Influence of head injury on potency

Neurology and potency

On 18 December 2013.

Problems with the implementation of sexual intercourse in a man arise under various circumstances, one of which may be the presence of any disease that complicates the work of the reproductive system. In the population of patients with Erectile dysfunction, about 10% of cases are caused by various neurological factors, because tumors and injuries of the brain and spinal cord, multiple sclerosis, herniated discs, cerebral insufficiency, syringomyelia, stroke and other ailments can affect potency.

All changes in the spinal cord or brain that were obtained as a result of any diseases or injuries block and impede the normal passage of nerve impulses, which causes erection problems in men and neurogenic impotence occurs. In 75% of cases, it is caused by serious spinal cord injuries, the rest are cerebrovascular pathologies, neoplasms, hernias, multiple sclerosis and other neurogenic diseases.

Diagnosis of impotence in the presence of neurological problems

In all patients with neurogenic impotence, it is necessary to examine the sensitivity of the penis and carefully study their neurological status. It should be taken into account that a person has urination disorders and back pain that accompanies the pathology of some parts of the spinal cord. If a man does not have the ability to have erections, then this indicates a complete damage to his sacral regions.

In the diagnosis of impotence of a neurogenic nature, some of the following research methods are used:

• Determination of the sensitivity threshold of the penis to vibration - the procedure is performed using a special biothesiometer device, deviations in sensitivity are considered an early manifestation of peripheral neuropathy.
• Determination of refractoriness of the sacral nerves - the body or head of the penis is subjected to electrical stimulation and the induced muscle contractions are recorded electromyographically. The obtained data on reflexes can be used to clarify the diagnosis in case of suspected problems with the sacral spinal cord.
• Electromyography of the muscles of the perineum - using a sterile concentric electrode inserted into the bulbospongius muscle, an electromyogram of the muscles is obtained during contraction and at rest.
• Somatosensory potentials of the dorsal nerve of the penis - the right and left parts of the penis are periodically stimulated, thanks to this procedure it is possible to assess the state of the thalamocortical synapse.
• Monitoring of nocturnal erections - in healthy men, they occur in the phase of REM sleep, with neurogenic impotence, they are completely absent or weak and defective erections are recorded.

Neurology and potency - take care of yourself

Today there is no single answer to the question of how to avoid impotence, but there are general recommendations, following which you can maintain your sexual health for a longer time. First of all, you need to lead a normal lifestyle, do not abuse alcohol, nicotine and narcotic drugs. A decrease in erectile function is often observed in neurological diseases such as multiple sclerosis, epilepsy, as well as injuries of the pelvis and brain, and, unfortunately, the restoration of potency in this case can be very long. Take care of your nerves: avoid stressful situations, try to get enough sleep every day and have a good rest, do not worry over trifles.

Sexual dysfunctions in the late period of traumatic brain injury

Often, in studies of organic pathology of the central nervous system (CNS), the authors mention the identified sexual dysfunctions only superficially.

Due to the heterogeneity of the spectrum of consequences of TBI, it is impossible to accurately determine the pathogenesis of sexual dysfunction, on which the tactics and principle of treatment of the disorder depend. During the Great Patriotic War, as a result of histopathological studies, the foundations of the doctrine of traumatic brain disease were laid. Many authors paid attention to the early period of TBI, but to a greater extent - to the late one, due to the variety of mental, psychological consequences. According to S.S. Torosyan (1967) in every 3-4th patient aged 20-50 years, an organic disease of the central nervous system is almost always accompanied by certain sexual dysfunctions, but they are more often superseded by other symptoms: motor and sensory disorders, loss of some higher mental functions. In the works of the late 19th - first half of the 20th century, sexual disorders were divided into organic and functional. There have been attempts to clearly define the localization of the so-called "sexual center". THEM. Porudominsky introduces the concept of "cortical (cerebral) impotence".

Among the manifestations of sexual disorders due to organic brain damage, dysfunctions of all spheres of the copulatory cycle are described: violation of sexual desire, violation of physiological arousal, lubrication disorder in women and erection in men, and orgasm and ejaculation disorders. In his work, S.S. Torosyan notes that 10 out of 15 men had a violation of the various phases of sexual intercourse. An initial decrease in libido is characteristic in sexual disorders of diencephalic genesis, and then a weakening of erections and premature ejaculation. Hypolibidemia also develops as a result of other brain diseases.

