysfunction can attest to its challenges. From physical concerns (is he ill?) to emotional worries (is he having an affair?), various factors may take their toll on a relationship.

But our survey reveals encouraging results: Across the U.K., many couples are educating themselves on erectile dysfunction, seeking help for the condition, and sticking through the difficult times. “[It] initially made us feel less close but only for a short time,” one woman wrote in our survey. “We are much stronger now.”

If you or your partner are experiencing erectile dysfunction, seek help today. Take a brief and confidential online assessment for free from Superdrug Online Doctor, and a GMC-registered doctor will review your information and prescribe an appropriate medicine which will be delivered straight to your home. For more valuable advice about ED, visit Superdrug Online Doctor to learn about the symptoms, the causes, and how to best help a partner who suffers from ED.

Methodology

We surveyed 1,000 U.K. men and 1,000 U.K. women over the age of 35 about their experiences with ED. Eighteen of the survey questions were multiple-choice, and six of the 18 questions also had an optional free-text response. We analysed respondents’ demographics by age (35–55, 56–75, or 76-plus) and by region (East Anglia, East Midlands, London, North East, North West, Northern Ireland, Scotland, South East, South West, Wales, West Midlands, or Yorkshire and the Humber).

Sources

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My Life with ED: How a 48-Year-Old Nurse Lives with Erectile Dysfunction

There are statistics estimating that nearly half of American men experience some type of sexual complication, like erectile dysfunction. Despite how common ED can be, talking about potential solutions can cause communication and frustration issues between partners. Because conversations about ED are usually discussed as the male’s problem, a woman’s perspective is often ignored, or misunderstood. Female partners often don’t know how to talk about the struggles of a life with ED, including with their partner. The truth of the matter is that ED can cause great distress to women. Anger, frustration and plummeting self-confidence can all manifest as a result of ED for women. If proper lines of communication aren’t established, men can become withdrawn and they may avoid physical contact entirely, which can make matters worse. At Giddy, we aim to end the stigma around erectile dysfunction. Today we bring you a first-hand account of a wife whose husband has dealt with ED for some time now. Her powerful comments in our interview bring attention to how much ED can affect a relationship. She chose to remain anonymous, so we’ll call her Sarah. Sarah is 48 years old and lives in Minnesota. She’s been married to her husband for 17 years. He began experiencing ED as a result of his hypertension and diabetes medication. Often, prescription drugs can cause ED side effects because they restrict the flow of blood, which greatly affects erections. Sarah is a nurse and is open to trying different ED medications, however, her husband has shut down ED treatment because he does not want to take additional pills on top of his current prescriptions. Sarah admits she’s stopped discussing potential solutions because her husband becomes defensive.

He gets defensive and says all I want is sex and that’s not true. I do miss the intercourse, but I also miss the physical contact. He thinks I want sex all the time but I just want a little now and then.

This sentiment is expressed time and time again by women. A lack of sex shouldn’t be a cause to stop physical contact completely. Being intimate doesn’t always have to include sexual penetration. Many women feel like Sarah. She says, “I do not always want sex. I want the intimacy of the relationship, of being touched and held in the naked state.”

I feel lonely.. I miss the intimacy of our relationship. I miss the nakedness that we used to have. I liked having sex and the feeling of him inside me. I want to be touched by him and not a machine.

In addition to naked cuddling, couples can try manual or oral stimulation, along with long bouts of kissing. If couples decide to try having sex again, Giddy’s ED device is a great all-natural option, especially for men who don’t want to take ED medications. Giddy’s ED device doesn’t have any of the side effects that ED pills have and it’s much more discreet than pumps. While discussing erectile dysfunction can be difficult, it’s important for women to be open about the situation. No woman should feel solely responsible for her partner’s erectile dysfunction. However, women can be supportive and acknowledge the issue gently. Doctors suggest speaking of ED as matter-of-factly as possible, and to encourage a doctor’s visit since ED can be an underlying symptom of other health issues. It’s important to be warm and encouraging as many men feel a great deal of embarrassment. Keep the lines of emotional communication open to avoid feeling lonely and isolated. It’s your sex life too, and women have the right to find viable solutions for their partners as well as themselves.

My advice to others would be that ED is something all couples are likely to experience in their relationship at some point, and that it’s nice to have other women to talk to about it. Women you don’t necessary have to meet in person. ED’s the elephant in the room that’s just sitting there.

If you’re someone who is living a life with ED and would like to share your story, please reach out to us at [email protected]. We encourage men and women to share their experiences, whether anonymously or publicly, to further the conversation around erectile dysfunction, relationships, and sexual health and wellness. Legal Disclaimer: We appreciate you taking part in the discussion about sexual health and wellness. Because we include information about medical conditions and treatments, please note the following: Information provided on this site is for general informational purposes only. Any information provided here is not for the purpose of diagnosing, treating, curing, mitigating, or preventing any type of disease or medical condition. Before beginning any type of treatment regimen you should always seek the advice of your licensed healthcare professional. And remember, if you think you have a medical emergency, call your doctor or 911 immediately. All information on this site is provided in good-faith, however, Giddy Holdings, Inc, and its agents and employees, make no representation or warranty of any kind, express or implied, regarding the accuracy, reliability, or completeness of this content. Under no circumstances shall we assume any liability to you for any loss or damage of any kind incurred as a result of the use of this site, or the reliance on any information provided herein. Any application of the material provided here is at the reader’s sole discretion and responsibility.

Treatment motivation of men with ED: what motivates men with ED to seek professional help and how can women support their partners?

City Clinical Hospital №31 – Is impotence treated?

Weakness of the stronger sex

70% of all male failures in bed are by no means organic, but purely psychological reasons. But even if the origins of this innermost problem lie only in the physiology of a man, then not everything is hopeless.

Since 1988, the offensive term “impotence” has been renamed into a scientific, and therefore neutral definition – erectile dysfunction (ED). Nevertheless, the essence of the phenomenon, of course, has not changed.Let’s define in terms: ED is defined as the inability of a man to achieve or maintain an erection sufficient for normal intercourse. Unlike previous definitions, this is a more “vague” term, which is associated with differences in methods and criteria for diagnosis, age composition, etc. ED has many underlying causes and in most cases is just a symptom of other conditions. Diabetes mellitus, arterial hypertension, damage to the cardiovascular system, damage to the cardiovascular system, smoking is determined in almost 80% of cases of ED. Harmonious disorders – testosterone deficiency – in 30%.

There is no norm in sex

ED can be temporary and permanent. For a week or two, prolonged stress, past illnesses, overwork, etc. can disrupt an erection. A persistent inability to fulfill marital duties (more than several months) requires immediate examination. However, most often doctors have to deal with pseudo impotence, the causes of which have nothing to do with physiology, but are hidden deep in the male psyche.It is known that representatives of the stronger sex react extremely painfully to the slightest failures in sex. Just a couple of indelicate remarks are enough – and a healthy young man in the prime of years runs the risk of becoming a complete “impotent”. And the norm in such a delicate area is so conditional that it is absolutely impossible to give specific “correct” figures and indicators. It all depends on age, temperament, individual characteristics, field of activity, life circumstances, personal relationships of a person, etc.d.

