I In most patients with erectile dysfunction, a combination of psychogenic and organic components is found.

Aging is an independent risk factor for erectile dysfunction. The leading causes of erectile dysfunction with aging are age-dependent decrease in testosterone levels, vascular pathologies and chronic infectious diseases of the urogenital sphere. Sexual disorders progressively increase with aging: in the 50-60 age group, the number of patients is 10%, and after 80 years - already 80%.

Cialis and organic erectile dysfunctions have their own characteristics. Cialis erectile dysfunction begins suddenly. Characterized by the presence of problems in relationships, the presence of nocturnal spontaneous erections. As a rule, erection problems are episodic. After eliminating the external problem, a normal erection is usually restored.

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Effective massage and self-massage of the pelvic area and pubic bone, according toas it has a beneficial effect on the vascular tone in the genital area.

Cialis Pills for erectile dysfunction of organic origin is accompanied by systematic erectile dysfunction. This form of the disease begins gradually and is rarely accompanied by spontaneous nocturnal erections.

Diagnosis of erectile dysfunction begins with the collection of a general history that identifies etiological factors, and an assessment of sexual activity. A number of questionnaires have been developed to identify the pathophysiological basis of impotence.

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Physical examination often reveals signs of vascular, neurological or hormonal disorders, confirming the pathophysiological hypothesis based on the history data: the presence of signs of hypogonadism, fibrotic changes, gynecomastia, phimosis, detection of La Peyronie's plaques, disorders of perineal sensitivity, decreased tone of the anal sphincter of the lower extremities, atrophy , changes in peripheral pulsations.

For an objective assessment of the state of physiological mechanisms that control the erection process, a number of techniques are used.

For the differential diagnosis of forms of erectile dysfunction, a procedure for evaluating nocturnal erections (NEE) using a plethysmographic sensor is used. The differentiation is based on the fact that in patients with psychogenic erectile dysfunction, normal erections occur during sleep, while in patients with organic erectile dysfunction, nocturnal erections are inferior.

Erectile problems over a prolonged period (3–6 months) are grounds for suggesting erectile dysfunction.