The study of possible pathogenetic mechanisms of the formation of sexual dysfunctions in cerebral lesions in general and in brain injury, in particular, has been undertaken throughout the entire period of study of this problem. The development of neurophysiological research methods has made it possible to consider sexual function as a result of the influence of cortical regulation, of the entire associative-analyzing activity of the cortex. With organic brain damage, including after TBI, various sexual dysfunctions can be observed for the following reasons: violations of conditioned reflex regulation, as a manifestation of neuroendocrine pathology, as well as due to mental disorders (asthenic, affective and cognitive).

Some authors deny the development of sexual dysfunctions in unilateral brain damage, emphasizing the primary influence of spinal structures on sexual manifestations. But still, the concept of a conditioned reflex interaction between the "center" and the "periphery" is fundamental in the regulation of sexual functioning. With organic brain damage, sexual disorders can develop according to different mechanisms: due to a violation of the afferent and efferent pathways; as a result of pathological changes in various brain structures involved in the formation of conditioned reflex connections. In addition to organic influence, at present, in the development of sexual dysfunctions (with organic lesions of the central nervous system, including with TBI), an important role is assigned to changes in the sphere of feelings and emotions, as well as cognitive functions resulting from damage to the hypothalamus, limbic system and frontal bark.

A number of authors describe sexual dysfunctions in CNS lesions as a result of various diseases (encephalitis, parkinsonism, optochiasmal arachnoiditis, brain tumors and their consequences). The brain was assigned a dual role: on the one hand, it has an exciting effect on the spinal centers of erection and ejaculation, on the other hand, it has a delaying effect. In view of the insufficient knowledge of the influence of individual brain structures on sexual function, the spinal structures were considered to the greatest extent as the "sex center". The absence of a central inhibitory effect was considered the cause of a pathological increase in excitation, increased erection up to priapism.

The right and left hemispheres are unequally involved in the regulation of sexual function. The cortex of the left hemisphere carries out predominantly inhibitory secondary signal effects on cortical primary signal sexual impressions and on subcortical emotional-vegetative regulatory mechanisms. V.V. Krishtal notes that when the dominant hemisphere is damaged, leading to speech and motor disorders of the opposite limbs, sexual function suffers only due to asthenization of the body. The defeat of the subdominant hemisphere, even minimal, along with emotional and motor disorders of the opposite limbs, almost always leads to sexual disorders.

In the studies of neurophysiologists, neuropathologists, sexologists, attempts have been repeatedly made to combine information about the localization of brain structures responsible for the implementation of a particular sexual function. So, sexual disorders can occur in the pathology of the mediobasal parts of the frontal and temporal lobes, the striopallidar system, the paracentral lobules, and the brain stem. An increase in sexual excitability occurs when subcortical mechanisms (the striatum, thalamus, hypothalamus) are involved in the pathological process. Hyperlibidemia can be observed with lesions of the cerebellum, pons, cortex of the frontal regions in the structure of the "frontal syndrome".

In the studies of domestic scientists, much attention is paid to sexual dysfunctions in the defeat of the hypothalamus. To this pathology A.I. Belkin refers to those cases of damage to the hypothalamus, in which the main symptom is "sexual weakness". N.Z. Chait revealed other characteristic features in the study of two variants of the hypothalamic syndrome - vegetative-vascular and neuroendocrine. Sexual dysfunctions are observed equally often in all clinical variants of the diencephalic syndrome.A number of research papers describe the neuroendocrine role in the performance of sexual function, the role of hyperprolactinemia in the etiology of sexual disorders. In some works, attention is paid to the significance of the cellular structures of the tonsils in the event of libidinal reactions. These assumptions are based on the fact that in the limbic system, the amygdala provides arousal and maintenance of emotional behavior. Thus, the appearance of sexual dysfunction can sometimes be an early symptom of brain damage, long before the onset of other focal symptoms.

Peripheral mechanisms of regulation of sexual function are due to the influence of the central nervous system on the autonomic nervous system. It is known that the occurrence of sexual arousal (erection and lubrication) is associated with parasympathetic innervation of the arteries of the genital organs, and its extinction is associated with sympathetic. The release of ejaculate in men, orgasmic sensations in women are due to parasympathetic impulses.