There is still no culture of referring to doctors (narrow specialists) in our country. Often men solve intimate problems on the basis of the recommendations of the pharmacy workers, the advice of friends, the recommendations of psychiatrists, venereologists, etc. You need to contact an urologist-andrologist.

Psychogenic ED can be treated more effectively if you work not with one “victim”, but with a couple as a whole. In addition to psychotherapy, modern drugs are used, the effectiveness of which is much higher than that of the drugs of the previous generation.

If there is only a diagnosis

It is not uncommon for a man to have a morning erection with psychogenic ED and there are no problems with masturbation. When psychology has nothing to do with it, there is no normal erection under any circumstances. And then in men’s health you need to understand in detail.

Among the organic causes of erectile dysfunction, the most common is vascular pathology: either a weak flow of arterial blood to the penis, or blood stagnation. In the first case, an erection is achieved with great difficulty, and its quality is poor. In the second version, on the contrary, the male organ quickly comes into a state of full combat readiness, but this state ends so quickly that sometimes the would-be lover does not have time to get down to business. Such violations can occur when exposed to occupational hazards, for example, among drivers or households – irregular working hours, systematic overheating, hypothermia, high-frequency currents, vibrations, power quality.With diseases: endarteritis, atherosclerosis of large arteries, varicose veins, as well as as a result of injuries of the genitals and nearby tissues.

Patients and their spouses should be aware of the negative impact of forced interruptions in sexual activity on the well-being of men and women in general.

Doppler ultrasound is used for diagnostics. The man is handed an erotic magazine, with which he retires in a separate room, then with sensors attached to the penis, his blood vessels are measured.Revealed vascular pathologies are treated with surgery or medication.

Do not drop your dignity!

Among the ailments associated with erectile dysfunction, the most frequent are hypertension and diabetes mellitus. As well as neurological and endocrine diseases. Androgens (from Greek male + produce) i.e. male reproductive organs are produced in the testes and adrenal cortex. Testosterone is most active. It affects physical, sexual and emotional performance.A decrease in its concentration in the blood in men can lead to certain clinical manifestations, such as a decrease in sexual activity and performance.

To diagnose these disorders, it is necessary to pass tests for hormones and, if necessary, conduct an MRI of the brain. But chronic prostatitis, contrary to popular belief, does not in itself lead to impotence, but causes such severe pain that men lose the desire for intimacy.

Most of the problems leading to a worsening or even lack of erection can be solved with adequate treatment. But there are other pathologies, such as sclerosis of the corpora cavernosa of the penis. In this disease, the delicate elastic tissue of the cavernous bodies of the penis is replaced by coarse connective tissue that is unable to provide an erection. The reasons are penile injuries, repeated injections into the organ and even overly diligent, many hours of love exercises, in which a man tries with all his might to delay ejaculation as long as possible. Sex giants, keep in mind that everything is good in moderation!

The best prevention of impotence is a healthy lifestyle, sports, careful attitude to alcohol and other harmful substances, regular sex life without prolonged abstinence and sexual excesses.

Love until the grave

Some drugs can interfere with erection. The effect of “contrasex” is possessed by antihypertensive drugs, but also some quite harmless drugs, for example, antihistamines – psychotropic, say, the well-known diphenhydramine. Therefore, it should not be drunk for more than 5 days.

Also, do not self-medicate with drugs that improve male strength. Overdose leads to general depletion of the body. Cores should be especially careful: taking Viagra together with nitroglycerin threatens them with sad consequences.

The accumulated experience in the treatment of ED, the rational use of drugs and technologies, allows many patients to restore sexual activity, the quality of erections with a minimum risk of side effects of treatment.

You can make an appointment with a highly qualified urologist at the KGB # 31. We offer quality medical care in cases of any degree of complexity.

Make an appointment with our specialists

You can make an appointment for a paid appointment to the doctor by calling of the Consultative and Diagnostic Center +7 (499) 936-99-89 , or by filling out the form presented.

The conditions for the provision of paid services can be found here

To make an appointment for the OMS policy and in the direction of , you can call +7 (499) 936-99-71 .

90,000 Saudi Arabian women will be allowed to attend football matches

January 12, 2018

Photo author, AFP

Photo caption,

Women were allowed to attend a public celebration of National Day in September 2017 for the first time. Events took place at a stadium in Riyadh

Important changes are once again taking place in the lives of women in Saudi Arabia.On Friday, they will be allowed to attend the stadium for the first time during a football match.

They will be able to watch the match between football clubs “Al-Ahli” and “Al-Batin”, which will be held at the King Fahd stadium in the framework of the Saudi Arabia football championship.

Saudi Arabia has begun to gradually expand women’s rights in response to activists’ demands. But how significant are these changes?

Which matches can women watch?

Women are allowed to attend matches at stadiums in three cities – Riyadh, Jeddah and Ad Dammam.

Prior to that, only men could attend stadiums and concert halls in Saudi Arabia.

Following Friday’s match in Riyadh, Saudis will be able to attend the match between Al Hilal and Al Ittihad at King Abdullah Stadium in Jeddah.

Photo author, AFP

Photo caption,

The first women’s basketball team in Saudi Arabia appeared in Jeddah in 2009

Residents of the city of Al-Dammam will be able to attend the match between the teams “Al-Ittifak” and “Al-Faisali” , which will take place on January 18 at the Prince Mohamed bin Fahd Stadium.

Also this week, for the first time in Saudi Arabia, there will be a women’s squash competition. Last November, Saudi Arabia hosted the first basketball competition for women’s varsity teams. The competition was held in Jeddah, attended by about 3,000 spectators.

What places will women be allowed to take?

Special “women’s” sectors will be provided at the stadiums, where only women and children will be able to take seats. This means that women will be able to attend football matches even if they are not accompanied by a man.

There will also be special places for women in cafes and restaurants located on the territory of the stadium. This is due to the country’s strict gender segregation rules. As a rule, even during such celebrations as weddings, women and men celebrate separately – in different rooms.

Photo author, Getty Images

Photo caption,

Women in Saudi Arabia must cover their heads and wear wide Arab dresses at home at home. hiding a figure – mostly Saudis wear long traditional Arab abaya women dresses.

Why is this happening now?

These changes are part of a social reform plan announced by the Crown Prince, Deputy Prime Minister Mohammed bin Salman Al Saud. Last November, the 32-year-old prince announced the Vision 2030 program, which, according to its authors, will help lead the country to a modern economic model.

Introducing the program, the prince stated that it is impossible to change the economic model without modernizing the mentality of people and their way of life.According to him, “the era of extreme religious conservatism” must remain in the past.

Vision 2030 aims to empower women in Saudi Arabia.

In September 2017, the King of Saudi Arabia issued a decree ordering to start issuing driver’s licenses to women by June 2018. Also in September, women were allowed to attend National Day events for the first time.

Photo author, Getty Images

Photo caption,

Hiba Tawaji’s performance was the first concert for Saudi Arabia with the participation of the singer

Last year, Riyadh announced that the ban on showing commercial films, which had been in force for more than 30 years, would soon be lifted …The first cinemas are expected to open in Saudi Arabia in March.

