Male erectile dysfunction, called erectile dysfunction, is the inability to reach and / or maintain the erection state, as a result of which it is not possible to have sexual intercourse. At CIFS, Centro Italiano di Fertilità e Sessualità in Florence, we provide in-depth diagnosis of the causes of erectile dysfunction, and try to find a solution to the problem.

How do erections work?

Erection is a complex physiological response that depends on a perfect integration of vascular, endocrine and neurological mechanisms. Until a few years ago it was thought that about 90% of cases of erectile dysfunction were of a psychological origin, but recent studies have shown organic etiology in about 50% of cases of impotence. There are two mechanisms that determine the erection:

  • Psychological stimulation through images, fantasies and erotic stimuli
  • Direct stimulation of the genitals: these stimuli cause a smooth muscle relaxation of the penis while peripheral resistances diminish and a massive and rapid blood flow to the corpora cavernosa of the penis results in an expansion thereof by compressing the veins and thus preventing the erection from stopping

Types of erectile dysfunction

The problem, which causes interpersonal difficulties and considerable discomfort, is often associated with sexual anxiety, worry about performance itself, or a reduced feeling of excitement / pleasure. can It manifest in a number of ways, including:

  • Inability to get an erection from a sexual experience
  • Loss of erection during penetration
  • Drop in tumescence during push after penetration

Diagnosis and Care of Impotence

The first step is to thoroughly assess the problem through examinations such as nighttime electrometry, hormone doses, and penis ultrasound.

If organic causes are found, pharmacological, hormonal or surgical remedies may be possible.

If the problem is psychological, it is possible to begin a course of cognitive-behavioral psychotherapy, the only psychological therapy with proven effectiveness in treating this disorder.

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