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ED kya hai
Erectile dysfunction (ED) ka matlab hai ke mard ko aksar erection hasil karne mein mushkil ho, ya erection itna mazboot na rahe ke jinsi taluq ho sake. Kabhi kabhar kisi raat aisa ho jana bilkul aam baat hai. Yeh tab tibbi masla banta hai jab yeh baar baar ho, ya aap ko ya aap ke rishte ko pareshan kare.
Erection kai cheezon ke mil kar kaam karne se hota hai. Dimagh aur nasein ishara bhejti hain, khoon ki nalian khulti hain taake khoon penis ke spongy tissue mein aa jaye, aur tissue us khoon ko rok kar rakhta hai. Hormones aur zehni kaifiyat ka bhi hissa hota hai. In mein se kisi bhi marhale mein rukawat ho to erection hasil karna ya qaim rakhna mushkil ho sakta hai.
ED aik tibbi masla hai. Yeh aap ki koi kamzori nahi hai aur is ka yeh matlab nahi ke aap kam mard hain. Meherbani karke sharminda na hon: urologists apne mareezon se is baare mein baat karte hi rehte hain.
Yeh kitna aam hai
ED aam hai, aur umar ke saath is ke imkaan barh jate hain. Lekin yeh sirf umar ka masla nahi: jawan mardon ko bhi ho sakti hai, aksar tension, fikr, tambaku ya kisi chhupi sehat ki mushkil ki wajah se. Bohat se mard madad maangne se pehle lambay arse tak yeh bardasht karte rehte hain. Aap ko aisa karne ki zaroorat nahi.
Yeh kyun hoti hai
Aksar aik se zyada wajohat hoti hain. Yeh teen gharon mein aati hain.
Jism
- Tang ya band hoti khoon ki nalian, jo aksar high blood pressure, high cholesterol aur dil ki bimari se judi hoti hain.
- Diabetes, jo khoon ki nalion aur nasoon dono ko nuqsan pohancha sakti hai.
- Nasoon ke masail, masalan reedh ki haddi ya pelvis ki chot ke baad.
- Testosterone ki kami (hormone ka masla), jis se aksar jinsi khwahish bhi kam ho jati hai.
- Kuch dawaiyan, jin mein blood pressure, udaasi aur prostate ki kuch dawaiyan shamil hain. Meherbani karke koi dawai khud se band na karein. Pehle apne doctor se baat karein.
- Pelvis ka operation ya radiotherapy, masalan prostate ya masanay ke liye.
- Tarz-e-zindagi: tambaku, sharab ya nashay ka istemal, mota hona, kam warzish aur kam neend.
Zehen
- Tension, fikr aur udaasi.
- "Performance" ki fikr, jo aik chakkar ban sakti hai: aik mushkil martaba darr paida karta hai, aur woh darr agli baar ko aur mushkil bana deta hai.
- Thakan, kaam ka dabao, ya rishte mein khichao.
Dono ka milap
Bohat aksar dono wajohat hoti hain. Choti si jismani wajah fikr ko janam de sakti hai, aur fikr halaat ko aur kharab kar deti hai. Isi liye achhi jaanch poore insan ko dekhti hai, sirf penis ko nahi.
Meherbani karke apne aap ko qasoorwar na thehrayen. Tambaku, wazan ya diabetes ke baare mein jaanna is liye faida mand hai ke un mein behtri layi ja sakti hai.
Check karwana kyun zaroori hai
Jo khoon ki nalian penis ko khoon deti hain woh bohat chhoti hoti hain, is liye khoon ke bahao ki mushkil yahan pehle nazar aa sakti hai, jabke baaki jagah abhi pata nahi chalta. ED dil ki bimari, high blood pressure ya diabetes ke pakre jane se pehle bhi ho sakti hai. Isi wajah se aap ka urologist aam tor par aap ki aam sehat bhi check karega, aur ED ko serious lena chahiye chahe woh aap ko zyada pareshan na bhi kare.
Achhi baat yeh hai ke wajah ka khayal rakhne se aksar sirf erection hi nahi, aap ki poori sehat behtar hoti hai.
Tashkhees kaise hoti hai
Sab se ahem hissa aik nijji, bina jaldi ki guftagu hai. Aap ka urologist aam tor par:
- Sawalaat poochega: yeh kab shuru hui, achanak aayi ya ahista ahista, kya aap ko ab bhi subah erection ke saath neend khulti hai, jinsi khwahish, tension, rishta, doosri bimariyan, dawaiyan (jari booti wali bhi), aur tambaku aur sharab.
- Aam sehat check karega, blood pressure samet, aur kabhi kabhi jismani muaina aur prostate ka muaina bhi.
- Blood tests likhega, masalan blood sugar aur cholesterol ke liye, aur kabhi kabhi testosterone ke liye.
- Kabhi kabhar khoon ke bahao ke mazeed tests likh sakta hai, agar un se ilaaj badal sakta ho.
Agar chahein to apni biwi ya saathi (partner) ko saath la sakte hain, bohat se jode ise madadgar paate hain. Akele aana bhi bilkul theek hai. Jo dawaiyan ya cheezein aap ne istemal ki hain, jin mein bina nuskhay ke li gayi cheezein bhi hain, un ke baare mein khul kar batayein. Aap ka urologist yeh sab pehle bhi sun chuka hota hai aur sirf aap ki madad karna chahta hai.