In December, Saudi Arabian women were allowed to attend a music concert for the first time: Lebanese singer Hiba Tawaji performed in front of thousands of women. In addition, the performance of the Lebanese singer was the first music concert for Saudi Arabia with which a woman performed. Prior to that, none of the singers were allowed to perform in the country.

What remains prohibited?

However, women remain largely dependent on their male guardians (mahrams).A mahram for a woman can be her husband, father, brother, or even son. If she has no husband, no father, no brother, no son, or none of them can take care of her for some reason, any other male relative of her can become a guardian.

Without the permission of a male guardian, a woman cannot:

• apply for a passport
• go abroad
• get married and file for divorce
• open a bank account
• engage in entrepreneurship
• do routine) (non-emergency
• Leave prison

According to the rules in force in Saudi Arabia, all women are required to move outside the house with a mahram man, or obtain permission from him to leave the house accompanied by someone or one.

Photo caption,

Wahhabis remain consistent supporters of strict gender segregation

In practice, this means that a woman cannot actually leave the house on her own – for example, to go to watch a football match – unless she receives permission from her guardian.

The current system of guardianship for women in the country is due to the fact that the overwhelming majority of the country’s population professes Wahhabism – a relatively new but very conservative trend in Sunni Islam.

Adherents of Wahhabism demand complete segregation of the sexes and insist on the exclusion of women from the public sphere.

90,000 12 films about women with a strong character – What to see

Strength of character is not determined by strong muscles, much more often it is the ability to continue the chosen path, despite censure, stereotypes, and danger. In principle, this is the ability to find your way without blaming anyone for your choice. We have collected several stories about extraordinary women that are worthy of admiration.

Queen Mary

Queen Marie of Romania, 2019

Princesses do not choose suitors for themselves, they appoint who is supposed to be. The British Princess Mary of Edinburgh, granddaughter of Queen Victoria and Emperor Alexander II, was ordered to marry the Crown Prince of Romania. Not the most brilliant country, but after becoming queen, Maria fell in love with her new homeland with all her heart. Therefore, when, at the end of the First World War, the allies were in no hurry to fulfill their promises and recognize the unification of the disparate parts of the state in Greater Romania, the queen herself went to Paris to achieve the desired decision.Needless to say, at home, no one believed in the success of her trip.

Little women

Little Women, 2019

The lovely March sisters, from the poor family of the local pastor, have a lot of talents and aspirations. One is artistic, the other writes well, the third draws, the fourth plays the piano beautifully. It’s the middle of the 19th century, and marriage and motherhood are considered the only true social role of a woman, so girls can cherish their talents, but not pin high hopes on them.However, the stubborn young writer Joe does not agree with this alignment and is sure that she will succeed.

The artist and the thief

The Painter and the Thief, 2020

A documentary story about the creativity and knowledge of someone else’s soul. Two paintings were stolen from a young artist Barbora Kisilkova from the exhibition. The police quickly found one of the villains, but no one knows where the paintings are. During the trial, the artist asks for an opportunity to talk to the offender in private and suddenly decides that she wants to paint his portrait.

They crawl after you

Them That Follow, 2019

Pastor’s daughter Mara grew up in a sectarian serpentine community, conducting dangerous rituals involving snakes. It seems like the snake will bite the sinner, but the righteous will not touch. Mara truly believes in all of this. The sect’s laws prescribe a woman to choose a husband who will decide her fate, but Mara is not given true freedom of choice, imposing a diligent believer Garrett into her husbands.And her heart, which you cannot command, is with Augie, an unacceptable bridegroom who ignores collective prayers. Moreover, it is a terrible sin – she is pregnant with Augie.

Private war

A Private War, 2018

Mary Colvin, a military journalist, does not know how to live differently than risking her own life in an attempt to obtain objective information from the battlefield. In February 2012, together with war photographer Paul Conroy, who accompanies her on all trips, they embark on an incredibly dangerous mission in Syria.

Two queens

Mary Queen of Scots, 2018

Mary Stuart, Queen of Scots, had approximately the same rights to the English throne as Elizabeth I, Queen of England. If she were a more timid and calm woman, the lady would quietly rule over her Scots without annoying her more powerful colleague. But Maria wants more and is ready to risk her life for her goal.

Mary Magdalene

Mary Magdalene, 2018

A new look at the personality of Mary Magdalene, who left her loved ones and joined the group of apostles following Christ to Jerusalem. Critics often accuse the painting of rabid feminism, however, first of all, this is a look at the canonical plot through the eyes of a woman, which cannot but differ from the male interpretation.

Gravity

Gravity, 2013

Several people are performing installation work on the space station when a terrible catastrophe occurs. It is very difficult to return to Earth – there are debris around, everything revolves, confusing, and even the smallest mistake leads to death.Dr. Elizabeth Stone is in space for the first time, and there is such a misfortune.

Evita

Evita, 1996

One of the most controversial figures in the history of Argentina. Eva Duarte de Peron arrives in Buenos Aires at the age of fifteen and, thanks to her powerful charisma, makes her way into the world of luxury and glamor, to the very heights of power. She becomes the patroness of the poor and the spiritual leader of the nation, but at the same time contributes to the establishment of a dictatorship and severely suppresses any dissent.

Haute couture revenge

The Dressmaker, 2015

A stylish lady with a suitcase of fashionable rags arrives in the Australian outback. She returned to her home and hatches a plan: how to sort out that dark affair that happened many years ago, when she was a girl, and how to deal with the offenders, having only golden hands and impeccable taste.

All about Eve

All About Eve, 1950

A young girl, a fan of talent, is stuffing herself into an assistant for the aging actress.She readily fulfills the errands of the hostess and waits when she can sit on her in a moment of weakness and take the place of the prima on the stage. All available tools are used: the girl is selected not only to work, but also to the man of her victim, to her friends. She flatters, flirts – weaves her own net.

Hussar ballad

1962

1812 Napoleon invades Russia with his gigantic motley army, gathered throughout Europe.Young lady Shurochka Azarova feels that she cannot sit on the priest evenly and humbly wait until the Russian troops reconquer the country without her. She changes into a hussar uniform and goes to the front without permission.

Three Billboards Outside Ebbing, Missouri

Three Billboards Outside Ebbing, Missouri, 2017

A story about a woman who wanted to sneeze into public opinion. Mildred Hayes’s daughter was killed a few months ago, but the culprit has not yet been found.A desperate mother buys advertising space on three old billboards and posts an angry message to the local police chief. Well, in general, it scandals and attracts attention.

Suffragette

Suffragette, 2015

Hard, low-paid work, combined with complete lack of rights, is what the first suffragettes in Great Britain fought against in the early 19th century. For the sake of a goal that seemed almost unattainable in those years, causing only ridicule and mockery, girls are ready to put everything on the line – work, home, family, and even their lives.

If you liked the article, take a look at this page as well.

January 21, 2021

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Erectile dysfunction (impotence) – Medical Center “Alone”

Data on age-related androgen deficiency.

The term impotence in urological practice has been replaced by erectile dysfunction for moral and ethical reasons and as a term that fully reflects the condition of a man with erectile disorders.

