What causes impotence

Determining the cause of sexual dysfunction is an important task, on the solution of which the tactics of the forthcoming treatment will depend. The physician establishes the final diagnosis based on a set of methods of instrumental and laboratory diagnostics.

Causes of Sexual Disorder

When carrying out diagnostic measures in order to identify the pathogenesis of sexual dysfunction, the doctor finds out whether the patient has the following functional abnormalities:

• vasculogenic disorders, which include cardiovascular diseases and hypertension, diabetes mellitus and smoking, hyperlipidemia, as well as the consequences of major surgery or radiation therapy applied to the retroperitoneal space or pelvis;
< li>neurogenic diseases, in particular multiple atrophy or sclerosis, neoplastic lesions and Parkinson's disease, pathologies of the intervertebral discs and the consequences of ischemic stroke, diseases of the spinal cord and polyneuropathy;
• structural abnormalities, namely, congenital curvatures or pathologies genital development, Peyronie's disease;
• hormonal diseases, for example, hypogonadism and Cushing's disease, hyperprolactinemia and androgen deficiency;
• unwanted changes as a result of drug therapy using antidepressants and muscle relaxants, beta-blockers and diuretics, neuroleptic and antiandrogenic substances, narcotic and antigens istaminic remedies;
• psychogenic lesions arising from situational (lack of sexual desire for a particular sexual partner, chronic stress, physical fatigue) or generalized (obsessive waiting syndrome after unsuccessful sexual intercourse) reasons.

Carrying out minimal diagnostics and assessment of the patient's condition, the physician, first of all, establishes the presence of cardiovascular pathologies. The risk group includes men who report:

• persistent moderate angina pectoris, unstable severe angina pectoris
• the presence of signs of coronary heart disease
• serious functional changes after myocardial infarction
• uncontrolled hypertensive attacks disease
• occurrence of heart valve disease

The level of sexual activity in men with erectile dysfunction directly depends on the severity of cardiac diseases. That is why men with cardiac and vascular disorders are referred for consultation and treatment to a cardiologist.

Taking a life history

To receive adequate treatment, the patient needs to go through a set of measures aimed at collecting a medical and psychological history. In addition, doctors advise to undergo examination together with a sexual partner in order to find out the complete clinical picture of a sexual disorder. At the reception, the specialist conducts a conversation with the patient about the quality of sexual life and the general level of sexual activity. During the survey, the andrologist finds out information about:

• the patient's past and present sexual contacts
• current emotional state
• peculiarities of the management and duration of sexual contacts
• the degree of rigidity and duration of erection
• the presence of spontaneous arousal in the morning and evening
• the nature and severity of problems with arousal and erectile function

The patient is also offered to fill out a series of questionnaires that help to supplement the clinical picture and obtain the most complete data on the intensity of sexual desire and erection, the body and ejaculation.

Physical examination

The next stage in the diagnosis of disorders in the intimate sphere is a physical examination, which involves a detailed study of the state of the nervous and genitourinary, endocrine and cardiovascular systems. During the study of internal organs, a physician can detect hidden pathologies that occur in a latent form. Doctor measures blood pressure and heart rate

Lab Testing

Microscopic examination is required to determine the level of glucose and lipids in plasma. If a doctor suspects a patient with prostate cancer, the man is required to take a PSA test. Also, laboratory tests can help identify hormonal imbalances. To do this, it is necessary to analyze the composition of the plasma obtained in the morning, and check the content of free and bioavailable testosterone. Identification of an insufficient amount of male sex hormones in the blood entails the need for additional examination to establish the plasma concentration of FSH and LH, prolactin.