CHAPTER ONE
INTRODUCTION
Erectile dysfunction,
ED, is a sexual dysfunction that affects the reproductive systems of both men
and women. By definition according to National Institute of Health consensus
Development Panel on impotence (1993), in Males, it is a sexual dysfunction
characterized with the inability to develop or maintain an erection of the
penis sufficient for satisfactory sexual performance. It is also known as Male
impotence or Baby D syndrome, while in women, according to American Psychiatric
Association (1994), it is characterized with the persistent or recurrent
inability to attain, or maintain until completion of the sexual activity, an
adequate Lubrication- Swelling response that otherwise is present during female
sexual arousal and sexual activity is thus prevented. Hence, it is called Women
impotence or female erectile dysfunction.
The word impotence may
also be used to describe other problems that may interfere with sexual
intercourse and reproduction, such as lack of Sexual Desire and problems with
ejaculation or orgasm. Using the term “erectile dysfunction,”
otherhoweverproblemsare makes not involved (NIH, 2005).
An erection occurs as a
hydraulic effect due to blood entering and being retained in sponge-like bodies
within the penis and clitoris. The process is most often than not initiated as
a result of sexual arousal, when signals are transmitted from the brain to nerves
in the pelvis. Erectile dysfunction is, therefore indicated
when an erection is consistently difficult or impossible to produce, despite
arousal (Laumann et al., 1999).
1.1 PREVALENCE
OF ERECTILE DYSFUNCTION IN WOMEN
Erectile dysfunction
which is known as Female erection dysfunction in women occurs in about 43% of
American Women (NIH Consensus Conference, 1993). And this medical Condition is
a persistent or recurrent inability to attain or maintain clitoral erection
until completion of the sexual activity, an adequate Lubrication –Swelling
response that is normally present during Female sexual arousal and sexual
activity is therefore, absent. The individual having the condition is said to
experience frigidity (American Psychiatric Association, 1994). Again,
According to Otubu et
al. (1998) about 8.7% of Women suffer from this very condition in the United
States while between 35.3 - 40%, according to Adequnloye (2002) and Eze (1994)
of Women in Nigeria suffer from this condition. Spector and Carey (1994)
reported 5-10% in the United States.
In addition, Female
erectile dysfunction occurs at any age but majorly in old age. Hence, the most
significant age related change is menopause (Karen, 2000) and (Rod et al.,
2005). However, erectile dysfunction may be caused by diabetes,
atherosclerosis, hormonal imbalances, neurological problems etc. (Organic
causes) or stress, depression etc.
Because treating the
underlying causes (Organic or Psychological), the first line treatment of ED
consists of a trial of PDES inhibitor (the first of which was Sildenafil or
Viagra). In some cases, treatment can involve prostag-Landin tablets in the
Urethra, intravenous injection with a fine needle into the penis or clitoris
that causes swelling of Penis or Clitoris Pump or Vascular surgery, estrogen
replacement therapy for the women etc.
Although there are
various methods and techniques that are used to treat this very condition,
however, for the purpose of this project, the treatment is restricted to Yohimbe,
an extract from Pausinystalia yohimbe.
1.2 PREVALENCE
OF ERECTILE DYSFUNCTION IN MEN
Erectile dysfunction,
ED, varies in severity; some men have a total inability to achieve an erection,
others have inconsistent ability to achieve an erection, and still others can
sustain only brief erection. The variation in severity of erectile dysfunction
makes estimating its frequency difficult.
Many men also are
reluctant to discuss erectile dysfunction with their doctors, and thus, the
condition is under-diagnosed. Nevertheless, experts have estimated that ED
affects 30 million men in the United States. Again, according to the
statistical research carried out by Adegunloye (2002) and Eze (1994)
respectively in Nigeria, results shows that about 23-26.4% of men suffer from
this condition while according to Spector and Carey (1999) discovered that
about 4-9% of men suffer from the condition in the United States.
While erectile
dysfunction can occur at any age, it is uncommon among young men and more
common in the elderly. By the age of 45, most men have experienced erectile
dysfunction at least some of the time. According to the Massachusetts Male Aging
Study, complete impotence increases from 5% among Men 40 years of age to 15%
among Men 70 years and older. Population studies conducted in the Netherlands
found out that some degree of ED occurred in 20% of Men between 50 - 54 and in
50% of men between ages 70 - 78. In 1998, the National Ambulatory Medical care
Survey counted 1,520,000 Doctor Offices visited for ED.
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