This is a disease (condition) in which erectile dysfunction occurs in men, leading to the absence or deterioration of sexual activity, making it inadequate and leading to psycho-emotional disorders and a decrease in the quality of life. The question of erectile dysfunction arises when there is an inability to achieve or maintain an erection sufficient for intercourse. As a diagnosis, this disease is considered when the described violations are observed in more than half of the attempts at sexual intercourse within six months and under the condition of regular sexual activity.

Risk factors for this pathology are cardiovascular diseases, diabetes mellitus, arterial hypertension, high blood cholesterol levels, radiation and chemotherapy, overweight, a sedentary lifestyle, smoking, the use of drugs and certain drugs and substances, somatic diseases and individuals , whose work is associated with high physical and psycho-emotional stress. Men with erectile dysfunction, experiencing their condition, are prone to depression, irritability, withdrawal and anger.

The erection of a man depends on a number of mental, neurogenic, hormonal, vascular and anatomical factors. Accordingly, drawing a conclusion from the above, the causes of this disease may be as follows:
1) Mental disorders and illnesses:
Among the causes of psychogenic erectile dysfunction, there are strict upbringing, religious beliefs, fear of sexual activity, sexual perversions (perversions), depression, fear of aging, physical disabilities, a certain sexual preference of a partner, conflict with a partner, negative first sexual experience in a man, expectation of failure in contact with a partner, mental illness and some other conditions.

2) Neurogenic erectile dysfunction occurs as a result of damage to the central nervous system (brain and spinal cord) and or peripheral nerve structures. Tumors, epilepsy, strokes, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, vascular diseases of the brain can lead to erectile dysfunction due to suppression of libido (libido) or excessive inhibition of spinal erection centers or nerve conduction disturbances in the lesion that is involved in the emergence and maintenance of an erection necessary for the implementation of a full sexual intercourse. With lesions of the structures of the spine and spinal cord, such as osteochondrosis and herniated disc, tumors, multiple sclerosis, the innervation of the penis can be disrupted, which also leads to erectile dysfunction.

3) Endocrine diseases are the most widespread and often detected in patients with erectile dysfunction. Patients with diabetes mellitus are most often treated. The cause of erectile dysfunction in this case is not so much the underlying endocrine disease as vascular problems and damage to peripheral nerves.Tumors of the hypothalamus and pituitary gland can also lead to a decrease in libido, a change in the level of hormones that are responsible for an erection. In a certain percentage of cases of thyroid gland disease, directly and indirectly affect a man’s ability to have sexual intercourse. Recently, a view on the problem of male aging has become relevant, because with age, many physiological functions of a man fade away, and many of this group of patients want and have the opportunity to live a full sexual life.One of the first terms that appeared to describe age-related changes in men is the term “male menopause”, which is currently used quite widely as a description of a complex of symptoms that develop in a man after 45-50 years and are manifested not only by a decrease in sexual desire, erection in incl. and morning and dissatisfaction in sexual life, but also depression, decreased attention and memory, increased nervousness, fatigue, decreased muscle strength, hot flashes and sweating, sleep disturbances and other symptoms.But men do not have a clear age period for a decrease in the production of sex hormones, unlike women. Therefore, the use of the term male climax (from Latin “climax” means a step, a ladder) is not correct, because in men, this condition has a blurred and gradual onset lasting for years, and in women it has a sharp and spasmodic course. Therefore, the term male menopause should be considered as age-related androgenic deficiency. In the absence of contraindications, it is possible to prescribe testosterone replacement therapy to such patients to restore sexual function, erection and improve the quality of life.

4) Pathology of the arteries and veins of the small pelvis, arteries and veins that supply the penis with blood can, to a certain extent, lead to insufficient blood supply to the corpora cavernosa with the development of erectile dysfunction. Arterial pathology is most often caused by stenosis or atherosclerotic lesions of the arterial wall, as a result of which blood perfusion through the cavernous bodies of the penis decreases with the development of erectile failure. Patients with arterial insufficiency most often note an incomplete erection and difficulty in maintaining it.With pathological venous outflow, patients also note weakness and the rapidity of the disappearance of an erection soon after its onset.

5) Sometimes drugs that are recommended to a patient for another disease can lead to erectile failure. Most often it occurs in patients taking sleeping pills, sedatives, antidepressants, hormones and anabolic steroids, blood pressure lowering drugs (diuretics, beta-blockers, ACE and Ca-channel inhibitors) and other drugs.Therefore, such patients need to correct the appointment by canceling or replacing drugs in conjunction with a therapist or cardiologist (if, for example, erectile dysfunction is caused by taking antihypertensive drugs).

In the differential diagnosis of sexual dysfunctions, a detailed sexual history of the patient, as well as a thorough laboratory and visual examination, play an important role. Given that there are many reasons for erectile dysfunction, patients are prescribed without fail:

• general analysis of blood and urine,

• determination of fasting glucose,

• creatinine,

• urea,

• testosterone,

• prolactin and other hormones as needed.

These tests are carried out at the initial stages of the examination, further diagnosis and treatment by a urologist depends on the general condition of the patient, the desire to be treated and the patient’s financial capabilities.

“Psychotherapy begins when the patient enters the office” – Vademecum magazine

Sexologist Mikhail Yagubov – about the sources of ED and the components of its treatment.

Mikhail Yagubov, Chief Researcher of the Department of Sexopathology of the Moscow Research Institute of Psychiatry, Professor of the Department of Psychotherapy and Sexology of the Russian Medical Academy of Postgraduate Education, is convinced that erectile dysfunction (ED) is treated better in Russia than abroad.The doctor of medicine told VM about the reasons for this confidence.

“Women often have unrealistic expectations and demands”

– According to a recent epidemiological study, in Russia, up to 90% of men between the ages of 20 and 75, and there are about 56 million of them in the country, have identified signs of ED. Is the disease so successfully diagnosed?

– In order to talk about diagnostics, you need to understand what ED is.It is the sexual function that acts as a visual psychosomatic model. Erection, being one of the manifestations of sexual function, is provided by the integration of mental and somatic processes. With dissonance of certain components, problems arise. If the patient initially turns to a narrow specialist, then one of the components that ensure this function will be examined – endocrine, neuropsychiatric, vascular. And in sexology, an integrated, interdisciplinary, systematic approach is used, aimed at researching and establishing the role of disorders in various systems that contribute to the emergence of sexual pathology.

Therefore, initially, if you suspect ED, it is advisable to contact a sexologist. The systematic approach allows us to determine the leading, predisposing and aggravating factors that led to the development of this pathology. According to various sources, erectile dysfunction occurs in 5-8% of young men.

With age, this figure grows and can reach 50–75%, since somatic pathology joins the basic one. However, still more often than others, young and middle-aged men seek help, and somatically burdened people go to doctors less often.At the same time, among young and middle-aged men, psychological, mental and social factors predominate among the factors contributing to the onset of ED.

– To what extent do sexologists take into account the organic problems of patients?

– We coordinate patients with serious organic diseases resulting in ED. It happens that a patient with sexual dysfunctions does not even know about the problems of his body. Sexual function, like a litmus test, testifies to the mental and somatic state of a person.And quite often at the reception with a sexologist using an integrated approach, for the first time, it is possible to establish problems in various systems of the body.

