Differentiation between psychogenic and organic erectile dysfunction, and characteristics and understanding of erectile dysfunction in newlyweds.
47.
Scientific differentiation between psychogenic and organic erectile dysfunction
Psychogenic erectile dysfunction is caused by physiological changes in the nervous system and is only manifested as the inability to achieve an erection during sexual intercourse; while organic erectile dysfunction is caused by insufficient arterial blood supply, venous leakage, neurological factors, endocrine factors, etc., which cause the penis to be unable to achieve an erection at any time.
Since the treatment methods for the two types of erectile dysfunction are different, and the treatment effects are also different, it is essential to distinguish between psychogenic erectile dysfunction and organic erectile dysfunction.
The following aspects can be used for identification:
(1) From the perspective of the causes of the disease: psychogenic erectile dysfunction is closely related to mental factors, such as fear, depression, anxiety, marital discord, lack of sexual knowledge, excessive masturbation, etc.; organic erectile dysfunction is mostly related to anatomical abnormalities of sexual organs, trauma, drug poisoning, certain chronic diseases, etc.
(2) From the perspective of the course of the disease: psychogenic erectile dysfunction usually has a sudden onset and rapid progression, while organic erectile dysfunction usually has a gradual onset and slow progression.
(3) Judging from the erection of the penis: from night to early morning, psychogenic impotence has a firm erection, while organic impotence has no erection or a weak erection.
In psychogenic erectile dysfunction, the penis erects under sexual stimulation, but the erection disappears when attempting intercourse. In organic erectile dysfunction, the penis erects weakly or not at all, and there is a lack of response to sexual stimulation.
(4) Based on the drug injection experiment, psychogenic erections can generally achieve full and firm erections within 8 to 10 minutes, while organic erections (except for neurogenic erections) do not achieve satisfactory erections within 8 to 10 minutes.
(5) In terms of prognosis: psychogenic erectile dysfunction is mostly treated with psychological and drug therapy and has a better prognosis, while organic erectile dysfunction is mostly treated with instruments and surgery, and the short-term and long-term effects are unsatisfactory.
48.
Characteristics of newlywed erectile dysfunction
Newlywed impotence refers to the failure of penile erection during sexual intercourse during the honeymoon period. Statistics show that the failure rate is over 75%. Occasionally failing to achieve an erection during intercourse during the honeymoon period cannot be called impotence.
The causes are very complex, but the vast majority are functional erectile dysfunction, which is a sexual dysfunction in a special period. Both partners often have a sense of novelty and timidity, which to some extent affects higher nerve activity and leads to failure of sexual intercourse.
Comprehensive treatment combined with medication is often used, and the results are satisfactory.
49.
Understanding Erectile Dysfunction in Newlyweds
As the name suggests, it refers to erectile dysfunction that occurs during the honeymoon period.
This is quite common in real life.
If not handled properly, it can lead to a series of social and family problems.
Clinical analysis suggests that over 98% of cases of erectile dysfunction in newlyweds are psychological, caused by a lack of psychological, social, and sexual knowledge.
For newlyweds, the most common psychological obstacle is a lack of proper sex education before marriage, an inability to understand the process and techniques of intercourse, or the existence of incorrect concepts about sex.
If a person has unrealistic expectations about sex before marriage, or discovers that their penis is not firm enough during masturbation, they may assume that they have erectile dysfunction and carry this "psychological burden" into their marital relations, leading to failure.
Another common cause of impotence in newlyweds is what is known in folk terms as "seeing the flower wither," characterized by the man having normal libido and the ability to achieve an erection, and being able to control himself normally, but upon contact with his partner, semen leaks out and the penis becomes flaccid.
This is a pathological condition that involves psychological, physiological, and pathological factors simultaneously.
In addition, social factors are also common in newlyweds, such as marriages without affection or with strong illicit intentions, or the excessive energy and financial resources spent on wedding preparations, which increases the burden and anxiety on both parties and leads to overwork, thus inhibiting the sexual center and inducing erectile dysfunction.
