AcasăTerapiiPsihologieCe este Disfuncția Erectilă și de ce este important să știm despre...

Ce este Disfuncția Erectilă și de ce este important să știm despre ea?

Erectile dysfunction, also known as sexual impotence, is one of the biggest concerns for men in terms of sexual health. Currently, there has been a noticeable increase in medical and psychological consultations related to this issue. Human sexuality consists of a relevant dimension of personality and individual experience that arises as a result of the interaction of different factors such as organic, psychological, environmental, social, etc. Consequently, there is a need to address this issue from a holistic perspective and a multidisciplinary approach. In this way, sexuality constitutes a biopsychosocial function whose effectiveness depends on the coordination of various components. Additionally, this function is structured in a complex process in which different phases are differentiated: sexual desire, arousal, and orgasm. We can speak of sexual dysfunction when one or several of these phases are altered. In this way, it is possible to differentiate different groups of problems associated with sexuality: disorders of sexual desire, disorders of sexual arousal, disorders of orgasm, sexual pain disorders. This more generalized classification needs to be supplemented with issues associated with a medical condition or pathology that could justify the presence of some of these problems, as well as sexual dysfunction induced by substances, including the use of certain medications. Furthermore, these issues can arise at the beginning of sexual life or in more advanced stages. On the other hand, due to the involvement of this variety of factors and the great diversity of sexual behaviors, there is a great difficulty in establishing a difference between normality and pathology. Despite the long list of research on this subject, the exact prevalence of sexual dysfunctions is not known due to the numerous variations found in different studies. However, data obtained so far indicate the presence of a high percentage of men and women who suffer from one of these conditions at some point in their lives. Among male sexual dysfunctions, the most common are premature ejaculation, erectile dysfunction, and lack of sexual desire. These problems, which affect different phases of human sexual response, prevent the enjoyment and complete resolution of sexual activity, generating serious repercussions at an individual and interpersonal level. Until recently, sexual issues have reflected a very small number of consultations for various social and cultural reasons. However, with the appearance of various campaigns and new forms of intervention, there has been a normalization of these types of problems, contributing to a different interpretation of them and an increase in medical and psychological consultations. What is Erectile Dysfunction Erectile dysfunction consists of difficulty in achieving and maintaining an appropriate erection until the end of sexual activity. However, this difficulty does not necessarily imply the presence of problems with ejaculation or arousal. This problem can arise at different times. Depending on the timing of onset, it can be classified into two different types: Primary: appears at the beginning of sexual life (adolescence) and may be the result of vascular abnormalities or other organic problems. Secondary: occurs after a period of normal erectile function and sexual activity. It is usually more related to psychologically based causes. Erectile dysfunction has become the most common reason for consultation within sexual dysfunctions. However, it has been observed that its prevalence is lower than problems associated with a lack of control over ejaculation. In this line, it is estimated that the prevalence of males with erectile dysfunction ranges from 8% to 52% of men between 40 and 70 years old, rising to 75% in the case of people over 80 years old. Also, various studies have found that 8.6% of men between 25 and 39 years old have some degree of erectile dysfunction. Causes of Erectile Dysfunction Regarding the etiology or causes of this type of problem, both organic and psychological factors are highlighted. Also, in many cases, factors from both types may appear, making it difficult to identify the main cause and establish a single underlying factor. The main factors responsible for the origin of erectile dysfunction are the following: Organic: vascular problems, hormonal alterations, neurological injuries, anatomical alterations, endocrine causes, etc. Psychological: anxiety, concern about sexual performance, negative sexual experiences, fear of failure in the relationship, inadequate sexual education, specific sexual phobias, stressful situations, etc. Negative sexual experiences and anxiety associated with sexual activity can lead to a loss of self-esteem and an increase in anxiety levels that will result in poorer performance in future sexual practices. In this way, a cycle is created that can explain the maintenance of these types of problems. On the other hand, both erectile dysfunction and premature ejaculation have been associated with stress responses and known psychosomatic disorders. The presence of stressful life events can have harmful consequences for the body. In this way, these events can alter the individual’s intrapsychic balance, leading to behavior patterns and new habits that seek readaptation in the environment. Some authors have defined the existence of a complex process that explains the origin and maintenance of erectile dysfunction: the presence of a negative experience and the demands of the partner generate a negative predisposition accompanied by a perception of lack of control over one’s own sexual response as well as its outcomes. This situation would shift attention from erotic stimuli (necessary for adequate arousal and erection) to negative consequences (inability to maintain an erection and carry out sexual intercourse), resulting in increased anxiety levels that cause loss of erection and, ultimately, an aversion to sexual relationships. Consequences of Erectile Dysfunction Through various studies, a long list of both individual and interpersonal consequences has been observed: Reduced self-esteem and self-confidence. Alteration in the sense of masculine identity. Decreased quality of life. Interpersonal conflicts with the partner. Deterioration of the relationship. Feelings of shame, humiliation, and guilt. Emotional instability: anxiety, stress, low mood, etc. Decreased interest in sexual activity. Disruption in social interactions. Decreased productivity in different activities (including work tasks). All of these consequences, along with experiences of failure and fears of further unsuccessful attempts, can lead to denial and avoidance behaviors that prevent proper coping with the problem and the search for a solution. Treatment of Erectile Dysfunction First of all, it has been emphasized on many occasions that, regardless of the cause of erectile dysfunction (organic or psychological), psychological intervention is a fundamental pillar due to the various emotional repercussions generated on the individual and their environment. Numerous approaches have highlighted the need to eliminate the anxiety that commonly underlies this type of problem as the main objective of intervention. This anxiety can manifest itself through fear or apprehension of failure in future sexual practices. At this intervention point, there is controversy regarding the primary objective. Many interventions focus on reducing activation levels or anticipation without paying attention to predisposing or vulnerability factors that have contributed to the origin of the problem. However, other interventions try to go further, considering this anxiety or fear as a reflection of an intrapsychic dynamic developed from adverse experiences throughout the individual’s development. This latter intervention seeks to carry out more thorough work that will allow going back to the primary origin of the problem, as well as the elaboration of adverse experiences that have not been properly processed and that may have manifested through the anxiety or fear that underlies a sexual disorder. On the other hand, a fundamental objective in the treatment is addressing the improvement of communication between the individual and their partner.

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