Of course, if a man has a suspicion of having a somatic pathology, we refer him to the right specialists.

I had a patient who came with a sexual problem, and on examination revealed an inflammation of the foreskin, characteristic of diabetes mellitus. On my recommendation, the patient donated blood for sugar, and it became obvious that he had decompensated diabetes, which he had no idea about.

Naturally, a sexologist does not treat such patients. We take on our work only if the man’s condition is compensated, but problems with sex remain.

As a rule, we examine the patient for the presence of vascular pathology. If a man has severe vascular atherosclerosis, we refer him to a urologist, cardiologist, surgeon. Naturally, with severe organic pathologies, men independently turn to the appropriate specialists. In our country, they appear mainly with latent, mild states.

When establishing organic diseases, the sexologist never locks the patient into himself – he helps to understand the general state of the body. In our country, it is customary: if there are problems in the genital area, then you need to contact a urologist. But urologists have recently been increasingly talking about the fact that psychogenic factors play a leading role in the onset, persistence and persistent ED. In addition, more and more specialists from other fields are referring their patients to us.

– Is it possible to identify the psychogenic nature of the problem?

– We always begin the reception with a questionnaire survey of patients on all spectra of their lives – we study a set of biopsychosocial factors.The features of sexual development, personality traits, mental state, peculiarities of the partner situation, endocrine and general somatic statuses are investigated. An important role in the collection of anamnesis is played by social factors – family, upbringing, the place of the sexual sphere in the hierarchy of values, and so on. Without considering these aspects, treatment of ED will be ineffective, since sexual function is paired and not related only to instinct. After clarifying all the circumstances, we determine the therapeutic targets.

– Has a typical patient profile been identified today?

– Most often, sexual problems arise in individuals with a certain psychological makeup. These are anxiously suspicious people with a tendency to introspection, obsessions, hypochondria and phobias. These patients are more likely to develop anxious expectations of failure, phobias and depression.

The partner situation is no less important: in ED, the partner’s behavior plays an important role. We are interested in the nature of relationships and conflicts within the couple.In the case of ED, one cannot consider only the absence of an erection – this is too limited an approach, it is necessary to trace the development of relations, the partner’s reaction to the problem, to find out what her expectations and ideas about sex life are. Unfortunately, women often have unrealistic expectations and demands.

There are times when patients think that only sexual manifestations should be discussed, and everything else does not matter. But in fact, it turns out that the problems are caused by psychological conflicts in a couple, people sometimes do not see each other as a sexual partner, but do not admit it.And if in this case we direct all efforts to cure ED only on the study of the penis, then we are unlikely to get a result.

“We cannot heal at random”

– Can you name the approximate ratio of organic and psychogenic ED?

– In my opinion, ED can only be divided into psychogenic and mixed. Purely organic dysfunction does not exist, because any man is psychologically hard going through problems in sex life.

There are patients who, at 70 and 80 years old, experience misfires in their sexual life.We were also approached by 90-year-old men – it all depends on the psychosomatic state of a person. Most often, long-livers also retain sexual function.

Erection is generally a very controversial phenomenon. Firstly, this is the earliest manifestation of sexual function, because the first erection occurs in the womb. At the same time, this is the most vulnerable, sensitive male side, most of a man’s experiences are associated with it. After all, if a woman is responsible for procreation, then a man must guarantee the process that will lead to fertilization.

– What kind of ED therapy do sexologists offer?

– Therapy is differentiated, it is prescribed taking into account all the factors that contributed to the onset of the disorder. Most often, the treatment is complex, using both psychotherapeutic and pharmacotherapeutic and physiotherapeutic techniques. For example, a man may be successful in bed with a regular partner, but have problems with each new one. In this case, ED has nothing to do with the vessels. As a rule, until he is used to a woman, problems arise. But as soon as the man becomes comfortable with his partner, and she shows a benevolent attitude, the problem with sexual dysfunction will be resolved. But work with the patient is also aimed at correcting automatic thoughts that trigger anxiety and phobic symptoms leading to ED. Treatment is aimed not only at the adaptation of this couple, but also at the formation of certain behavioral techniques that increase the patient’s adaptive capabilities in the sexual sphere.

We cannot treat at random, because in the case of ineffective treatment, the patient will become less confident in his own abilities each time. If he is not prescribed adequate treatment, then in the eyes of the patient, the method or drug is discredited. In this case, the patient becomes less amenable to therapy.

– Without knowing psychiatry, it is impossible to deal with sexual pathology?

– Naturally. An ED patient may be in a serious mental state that will endanger his life, and even the life of a doctor.We do not only carry out psychocorrection – we deal with the sexual function in general. And above all, the correction of conditions that lead to psychogenic ED. At a sexologist, psychotherapy begins at the moment when the patient enters the office. It should be borne in mind that any communication is difficult for a person with this problem.

If you do not remove the conflict in the relationship between partners and the female attitude “when you have a stand, then come closer to me,” then the problem can persist for a long time.

– Should both partners contact a specialist to correct such conditions?

– Yes, because the sexual function is a pair. But, unfortunately, most often partners come separately. There is a stereotype: only those who have erection problems should be treated. We try to attract partners when we understand that it is the relationship that provokes problems in the sexual sphere.

“The method becomes bad only if it is used out of place”

– How successful is therapy for psychogenic erectile dysfunction?

– Psychogenic ED is treatable in almost 100% of cases.

– Do you use additional methods along with psychocorrection?

– We prescribe both drugs and hardware methods of treatment. In psychogenic forms, the leading method is psychotherapy, sex therapy, aimed at using certain behavioral sexual techniques that allow the patient to be convinced of their capabilities. We also use all traditional methods – vacuum, reflexology and physiotherapy. There are no bad methods, they can become such only if they are used out of place.

– What about the popular drugs of the PDE-5 inhibitor group?

– By the time phosphodiesterase type 5 inhibitors appeared, I had been doing sexology for many years. Before that, there were intracavernous injections and vacuum therapy. The specialists were very pleased with the new tool for improving erectile function, because this is an effective way to help patients. But it is effective when applied appropriately to the situation. If the patient has a developed phobic syndrome with depressive symptoms, which led to a decrease in sexual desire, then, naturally, the drug will not work.In addition, the drug must be prescribed by a specialist in combination with other methods so that the patient does not become dependent on it.

– When do you prescribe medication to patients?

– We prescribe a single dose of the drug when a person has fears about sexual relations or expressed anxious expectations, for example, immediately before the first possible contact with a partner. Thus, we demonstrate to the man that he does not have organic pathology.

But it happens that men self-medicate or specialists mistakenly prescribe them a regular intake of drugs that increase potency. In this case, the patient begins to form a certain dependence on taking such drugs.

Then there is a risk that the man will gradually begin to abandon the realization of his own physiological capabilities. Let me explain: in the endothelial cells of the vessels of the cavernous bodies of the penis, nitric oxide is formed, which triggers a cascade of reactions leading to blood flow into the cavernous bodies of the penis and erection.The enzyme phosphodiesterase type 5 inhibits this process, therefore, with its inhibition, a positive effect is achieved. Over time, the body seeks to eliminate such interference, the effect of the drug decreases, and the patient is forced to increase the dose, otherwise the drug will simply stop working.