In addition to the morphological focus, depending on the nature and severity of the resulting TBI, the victim develops various neuropsychic consequences: from asthenic disorders to impaired consciousness, affective and mnestic disorders, epileptic syndrome, pseudodementia, post-traumatic hysteria and psychosis. Emotional disorders as a consequence of traumatic brain damage, as well as neurotic manifestations as a cause of sexual disorders, have been repeatedly described in Russian literature. According to some authors, in the development of sexual disorders in neuroses in men, damage is observed not only to the mental, but also to the neurohumoral spheres of the copulative cycle due to general neurotic phenomena (asthenia, vegetative disorders) and a decrease in androgenic saturation of the body as a result of stress reactions.

The sexual sphere becomes more vulnerable with deep violations of higher mental, motor functions, loss of sensitivity, coordination, etc. At the same time, in the acute period of the disease, due to these disorders, deactualization of sexual manifestations occurs. Such patients seeking help with complaints of a sexual nature occur at the later stages, when the problem becomes most significant.

The prevalence of sexual dysfunctions after TBI makes the issues of their correction and prevention relevant. The variety of pathogenetic mechanisms, the vulnerability of sexual function in various consequences of TBI require their consideration in the development of treatment and rehabilitation measures. A number of authors adhere to combination therapy, including the simultaneous or sequential use of drugs, physical methods, treatment regimen, and psychotherapeutic effects. P.I. Zagorodny recommends the use of sedatives and tonics at the first stage, tonic at the second, and stimulating treatment at the third.

Treatment. The basis is symptomatic treatment: in asthenic conditions - restorative, neurometabolic, vitamin, nootropic drugs; with convulsive syndrome, dysphoric conditions - antiepileptic drugs in equivalent doses. In this case, the side effect of drugs on sexual manifestations should be taken into account. Reception of sex hormones is indicated for hypogonadism due to hypothalamic disorders. Vasoactive drugs are used both for general action in dyscirculation and for selective action, to a greater extent for the purpose of psychotherapeutic correction. Special conditions in the form of a frontal syndrome with "Mori-like" manifestations, sexual disinhibition require the appointment of neuroleptic therapy. In affective disorders in the form of depressive symptoms, antidepressants from the SSRI group should be prescribed, tricyclic antidepressants can be used. Stabilization of the patient's emotional sphere improves the effectiveness of psychotherapeutic intervention.

At the stage of psychotherapy, one should resort to family and sex therapy, since a new condition for the patient (a physical defect, a speech disorder, etc.) is additionally traumatic and requires social support from relatives and others. Particular attention should be paid to the correction of violations of higher mental functions (memory, speech, praxis, gnosis), the restoration of which contributes to family and social adaptation. Much attention is paid to non-drug effects: hemotherapy for paracentral lobule syndrome, acupuncture, physiotherapy methods.

At the moment, studies of the sexual sphere of patients with the consequences of TBI remain relevant due to the lack of knowledge of the mechanisms of formation (a number of interpretations of data on sexual disorders in TBI appear outdated in the literature), the features of clinical manifestations and the dynamics of these disorders, low efficiency treatment and rehabilitation measures, which indicates the need for further study of sexual disorders in people with traumatic brain injury, as well as with its long-term consequences. Traumatic brain disease also needs neurorehabilitation approaches that pay attention, among other things, to the normalization of sexual function.

Source: article "Sexual dysfunctions in the late period of traumatic brain injury" B.G. Karasheva, N.D. Kibrik; Moscow Research Institute of Psychiatry; Journal "Social and Clinical Psychiatry" Issue 2 / Volume 23 / 2013

Violation of the sexual sphere

Problems with potency appear in men at different ages and are associated with various reasons. This pathology also affects the psychological state of a man. Any pathological processes in the genitourinary system should be discussed with the attending physician. Timely medical intervention will help maintain sexual activity at the proper level.

Characterization of sexual life

Potency is formed due to the coordinated work of several systems in the body. Sexual attraction arises due to the active work of the hormonal and nervous system. The hormonal background has a major impact on the sexual function of a man. Testosterone is required for arousal. It forms the sexual characteristics of a man, is responsible for spermatogenesis. The nervous system helps to activate the nerve endings on the penis.

