摘要
勃起功能(EF)是令人满意的性交(SI)的先决条件,是男性性功能的核心。令人满意的SI最终会引发性高潮-一种快乐的生物生理状态-带来一种幸福感、快乐感和积极的心理健康感。对于精神病学家来说,治疗ed是自我推动的,除了鼓励身体健康和感官之外,还能协调这些愉快的经历。因此,Pde-5i的作用在这方面起着关键的作用,并构成治疗方面的挑战。Pde-5i通过多巴胺能-催产素-一氧化氮途径通过增加内皮鸟苷磷酸(GMP)的有效性,立即引起阴茎平滑肌松弛和勃起。Pde-5i,如西地那非、伐地那非和他达拉非,与其他治疗方式相比,在治疗ED方面有一定的优缺点。治疗失败与缺乏(或不充分)性刺激、性心理冲突和医学疾病共存等因素有关。管理ED需要处理潜在的医疗疾病,解决其他共同病态的性功能障碍,如早泄(Pe),以及教育患者健康生活方式。此外,通过处理夫妻之间的人际关系,并接受适当的生活方式(管理压力和修改性脚本),Pde-5i治疗效果可能会得到加强。在这次审查中,我们提出了对患有ED的患者进行精神管理的整体概念的框架方法。
关键词: 勃起功能障碍,Pde-5抑制剂,ED的精神治疗,体重指数,高血压,性幻想。
Current Drug Targets
Title:The Phosphodiasterase 5-Inhibitors (PDE-5i) for Erectile Dysfunction (ED): A Therapeutic Challenge For Psychiatrists
Volume: 19 Issue: 12
关键词: 勃起功能障碍,Pde-5抑制剂,ED的精神治疗,体重指数,高血压,性幻想。
摘要: Erectile function (EF) is a prerequisite for satisfactory sexual intercourse (SI) and central to male sexual functioning. Satisfactory SI eventually initiates orgasm – a biopsychophysiological state of euphoria – leading to a sense of bliss, enjoyment and positive mental well being. For a psychiatrist, treating ED is self-propelled to harmonize these pleasurable experiences alongside with encouragement of physical wellness and sensuality. Hence, the role of PDE-5i is pivotal in this context and constitutes a therapeutic challenge. PDE-5i work via the dopaminergic-oxytocin-nitric oxide pathway by increasing the availability of endothelial’s guanosine monophosphate (GMP), immediately causing relaxation of the penile smooth muscle and an erection. The PDE-5i, like sildenafil, vardenafil and tadalafil, are effective in the treatment of ED with some benefits/ flexibilities and disadvantages compared to other treatment modalities. Prescribed PDE-5i exclusively improve EF, fostering male’s self-confidence and self-esteem. Treatment failures are associated with factors such as absent (or insufficient) sexual stimulation, psychosexual conflicts and the co-existence of medical disorders. Managing ED requires dealing with underlying medical diseases, addressing other co-morbid sexual dysfunctions like premature ejaculation (PE), and educating the patient on healthy life-styles. Furthermore, by dealing with interpersonal dynamics within the couple and embracing adequate lifestyles (managing stress and revising one’s sexual scripts), PDE-5i treatment benefits may be enhanced. In this review, we propose a holistic conceptual framework approach for psychiatric management of patients with ED.
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The Phosphodiasterase 5-Inhibitors (PDE-5i) for Erectile Dysfunction (ED): A Therapeutic Challenge For Psychiatrists, Current Drug Targets 2018; 19 (12) . https://dx.doi.org/10.2174/1389450118666170215164747
DOI https://dx.doi.org/10.2174/1389450118666170215164747 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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