Sexologists do not strive for a man to have sexual intercourse once, we need to prove to him that he is generally sexually successful. In this case, in the future, he will not be dependent on drugs or women.

Along with PDE-5 inhibitors for the treatment of sexual impotence, we prescribe anti-anxiety drugs or antidepressants – it all depends on the patient’s condition.

“Getting rid of intimate problems – creativity”

– What external factors can influence the increase in the incidence of psychogenic ED?

– Certainly, the number of persons with psychogenic ED increases with socio-economic changes. When cataclysms occur or a crisis occurs, the man becomes not up to sex.Against the background of social disorder, he is not able to initiate sexual intercourse. After all, full-fledged sex can only be if the partners abstract themselves from all the problems, otherwise misfires will occur. It can be assumed that now, during the crisis, the number of men with PEP has increased, but it is incorrect to judge the increase in morbidity by the number of people who applied. Because people are less likely to turn to a crisis. The consequences become apparent years later, when the unfavorable period passes. A man comes to us, having restored his social status.

– How accessible is the help of sexologists in Russia? Or can you get it only in the commercial segment?

– There is officially a staff of sexologists in Russia. By order of the Ministry of Health, there should be one specialist for every 250,000 population. Count yourself. Free specialized help is available at some neuropsychiatric dispensaries, Marriage and Family counseling, and antenatal clinics.

And in the West, the help of sexologists is not included in the insurance.In addition, only in a few countries of the world sexology is, in principle, a separate specialty – mainly psychiatrists, urologists, and endocrinologists are indirectly involved in sexual problems all over the world.

Back in the 70s, our center was the only institution in the USSR where patients with sexual dysfunctions could receive specialized care. Then the recording was conducted for six months in advance. And when the market for medical services began to emerge, patients moved to commercial clinics.

Today we are most often approached by people who have visited some other institution, but have not received qualified assistance there.

– Does this approach differ from the Western model of patient sexual rehabilitation?

– We can unequivocally say that our approach is no worse, and maybe even better than the foreign one. There are ED treatment standards that use yohimbine, PDE-5 inhibitors, injections and prosthetics in sequence.

These standards, among other things, are designed to protect doctors from persecution. In Russia, this approach is not applied, and, in my opinion, it is impossible to standardize this assistance – everything is too individual here.Getting rid of patients from intimate problems is a creative work that needs to be built taking into account well-known methods, and the main thing here is medical thinking. We have patients who, having traveled all over the world in search of help, return to our center and receive it.

 erectile dysfunction, treatment, sexologist 

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Eroton – a drug for the treatment of erectile dysfunction

Traditionally, impotence has most often been defined as the inability to achieve or maintain an erection. In 1988, doctors agreed once and for all to get rid of the degrading term “impotence”, now erectile problems are called “erectile dysfunction”. This term refers to the inability to achieve or maintain an erection of the penis sufficient for satisfactory (that is, satisfying both partners) sexual intercourse. Erectile dysfunction can be combined with decreased sex drive, ejaculation and orgasm disorders.

Erectile dysfunction is a very common condition. It is noted in hundreds of millions of men around the world, with a persistent trend towards an increase in the number of such patients. This is due to many reasons, including the deterioration of the ecological situation on the planet, the growth of urbanization, as well as an increase in the average age of the inhabitants of the Earth.

One in ten men over the age of 21 suffers from an erectile dysfunction, and one in three men over the age of 60 are unable to have sexual intercourse at all (Lue T.H., 1990). Thus, about 150 million men in the world suffer from this disease, and it is assumed that over the next 25 years, this figure may increase significantly, since according to the UN forecast, in 25 years the number of people over 65 will triple (United Nations, 2001 ). This is also partly due to the steady increase in the prevalence of risk factors and causes of erectile dysfunction, among which diabetes mellitus and cardiovascular disease play a major role.

Despite the problem of population aging in developed countries, more patients with erectile dysfunction should be expected in developing economies (including Ukraine).This leads to a high level of injury, alcoholism and smoking. In addition to these reasons, an important risk factor for erectile dysfunction in our compatriots is a high level of stress, which leads to depressed mood and decreased sex drive in men.

The causes of erectile dysfunction are divided into two large groups:

1) organic – when there is some kind of disorder in the body;

2) psychological – which are due only to the characteristics of the patient’s psyche.

Erectile dysfunction is diagnosed in men of all ages, from adolescence. In most cases in young men under the age of 25-30, erectile dysfunction has a psychogenic root cause when it comes from excessive excitement. Psychologists call it “failure expectation syndrome.” In men over 40, other reasons lead to a decrease in sexual functions, for example, stressful effects, psychoemotional overload, irregular sexual activity. With the wrong behavior of a man during this period, temporary disorders can turn into a persistent violation of sexual functions, due to the development of a complex of his own inferiority.

Various diseases can become organic causes of the development of erectile dysfunction. These include atherosclerosis, arterial hypertension, diabetes mellitus, multiple sclerosis, etc. Frequent causes can be alcoholism, tobacco smoking, drug addiction, injuries and diseases of the spine, etc. Erectile dysfunction can occur as an adverse reaction to certain medications (estrogen hormones, pain relievers, drugs used to treat alcoholism, etc.)etc.).

It is important to emphasize that erectile dysfunction of mixed origin is most often detected when psychogenic and organic factors are combined.

For many centuries, people have not put up with sexual weakness and have looked for ways to treat it. Greek healers recommended dope seeds and male fern flowers as medicine, which should be taken orally, used as lotions and wraps.

In Russia, the problem of sexual impotence worried men no less than in other countries.Healers offered exotic recipes for the treatment of “nevstanikha”. For example, “smear shame” with a mixture of chicken heart and reindeer lard or eat thirty sparrows stewed in a pot. How effective such methods were, history is silent. Conspiracies were also very popular.

Aphrodisiacs have become popular for a long time. This name comes from the name of the Greek goddess of beauty Aphrodite. The effects of aphrodisiacs include increased attraction to a sexual partner, increased potency, sexual pleasure, etc. e. Since ancient times, they tried to achieve the corresponding effect by eating the genitals of various animals: for example, the testes of a bull, which to this day are offered to be tasted in Latin American countries. The similarity of some plants with genitals (mandrake root) did not escape the attention of ancient healers. Even today, one can often hear the opinion that parsley root is very helpful in bed. True, over time, a significant addition to this advice was lost, namely, how it is best to tie it …

Very often, substances that were considered aphrodisiacs were found to be dangerous to human health, for example, the substance contained in the wings of the famous Spanish fly.With repeated use in men, it causes a prolonged painful erection, ending with rupture of blood vessels and complete impotence. Women experience severe painful swelling of the genitals.

The scientific approach to the study of potency problems arose only at the end of the 19th century. First of all, the causes of sexual impotence began to be divided into psychological and organic, then, having dealt with the causes of the disease, they moved on to its complex treatment.

Methods for restoring sexual function in men are divided into conservative and invasive.

