Sex Injuries and Disorders – Medicine & Treatment
Many drugs, both legal and illegal, have side effects that affect the user’s sexual function.
Because drug and alcohol use is commonly presented as an excuse for unacceptable behaviour, it is necessary to treat the idea of a direct causal relation between drug use and unsafe sex with caution. Drugs may provide a socially acceptable excuse for engaging in sexual behaviours in which people may want to engage but perhaps know that they should not.
Tobacco use (e.g., cigarette smoking), also reduces sexual function, with the incidence of impotence being approximately eighty-five percent higher in male smokers compared to non-smokers.
Since the partial cause of the refractory period is the inhibition of dopamine by an orgasm-induced secretion of prolactin, such potent dopamine receptor agonists as cabergoline may help achieve multiple orgasms as well as the retention of sexual arousal for longer periods
Erectile dysfunction (ED) or impotence is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual activity. A penile erection is the hydraulic effect of blood entering and being retained in sponge-like bodies within the penis. The process is most often initiated as a result of sexual arousal, when signals are transmitted from the brain to nerves in the penis. The most important organic causes are cardiovascular disease and diabetes, neurological problems (for example, trauma from prostatectomy surgery), hormonal insufficiencies (hypogonadism) and drug side effects.
Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility; this is somewhat less frequent but can often be helped. Notably in psychological impotence, there is a strong response to placebo treatment. Erectile dysfunction can have severe psychological consequences as it can be tied to relationship difficulties and masculine self-image.
Besides treating the underlying causes such as potassium deficiency or arsenic contamination of drinking water, the first line treatment of erectile dysfunction consists of a trial of PDE5 inhibitor drugs (the first of which was sildenafil or Viagra). In some cases, treatment can involve prostaglandin tablets in the urethra, injections into the penis, a penile prosthesis, a penis pump or vascular reconstructive surgery