Nevertheless, most cases of erectile dysfunction in newlyweds can resolve on their own after acquiring proper sexual knowledge.
However, consultation, guidance, and treatment from a specialist are necessary.
50.
Traditional Chinese medicine believes that the pathogenesis of erectile dysfunction is...
Erectile dysfunction is also known as impotence, impotence, or impotence.
Traditional Chinese medicine believes that impotence is closely related to the liver, kidney, and Yangming meridians, because the penis is reached by the Foot Jueyin Liver Meridian and is where the tendons of the penis converge.
The Yangming meridian governs the nourishment of the genital tendons. When the Yangming Qi declines, the genital tendons become weak. The kidneys store essence and govern the intake of Qi. When the kidney Qi is weak, sexual intercourse is impossible, and the penis cannot be used, thus causing impotence.
Its etiology and pathogenesis are as follows:
(1) Kidney Qi deficiency: early marriage and childbirth, masturbation in adolescence, excessive sexual activity, excessive lust, or congenital deficiency and weak endowment leading to insufficient kidney qi and decline of the fire of the gate of life. The penis loses the warmth and nourishment of kidney essence, the tendons of the penis become relaxed, and it becomes atrophied and unusable.
Insufficient kidney essence, over time, can lead to excessive fire in the kidneys. This deficient fire can damage the tendons and veins, and may also cause impotence.
(2) Overwork damages the heart and spleen: Improper diet and overeating will damage the spleen, while excessive mental exertion, unfulfilled desires, and depression will damage the heart and spleen.
The spleen is the foundation of acquired constitution, and the heart is the master of the five viscera and six bowels. When the heart and spleen are damaged, the six spirits lose their master, the kidneys are not nourished, and the disharmony between the heart and kidneys and the deficiency of both the spleen and kidneys can lead to impotence.
(3) Internal injury from the seven emotions: excessive worry, depression, or excessive anger can damage the liver. Since the penis is governed by the liver and is responsible for the movement of the tendons and ligaments of the whole body, and the penis is the ancestral tendon, if the liver fails to regulate the flow of qi and the qi mechanism is not in harmony, the ancestral tendon will become weak and atrophied. In addition, fright can damage the kidneys, and excessive thinking can damage the heart, which can also lead to impotence.
(4) Damp-heat in the lower burner: external invasion of damp-heat evil, coupled with spleen deficiency and internal generation of damp evil, excessive consumption of spicy food can also generate internal damp-heat. Damp-heat flows into the lower burner, obstructing the flow of qi, suppressing kidney qi, stagnating qi and blood, coupled with weakness of the life fire, resulting in the penis being unable to function and impotence.
51.
Priapism and priapism
Priapism is an erection unrelated to sexual desire, characterized by prolonged penile cavitary erection without sexual desire or stimulation, or a persistent erection after ejaculation that is difficult to maintain, accompanied by pain or pain during attempted intercourse. It can last for hours, days, or even months and has a rapid onset and is prone to leaving permanent erectile dysfunction as a sequela.
Based on the characteristics of penile blood flow changes, it can be divided into high-flow type and blood stasis type. In the former, the penile tissue is bluish-gray, the pain is mild, and the prognosis is better; in the latter, the penis is as hard as wood, loses its elasticity, the pain is severe, and the prognosis is poor.
In recent years, some researchers have referred to priapism without pain as priapism.
Erectile dysfunction is generally not present and is often induced by intracavernosal injection of drugs. Most scholars consider these to be different stages of a disease.
52.
Common causes of priapism
There are many causes of priapism, but about one-third of them have no obvious cause. They are estimated to be related to genetics or prolonged sexual arousal and are called primary (idiopathic) priapism. The others with identifiable causes are called secondary priapism.