Conservative treatments:

• Drug therapy. For a long time, drugs used for erectile dysfunction have included alpha-adrenergic receptor blockers (yohimbine, phentolamine), dopamine receptor antagonists (apomorphine), androgens (testosterone), adaptogens (pantocrin, eleutherococcus), peripheral and other vasoactive drugs
• Vacuum-constrictor therapy (vacuum erectors).

Invasive treatments:

• Method of intracavernous injection of vasoactive drugs (papaverine, phentolamine, prostaglandin E ₁ , etc.).
• Surgical restoration of sexual function (reconstructive vascular surgery, endophaloprosthetics, etc.).

The discoveries of recent decades have led to significant progress in the treatment of patients with erectile dysfunction. They contributed to the creation of a fundamentally new drug for the treatment of this disease – sildenafil, which belongs to a new pharmacological group of drugs – phosphodiesterase type 5 inhibitors. These drugs are today the undisputed leaders for the conservative treatment of erectile dysfunction among all existing ones and are recommended as the first choice drugs for its drug therapy (Fazio L.et al., 2004).

The emergence of newer type 5 phosphodiesterase inhibitors does not change the place and role of the pioneer of this group, sildenafil. It was he who overshadowed all the methods that existed before that were used to treat erectile dysfunction, making it possible to extend the sexual longevity of a man. Sildenafil therapy for erectile dysfunction has provided a number of undeniable advantages over other treatments:

• simplicity and ease of use;
• non-invasiveness;
• painlessness.

However, the most important advantage of sildenafil preparations is their high efficiency, reaching, according to the results of some studies, more than 90%. It is with sildenafil that the effectiveness of other drugs in this group is compared. As it turned out, their effectiveness is generally comparable to sildenafil (Brock G., 2003; Montorsi F. et al., 2004).

Sildenafil is an active ingredient of the EROTON drug of the company “Fitofarm”. EROTON is a highly effective, reliable, easy-to-use drug with a favorable safety profile.

According to the results of the MALES (The Men’s Attitudes to Life Events and Sexuality) survey, among patients with erectile dysfunction who did not use phosphodiesterase 5 inhibitors or who used them only once, high cost is a deterrent factor in 31 % of cases. Among patients who discontinued therapy with a phosphodiesterase type 5 inhibitor, 29% of respondents gave the answer “too expensive” (Eardley I. et al., 2003). Thus, about a third of patients who could get rid of erectile dysfunction with effective drugs do not receive treatment due to the high cost of the drug.

For domestic consumers, this problem is solved by the drug EROTON, the effectiveness of which, according to the results of a comparative study (Gorpinchenko I.I., 2006), is not inferior to that of the original drug Sildenafil, and the price is affordable for most patients.

Advantages of EROTON:

• is produced in a convenient dosage, packaging for use in various stages of the disease: 50 mg, No. 1 and No. 4, 100 mg, No. 1 and No. 4;
• Each tablet is protected from counterfeiting: it has an original shape in the form of a hexagon “Hexagon” with the letter F printed on both sides;
• the effectiveness of the drug is achieved primarily by the selection of the substance and excipients that meet the requirements of the European Pharmacopoeia and the characteristics of the technology;
• effectiveness is confirmed by the results of clinical trials;
• price is available for most patients.

A surprise awaits buyers in the package – two condoms.

The effectiveness of the drug is appreciated by doctors and patients. Therefore, pharmacies always enthusiastically order EROTON from distributors: Venta Ltd, BaDM, Donfarmholding, Fra-M, FF Apteka-95, Falbi, Optima-Pharm, Artur -K “,” Edelweiss “,” Arnika “(Donetsk),” Fito-Lek “(Kharkov).

“Weekly Pharmacy” in the next issues plans to acquaint readers with other novelties from the company “Fitofarm”.o

Igor Gorpinchenko, Honored Doctor of Ukraine, Doctor of Medical Sciences, Professor, General Director of the Ukrainian Institute of Sexology and Andrology, President of the Association of Sexologists and Andrologists of Ukraine, member of the European Society of Sexual Medicine, Head of the Clinic of Sexology and Andrology, and member of the Academic Council of the Institute of Urology of the Academy of Medical Sciences of Ukraine, member of the Academic Council of the Pharmacological Committee of Ukraine:

– In the structure of sexual disorders in men, erectile dysfunction occupies a leading place both in frequency of occurrence and in social significance.Although it does not threaten human life, it should by no means be regarded as some kind of trivial problem. The research results of recent years convincingly indicate that sexual activity is an integral element of the concept of “quality of life”. It is believed that sexual function diminishes over time. However, every man can have a quality sex life at both 50 and 60 years old.

Sexual relations between a man and a woman are the cornerstone, the key to the strength of any family.It must be remembered that female sexuality depends directly on male desire. In other words, in order for a woman’s sexuality to manifest, her desire must be awakened. At the same time, very often a man with erectile dysfunction, under various pretexts, refuses intimacy – he comes home later, goes to bed earlier, provokes scandals in order to avoid intimate relationships. This brings discord in family life. Although there is a way out!

The role of the pharmacist is to focus the attention of not only men, but also women who turn to the pharmacy for advice, on the fact that thanks to modern medicines, which is the domestic drug EROTON, it is possible to achieve harmony in sexual life.

If a man is overly worried and afraid of disrupting a long-awaited romantic meeting, he can play it safe. EROTON can be used to prevent failure expectation syndrome. That is, a man can pay more attention to building relationships, and not to his complexes.

We have conducted a study of the drug EROTON produced by OJSC “Fitofarm” on the basis of the Department of Sexology and Urology of the Institute of Urology of the Academy of Medical Sciences of Ukraine. In terms of efficiency, EROTON (0.05 g tablets produced by OJSC Fitofarm) is comparable to the original drug Sildenafil.The results of the study showed that EROTON is well tolerated. The identified adverse reactions were regarded as expected, not serious. The frequency and nature of the resulting adverse reactions are consistent with the literature data for sildenafil drugs. The results of the comparative clinical study allow us to recommend the drug EROTON manufactured by JSC “Fitofarm” for medical use in patients with erectile dysfunction.

It is necessary to dwell on the importance of taking the drug correctly.After the application of EROTON, after 30 minutes, in the presence of appropriate erotic stimulation, the man naturally begins an erection. This period of time depends on the characteristics of the organism and on what food the patient ate before taking EROTON. Fatty foods and alcohol slow down the absorption of the drug and its entry into the bloodstream. But this does not in any way affect the overall level of concentration of the drug in the blood. Therefore, if a man takes EROTON after a meal, it will take more time before the drug starts to act, but the effectiveness will not decrease.

EROTON can be safely called a drug that can help patients with erectile dysfunction get rid of their ailment and again feel the fullness and joy of life.

Information on preparations manufactured by Fitofarm
can be found on the website www.fitofarm.dn.ua.

