Viagra remains main treatment for erectile dysfunction, doctors say

Neither bicentennial, nor election. What stood out this Wednesday, September 7, was the sexual potency of President Jair Bolsonaro (PL), who drew a chorus with the term “imbrochable”.

According to experts, however, erectile dysfunction is a common problem among men, and not treating the issue seriously can increase stigma and undermine treatment, which has several therapeutic resources.

Viagra and other drugs in the group are some of the main ones, according to doctors, but men can also resort to penile prostheses, lifestyle changes and sexual therapies. A health professional must indicate the appropriate treatment for each case.

“[Imbrochabilidade] it’s nonsense. The healthiest guy possible can go through a situation of extreme stress that can prevent him from obtaining a penile erection”, says urologist Carlos Teodósio da Ros, 58, doctor at the Andrology Outpatient Clinic at Hospital São Lucas at PUC-RS in Porto Alegre.

Psychiatrist and cognitive behavioral therapist Rodrigo Barreto Huguet, 48, a doctor at the Mater Dei Hospital in Belo Horizonte (MG), agrees.

“It’s a myth. This type of demand ends up getting in the way of the person, who thinks they can’t screw up at all and gets more pressured, with more difficulty. Sex is very similar to insomnia, if you think you need to sleep, the person gets anxious and doesn’t sleep”, he says.

According to Huguet, it is unrealistic to think that a man will not have some type of erectile dysfunction throughout his life. “Erection is involuntary and depends on a series of psychological factors, on how the person is at the time. She thinks she should be in the mood, but the head and the body don’t”, says the psychiatrist.

The urologist Teodosius explains that erectile dysfunction (ED), formerly called sexual impotence, is the loss or failure to maintain an erection. Contrary to what many think, it is not just aging that causes the problem.

“It is related to a sedentary lifestyle, obesity, smoking, drug use, excessive alcohol intake, stress, sleep problems, low testosterone, hypertension, diabetes, with medication. it’s a hell of a loss of erection”, says the doctor.

He says that it is common for patients to look for information on the internet instead of seeking professional help for fear of talking about premature ejaculation, erection problems or lack of libido – as if admitting it was a failure or loss of masculinity.

The specialist also says that looking for solutions on your own can worsen the condition rather than solve it, especially if the person is taking medication for coronary problems such as angina, which are contraindicated if associated with drugs for erectile dysfunction.

“You have to go to the doctor, erectile dysfunction has a solution. From the simplest such as Viagra, Levitra or Cialis, something from the group of these medications, to more complex procedures such as the implantation of a penile prosthesis. , says the doctor.

“The most important thing is to have a healthy life, sleep, reduce stress and reduce alcohol intake.”

As age advances, however, lifestyle changes may not be enough. At this time, the doctor may indicate oral medication, testosterone replacement and the use of specific vacuum pumps, in addition to injections into the penis before sex.

Sex therapy is also sometimes necessary and the patient needs to see a psychologist or psychotherapist of sexuality.

For heterosexual people, keeping the partner aware and even taking her to an appointment also helps in the treatment, as it removes the idea that the problem is a lack of desire on her part, and shows that support works more than demand. Talking to friends and relatives who have gone through the same problem is another way to break some taboos, says the urologist.

According to Rodrigo Huguet, erectile dysfunction can also be derived from psychological disorders such as depression and anxiety, in addition to addiction to alcohol and other drugs.

For the psychiatrist, in these cases, overcoming prejudice against psychiatric and psychotherapeutic treatment is the first step towards returning to healthy sexual activity.

“Because of misinformation, the person thinks it is weakness to treat with antidepressant medication, which should treat everything through willpower. But it is necessary to balance this brain chemistry or through psychotherapy to give the person tools to deal with those difficulties”, says Huguet.

Pressure to be too manly can also get in the way of an erection. “This kind of behavior, talking [sobre ser “imbrochável”], ends up getting in the way and it’s not true. It’s the president’s small talk, there’s no such thing”, concludes Huguet.