Under the influence of substances, the work of the hypothalamus is enhanced. It transmits a signal to the roots of the penis. They are activated and increase blood circulation in the inguinal vein. The vein fills the cavernous bodies of the penis with blood. Fully filled bodies are preserved until ejaculation.

The ejaculation of a man depends on the work of the gonads and the hormonal system. The gonads are responsible for the production of seminal fluid components. The testicles produce special cells - spermatozoa. The prostate produces a fluid that is secreted by semen. Sperm production also depends on several systems.

When the body works properly, a man has a healthy sexual activity. If there is a violation of functions in the body, the potency is violated.

Basic disorders of the sexual sphere

When there are problems with potency, the patient has various symptoms. There are several main violations:

Lack of erection; Weakening of erectile function; Lack of ejaculation; Violation of the excretion of sperm; Loss of sexual desire; Additional Violations. Lack of erection is called impotence. Impotence has a different character. Pathology depends on various concomitant diseases of the genitourinary system and the psychological state. With organic impotence, the patient is diagnosed with various inflammatory and hormonal diseases. Psychological impotence has no obvious causes. Problems must be identified by a psychologist.

Weakening of erectile function occurs against the background of various pathologies. Often such changes occur due to the chronic course of inflammation in the urinary canal. If an incomplete erection appears or the tension of the penis decreases during sexual intercourse, it is necessary to visit a urologist.

The absence of ejaculation indicates the presence of a dangerous process in the body. Often with this pathology, sperm is released into the bladder. Seminal fluid cannot enter the vas deferens. In this case, surgery is required.

Potency may be impaired due to changes in the volume of ejaculate. To find out the cause of such processes, it is necessary to undergo a thorough medical examination.

Problems can also arise when sexual desire disappears. The reason is often the psychological state of the patient. The presence of stress at work, an unfavorable family environment or psychological stress affects sexual desire. To eliminate the cause, the joint assistance of a sexologist and a psychologist is recommended.

If at least one of the listed symptoms appears, it is recommended to visit a specialist. Timely medical intervention will help eliminate various complications.

Causes of sexual dysfunction

All signs of potency problems develop for various reasons. The following pathological processes are distinguished:

Various diseases of the genitourinary system; Irregular sexual contacts; The presence of bad habits and sedentary work; Excess weight; Changes in the body that occur with age. There are a number of diseases that cause various problems in the genital area.Inflammatory diseases of the genital organs affect the decrease in potency. Often there are pathologies of the prostate gland and urethra. The prostate gland is susceptible to the development of prostatitis. The disease can occur due to various pathogenic factors or bacterial infection. There are also various infections of the soft tissues of the reproductive system. All these pathologies significantly impair potency.

The problem can also arise against the background of the lack of a regular sexual life. If a man does not have sexual contact for a long time, there is a decrease in the work of the gonads. Libido is disturbed. A man loses excitement and desire.

Special attention should be paid to the presence of bad habits. The use of alcoholic beverages causes a change in spermatogenesis. Spermatozoa do not tolerate alcohol components well. There is a decrease in the number of healthy germ cells capable of conception. Sperm also cannot tolerate nicotine. The death of sexually mature cells increases, an increase in abnormal forms of spermatozoa is observed. All this entails a change in the composition of the seminal fluid.

Pathological disorders also occur during prolonged sedentary work. A long stay in one position affects the metabolic processes in the pelvic organs. This happens due to a slowdown in blood circulation. With insufficient blood flow, the supply of oxygen to tissue cells is reduced. Cells stop functioning normally. There is a decrease in sexual function.

Excess weight also causes problems with potency. The accumulation of excess body fat affects metabolic processes and the position of internal organs. Adipose tissue puts pressure on the organs, they are displaced. Their performance is deteriorating. Obesity is often accompanied by Inflammatory diseases of the prostate gland. Also, malfunctions in the hormonal background are detected.

A man's age also affects sexual activity. With increasing age, there is a decrease in the activity of the hormonal background. Testosterone ceases to be produced in large quantities. Sexual activity subsides. Problems are diagnosed in the early stages. If the pathology is ignored for a long time, the risk of impotence increases.

