Problems with erection in 2022, the urologist answers.

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Disappointing figures: almost 30% of men come to an appointment with a urologist with complaints of an erection. Why is that? What has changed in the sexual life of Americans? Is a “one-time misfire” not a reason to panic yet? How is an erection related to the brain? And what is the role of women in what is happening? These and many other questions are answered by Dr. Arthur L. Burnett.

How often do patients come to you with complaints of erection?

I have been working for a long time and in my practice the percentage of patients who treat this problem is quite high. The further, the more. Approximately 20-30% of men come with problems in their sexual life: erectile dysfunction, premature ejaculation, lack or low severity of orgasm. This is in the general structure of patients who turn to a urologist, including with inflammation, urolithiasis or for surgery.

At the International Congress of Urologists in 1999, it was estimated that about 100 million men on the planet have problems with erection. In 2005, this figure has already risen to 200 million. The forecast by 2030 is about 400 million men. It is clear that the population is growing and the proportions are changing. But still.

The second point is that the problem of erection begins to get younger and becomes relevant not only for men over 40 years old, as previously thought. Modern American statistics, which is certainly commensurate with what is happening in our country, says the following: mild erectile dysfunction — about 50% of the men surveyed, average — 15%, severe — 15%, complete absence of visible erection, that is, impotence — 5-10%. Tellingly, in 20% of cases, problems have already been observed in young children 20-25 years old. There is, of course, a way of life, genetics, and ecology.

That is, the bulk of complaints are not serious cases, but “small deviations” from the norm?

Let’s first define what erectile dysfunction is. This is the inability to achieve an effective erection or maintain it to ensure effective sexual contact. There is also a time factor — the symptoms should last at least three months.

So, a “one-time misfire” should not frighten the patient?

Sure. A “one-time misfire,” as you say, may be due to the fact that the man did not get enough sleep. Or he has nervous stress and worries. Or the deadline is burning at work. The nervous situation in the world. A quarrel with a partner … there can be many reasons. And that’s fine. Although a man in his sexual life is considered a primitive creature, they say, he saw a naked woman — and that’s it, in fact it is not so. A man is a delicate and vulnerable being. We can raise our arm, leg or head at will, but it is impossible to make the penis rise at any moment. This is a very complex mechanism. Behind these beards, which seem harsh and masculine, there are modest, refined, highly organized natures.

What does the “erectile norm” look like in men of different ages?

Scientists say that during his life a man performs about 5000 ejaculations. Although who calculated it and how?

Physiologically, if a man has an erection from two to six times a night, during the rem sleep phase, and lasts 5-10 minutes. This is possible if a person goes to bed on time and sleeps at least 7-8 hours. Therefore, it is important to sleep properly — in a dark room, with blackout curtains, at night. Circadian rhythms and testosterone production depend on whether we went to bed before 22-23 hours or not. Many men underestimate this moment. But a good sleep provides charging of the natural hormonal battery. Do you think you can go to a club at night, and catch up on everything during the day, get some sleep? Nothing like that. Daytime sleep does not bring any health benefits.

Then a young man may experience 10-15 spontaneous erections during the day. It may depend on the beautiful picture seen, etc. Why is it more difficult to excite a modern man? Too easy access to numerous visual stimuli. Previously, women were fully clothed and humanity has not yet invented videotapes for adults.

After 30 years, testosterone levels drop by about 1-2% per year, and, naturally, spontaneous erections may be absent.

Morning and night erection is a mechanism for training the vessels of the penis, which was invented by nature in case a man does not have regular sex. After all, Homo sapiens is the only mammal species that has sex at will, regardless of the mating season.

How is an erection related to the brain?

There is a certain chain of systems in the body that provides a male erection — both good and bad. These are the parts of the brain — the cortex, spinal cord, limbic system. Nerves that provide the impulse. Vessels. And actually, the male organ itself. Ideally, this whole system should work clearly and efficiently, like a conveyor, where no one thinks about where to screw the bolt.

The desire and libido of a man cause hormones, as well as the good work of blood vessels. The limbic system of the brain is responsible for emotions, mood, attraction, desire, arousal, brightly colored orgasms, etc. Reflexogenic or erogenous zones (penis, nipples or anal zones) are quite individual. Sensations from touches, sounds and visual images are processed in the brain.

What are the causes of erectile dysfunction?

Many people think that only older men have problems with erection. But a serious American study showed that about 40% of men over seventy are actively interested in sex life. Why is that? Food? Lifestyle? The remaining 60% would also like to have sex, but they cannot, because, for example, there is no partner. These data break down all the stereotypical ideas about erection and age. In fact, a man can have sex until a very old age. It’s physiological. There are a lot of 65-75-year-old patients at my reception who have small children.

erection

20-30% of the causes of erectile dysfunction are psychological factors. This is most relevant for men aged 20-25. Nerves, stress, worries, insomnia… Then the syndrome of waiting for failure. It didn’t work out once or twice, and a pathological connection is formed. Even a physically healthy man becomes incapable of effective sex. Because there is fear.

In 2021, covid is also added to the list of reasons?

There is a moot point here. Yes, there are a lot of studies that link covid and erectile dysfunction, but it is still not clear what is primary – psychological stress during a pandemic or organic changes due to the disease.

A pandemic is a fear for one’s life, anxiety, the risk of losing a job or relationship, the inability to make a date, meet a partner, in the end, suffocating intimacy in the family, when everyone is forced to be locked in one apartment and there is no opportunity to relax from each other. A very large percentage of divorces during the pandemic. All together, this adds up to a kind of puzzle – rather, a psychological problem.

Finally, I’ll say this. Only with the help of viagra, you will not solve the problem with an erection. For a good strong erection, you always need to follow the rule of “four S”: sex is regular, the sun is in abundance, sports are every day, sleep is deep and long. Health to you and your loved ones!

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