Press Service
“Weekly Pharmacy

How a red-haired guy with a guitar defeated show business

Edward Christopher Sheeran was born in Halifax, but moved to Suffolk in East Anglia with his family as a child.He went to school in the small commercial town of Framlingham, near the capital of Suffolk. Ed still lives and plans to raise children here. For several years, Sheeran bought houses in the neighborhood, then built a tree house on the site with a studio, great views and a swimming pool, soon there will be an underground cinema. This is in many ways his attempt to escape from popularity: “I used to love to communicate, all the hangouts of the music industry, it was like a hobby: to meet artists whose work I liked, to communicate with them, to drink.And now I start to get social phobia when there are a lot of people. Such an irony: I perform in front of thousands of stadiums, but I get claustrophobic when I’m close to a lot of people. ”

Ed’s older brother, Matthew, is a composer. Mom Imogen is an Englishwoman, she was engaged in public relations in the field of culture, and then she began to make jewelry. Father John is an art historian, art curator and teacher who can easily tell the history of St. Petersburg. In a large paternal family with Ed, there are 26 cousins ​​and second cousins.“They are all Irish: as soon as they look at women, they immediately become pregnant,” Sheeran said.

Sheeran began singing in the church choir at the age of four. As a result of an unsuccessful operation (a large birthmark on his face was removed with a laser), his eyes began to squint and he had difficulty speaking and stuttering. At the age of nine, his dad gave him, who is fond of rap, a new disc by Eminem “The Marshall Mathers LP” (clearly not knowing what it is about). Soon Ed learned all the songs by heart and read them clearly aloud. It became clear that he has a great sense of rhythm and hip-hop helps to overcome difficulties with speech.Therefore, he began to learn to sing: singing was not his innate gift (now, without shame, he puts on his early recordings, on which he frankly misses the notes). At the age of 11, greatly impressed by Damien Rice’s concert in a small Irish club and getting to know him, Ed returned home and began writing songs.

On his 15th birthday, his father gave him a loop pedal (Ed saw this at a performance by a little-known Irish musician): this way he could record musical fragments and compose other parts over them.It will remain his greatest passion: himself, the pedals and his little guitar, Little Martin, which is easy to take with you. The label asked to put Sheeran together – but why? With a pedal and a guitar, and without the band, for three nights in a row, he gathered 87 thousand people at Wembley Stadium.

At the age of 16, he dropped out of school, moved to London to study only music. He played in small clubs, worked as a guitar technician for the band Nizlopi, and then played as the opening act for them on tour. Auditioned for the musical series Britannia High.They were looking for those who can sing, write their own music, perform, play and dance. Ed was good at everything, but danced badly – he was not taken. But his drama studies were not in vain: he starred in The Diary of Bridget Jones, Game of Thrones (as a soldier of the Lannister army) and the film Yesterday, which will be released in Russia in September.

Most of the time he slept on the couch with Murray Cummings’ cousin – Ed is the closest of his huge family to him. Murray by that time was already actively working as a videographer with Irish bands (Westlife, for example) and filming videos.Murray went to support Ed at his very first concerts, filmed videos and posted them on MySpace and YouTube. At some point, Ed joked, they say, I will grow up and become famous, and you will make a documentary out of all this. On tour, Murray was the only peer of Ed’s age, so their friendship grew even stronger, and Murray’s camera seamlessly captured the most intimate scenes in which third-party operators would simply not be allowed.

From 70 thousand hours of archival material, Murray actually made the film “Songwriter”.It is the first documentary to focus on the songwriting process, in particular on how Ed Sheeran’s third studio album, Divide, was conceived and recorded.

We see the song “Love Yourself” appear: it will become a hit of Justin Bieber later, and while Ed, Murray and producer Benny Blanco on the bus discuss that it should become the same anthem of abandoned guys that was once “I Will Survive “. As after a transatlantic flight, he cannot sleep and in the morning in Malibu he gathers his fellow songwriters to try writing songs in different teams.As at five in the morning, he picks up a guitar and instantly comes up with a song. As at home in Suffolk, he goes to his school to communicate with the children and says that songs for him are like a tap in an old house: first, dirty rusty water flows (bad songs), but just like the water becomes cleaner as the pipes are cleaned, songs in the process of working on them become more interesting.

A red-haired teenager who raps with an acoustic guitar is not the one record label scouts have dreamed of finding. But since Ed just loved writing songs and performing with them, he continued to do it day after day: performing in the same clubs, in front of the same promoters, selling discs that he carried in his backpack, bracelets and merch.It was important for him to prove to his family that it was not in vain that he dropped out of school and that he could earn money by doing what he loved. It was often hard: I had to sleep on a bench in the park, or at the station. To say at a concert: “I have nowhere to spend the night, so if you give me a place to sleep and a cup of tea, I will gladly play a concert in your living room.”

In one 2009 he played more than 300 concerts, guided by his father’s admonition: “Look what those whom you respect are doing, and do the same – only twice as many.”In 2010, having several EPs in his asset, Ed took 2 thousand dollars and flew to Los Angeles – London still does not claim the status of the capital of world music. Ed was convinced that his melodic songs with tenacious choruses are doomed to popularity, the problem is only in the promotion. He did the same thing again: went to open microphones, performed at every opportunity, including at rap parties – and so the actor Jamie Foxx caught the eye.

Fox, a big fan of music (what else can you expect from the person who played Ray Charles), invited him to his radio show and, seeing how his harsh friends, 12 minutes later, were delighted with a white red-haired guy with a ukulele, settled him for a month and a half him on his couch while he continued to play concerts and meet the right people.Back in England, Ed released two more EPs. The last one is “No. 5 Collaborations Project ”(eight tracks with English grime-MCs) – got to the second place in the iTunes chart without any promotional support. Soon, a thousand came to Sheeran’s announced free concert in a club for 200 people: they had to play four concerts in a row, and then entertain the audience in front of the club on the street all evening. A month later, Ed had a contract with Asylum, Warner’s subsidiary.

Sheeran’s music seems to be sharpened for commercial success, and the album sounds like the top 20 of the current charts.All songs are only about love. About how every morning he cannot believe that his wife chose him (“Best Part of Me” – a duet with incredible vocalist Yebba). About the fact that “if you cross my woman’s path, then you’ll cross my path – and this will have consequences” (“Cross Me”, duet with Chance the Rapper). The fact that for his wife the time spent together is more important than money, but it is important to explain that he loves his career and also earns for the future of their family (“I Don’t Want Your Money,” with H.E.R.). The fact that he was most afraid that they would someday turn into superficial, beautiful people only on the outside, like most in Los Angeles, who care about connections and clothes (“Beautiful People” with Khalid). The fact that he no longer likes to go to all sorts of events in the music industry, but since he is with her, then you can have fun together and do whatever they want (“I Don’t Care” with Justin Bieber).

Back in 2012, Sheeran said in an interview with The Guardian that he had a plan: first two solo albums, each of which would be called a mathematical sign, and then a duet album, and after that he would move away from music for a while. to take care of the family.True, it was initially assumed that the duets would be with the masters of the old wave, on whose music he grew up and whom his father adored. But during this time Ed has already managed to collaborate with Elton John, Eric Clapton and The Rolling Stones. Therefore, Eminem (who else could have been invited by a man who grew up on The Marshall Mathers LP?) And 50 Cent are in charge of the old school on the new album. All the rest are either musicians who are popular right now, or unconditionally talented, but whose success is a matter of time.

Above the new album “No.