The common causes that can be found at present are:
(1) Blood diseases: occupy an important position, accounting for about 60%, among which sickle cell anemia is the most common cause. This disease is rare in my country.
However, it is important to note that chronic myeloid leukemia can cause priapism by directly infiltrating the corpora cavernosa of the penis. Other blood disorders that can cause this disease include thalassemia, polycythemia vera, essential thrombocytosis, and multiple myeloma, which can cause blood deposition in the corpora cavernosa and obstruct the return of blood from the efferent veins.
(2) Drug factors: Since the discovery that lead poisoning patients can experience this strange phenomenon of penile priapism, more and more drugs have been involved. Among them, antipsychotic drugs, antihypertensive drugs, and anticoagulants have been basically recognized. Important and commonly used drugs include: ① Antipsychotic drugs: chlorpromazine, diazepam, methaqualone, thiamethoxam, haloperidol; ② Antihypertensive drugs: guanethidine, reserpine, prazosin, hydralazine, etc.; ③ Anticoagulants: heparin; ④ Penile vasoactive drugs: papaverine, phentolamine, phenoxybenzamine, prostaglandin E₁, etc.; ⑤ Hormones: adrenocortical steroids, exogenous testosterone; In addition, there are topical drugs for the glans penis such as cocaine, marijuana, alcohol, etc.
(3) Nervous system diseases: such as cerebral hemorrhage, brainstem lesions, spinal tuberculosis, epilepsy, etc., may cause abnormal penile erection due to long-term pathological stimulation of the erection center of the brain and spinal cord.
(4) Local stimulation or disease of the penis: Conditions such as phimosis, circumcision, urethritis, prostatitis, urinary tract stones, and endoscopy can stimulate nerve endings and trigger abnormal penile erection through the spinal nerve reflex erection circuit.
(5) Other diseases: such as when the tumor infiltrates the corpus cavernosum or causes obstruction of venous return, the penis may experience persistent erection.
Inflammation and allergic reactions can cause perivascular lymphocytes to react and obstruct venous return, such as in mumps, orchitis, and tetanus antitoxin.
Amyloidosis, diabetes, chronic renal failure, and general anesthesia have also been reported to cause priapism.
53.
Traditional Chinese Medicine's understanding of the etiology and pathogenesis of priapism
Priapism is equivalent to diseases in traditional Chinese medicine such as "excessive yang," "excessive yang," "excessive yin," "excessive yang," "excessive yin growth," "unyielding penis," "internal wasting," and "kidney leakage."
Its etiology and pathogenesis are as follows:
(1) Sexual strain: Frequent masturbation in adolescence, excessive sexual activity after marriage, or unrestrained fantasies leading to depletion of yin essence, yin deficiency unable to control yang, excessive and restless ministerial fire, resulting in penile erection that is firm and does not weaken.
(2) Damp-heat descending: external dampness enters the interior and transforms into heat, or external damp-heat evil, or eating too much rich, sweet, spicy, or fried food or drinking too much alcohol, which damages the spleen and stomach, leading to the internal generation of damp-heat. Ultimately, the damp-heat in the liver meridian descends along the meridian to the penis or flows to the kidney and stagnates in the lower part of the body, causing injury to the penis and resulting in priapism.
(3) Fall injuries: Careless protection, injury to the vulva, or the penis being hit by a hard object, or being kicked in a fight, resulting in blocked blood vessels in the penis, blood stasis, and enlargement and erection that lasts for a long time.
(4) Excessive tonification: Excessive and prolonged use of kidney-warming and yang-strengthening products, or prolonged use of cinnabar and hot medicines for sexual intercourse in the hope of getting temporary pleasure, will lead to the retention of semen, accumulation of heat toxins, damage to kidney yin, and excessive fire.
When two heats combine, their momentum becomes uncontrollable. The fire is excessive while the water is depleted, leaving the pathogenic fire unchecked, resulting in persistent uterine prolapse.