Influence of the general state of the body on sexual activity

Problems with potency are also detected in various diseases of the body. There are several pathologies that cause a violation of potency:

• Cardiovascular disease;
• Nervous pathologies;
• Hormonal changes.

Diseases of the cardiovascular system cause a violation in the reproductive system. Problems arise against the background of atherosclerosis of blood vessels. This pathology causes a violation of blood circulation in the inguinal vein. She stops feeding the penis with enough blood. Erectile dysfunction appears.

Having a history of Parkinson's disease, epileptic seizures or head trauma leads to a violation of potency. These diseases are often accompanied by impotence. It is impossible to fix such a problem. Pathologies cannot be completely cured, only remission can be achieved.

The process is accompanied by a decrease in trophic nutrition of peripheral organs.

Psychological aspect

Many men find it difficult to diagnose problems with potency due to the lack of obvious symptoms and causes. In this case, you need to contact a psychologist. The doctor will identify pathological changes in the patient's condition. The decrease in sexual activity is influenced by such psychological reasons as:

Stress at work; Unfavorable situation in the family; depression; Sexual failures; The presence of psychological trauma; Overexcitation. Potency may worsen due to the presence of stress at work or at home. Verbal skirmishes, swearing and prolonged mental work lead to a decrease in vital processes. Against the background of these unpleasant phenomena, a man's sexual desire disappears. To restore potency, doctors recommend active rest and a change of scenery. Depression also often stems from stressful situations. Depression can be eliminated only under the supervision of a specialist.

Psychological changes can also appear against the background of sexual failures. Problems are observed when changing a sexual partner or starting a sexual life. The patient remembers the unpleasant experience and is afraid of repeating the situation. Sometimes, in case of failure, the patient does not receive support from the partner. In this case, a bad experience is stored in memory. It causes the development of psychological impotence.

Nervous excitement leads to rapid ejaculation or erectile dysfunction. This phenomenon is observed at the beginning of a sexual life or a change of sexual partner. The first sexual contact in many young people is accompanied by instant ejaculation. This should not be feared, since further contacts normalize the work of the gonads. But such failures in some men cause discomfort. Potency may be impaired.

Selection of necessary treatment

The treatment of potency problems depends on the causes that caused them. The main treatment for almost all disorders is medication. For the treatment of inflammatory diseases of the genitourinary system, antibiotics and anti-inflammatory drugs are used. Therapy is selected strictly by a specialist.

Psychological reasons require the intervention of a doctor. To select a treatment, the doctor finds out the psychological situation in the family, the presence of irritants in the environment. If the causes of psychological disorders are found, the specialist conducts the necessary treatment. In some cases, the joint work of a psychologist and a sexologist is necessary.

You can reduce such problems yourself. To do this, you must follow the following rules:

Power control; Uniform sexual activity; Refusal of alcohol and smoking; Active sports life; Preventive visit to the urologist. Nutrition control helps to get rid of various health problems. Potency is no exception. Men are advised to give preference to foods rich in vitamins and minerals. For the proper functioning of the hormonal system, it is recommended to increase the intake of zinc, iron and vitamin E. Zinc helps restore testosterone production. The hormone will help maintain sexual health.

To avoid a violation of potency, it is necessary to have a regular sexual life. In the presence of periodic sexual dormancy, there is a violation of blood circulation in the pelvis and spermatogenesis. Stagnation of seminal fluid causes a change in its composition. Recovery is very slow.

It is also recommended to stop drinking alcohol-containing cocktails and smoking. These substances have a detrimental effect on spermatozoa. If the pathological effect of alcohol is reduced, then vascular circulation increases and the composition of sperm improves.

Experts advise to increase physical activity. You can do small morning runs or go to the gym. Such exercises will help improve the functioning of muscle tissue, increase blood circulation, and restore immunity.

A healthy lifestyle will help strengthen the body as a whole and eliminate the problems of the sexual sphere. All these rules should be accompanied by a preventive examination by a urologist. It is recommended to visit a doctor at least once every six months.

The presence of various pathological changes in the body of a man leads to a deterioration in the sexual sphere. If you follow all the rules and carefully monitor your health, then problems with potency will not arise.