Ilaaj ke tareeqay
Ilaaj wajah, aap ki aam sehat, aur aap aur aap ke saathi ki pasand par mabni hota hai. Bohat se mardon ko aik se zyada tareeqay aazmane parte hain. Mukhya tareeqay yeh hain:
Agar aap ki ED prostate ke operation ya radiotherapy ke baad shuru hui hai, to apne urologist ko jald az jald bataein, kyunke kuch cheezein madad kar sakti hain.
Khud madadi: rozmarra zindagi
Yeh aasaan qadam madad kar sakte hain, chahe aap koi bhi ilaaj kar rahe hon:
- Apne saathi se baat karein. Khamoshi ko dilchaspi ki kami samjha ja sakta hai. Narmi se ki gayi sachchi baat cheet aksar dono ka bojh halka kar deti hai.
- Dabao kam karein. Qurbat ka matlab hamesha jinsi taluq nahi hota. Dabao kam hone se aksar erection wapas aa jata hai.
- Apne dil ka khayal rakhein. Chalna aur doosri baqaida warzish, mutawazin khurak aur theek wazan har jagah khoon ke bahao ko behtar karte hain.
- Har qism ka tambaku chhor dein aur sharab kam rakhein, khaas tor par jinsi taluq se pehle.
- "Karishmati" cheezon se hoshiyar rahein. Jo cheez mustaqil ilaaj ya pakki kamyabi ka wada kare us par bharosa na karein.
- Sabr karein. Aap ke liye munasib cheez dhoondne mein kuch koshishein ya ilaaj mein tabdeeli lag sakti hai.
Follow-up
ED ke ilaaj mein aksar tabdeeli ki zaroorat parti hai, is liye aap ka urologist aam tor par aap ko dobara dekhna chahega taake dekhe ke halaat kaise hain aur koi side effects to nahi. Apne blood tests ke nataij saath le jayein. Agar koi ilaaj kaam na kar raha ho to wapas aa kar baat karein, is ke bajaye ke jitna kaha gaya us se zyada lein ya doosri jagahon se cheezein aazmayen.
Naye alamaat, masalan zor lagane par seene mein dard ya saans phoolna, zaroor batayein, kyunke un ka theek se muaina zaroori hai.
Fauran madad kab lein
Agar aap ko in mein se koi bhi ho to foran apne qareebi hospital ke emergency department jayein:
- Aisa erection jo khatam na ho, khaas tor par agar dard bhi ho. Ise priapism kehte hain. Intezar na karein ke khud theek ho jaye, kyunke is se penis ko mustaqil nuqsan ho sakta hai.
- Seene mein dard, shadeed saans phoolna, behoshi ya bohat bura mehsoos hona jinsi taluq ke dauran ya baad mein, ya ED ki goli lene ke baad.
- Reedh ya pelvis ki chot ke baad achanak erection ka khatam ho jana, ya saath mein groin aur ran ke andar ki taraf sunn hona, taangon mein kamzori, ya peshab ya paikhane par qaboo kho dena.
- Na-umeedi mehsoos karna, ya khud ko nuqsan pohanchane ke khayalat aana. Meherbani karke kisi qabil-e-aitmad shakhs ko batayein ya abhi hospital jayein. Madad mojood hai.
Aam sawalaat
Kya desi ya jari booti wale nuskhay, "sandha oil" ya sarak kinare ke "hakeem" ki cheezein kaam karti hain?
In ke kaam karne ka koi achha saboot nahi, aur kuch khatarnaak bhi hain. "Taqat" ke naam par bikne wali cheezon mein chhupi hui dawaiyan ya steroids ho sakte hain jo khaas tor par dil ke mareezon ke liye khatarnaak hain. Har us ishtihar se hoshiyar rahein jo mustaqil ilaaj ka wada kare. Aap ne jo kuch aazmaya hai woh apne urologist ko zaroor bataein, aur kisi nuskhay ko theek jaanch mein der ka sabab na banne dein.
Kya dawai ki dukaan ya internet se li gayi goliyan mehfooz hain?
Doctor ke mashware ke baghair nahi. Sahi goli har mard ke liye mehfooz nahi hoti, aur sahi tareeqay ke bahar bikne wali naqli goliyon mein ghalat ajza ho sakte hain. Pehle apne urologist se poochein.
Kya masturbation ya maazi ki koi aadat ED ki wajah banti hai?
Nahi. Masturbation se ED nahi hoti aur na hi yeh jism ya penis ko kamzor karti hai. Yeh bohat aam fikr hai, aur yeh aik ghalat fehmi hai. Haan, sharmindagi aur fikr erection ko mushkil bana sakti hain, jo baat karne ki aik aur wajah hai.
Kya is se bachche paida karne ke imkaanat par asar parta hai?
ED aur fertility (bachche paida karne ki salahiyat) alag cheezein hain. Fertility ka ta'alluq sperm se hai. ED wale bohat se mard phir bhi walid ban sakte hain, aur madad ke tareeqay mojood hain. Kuch sehat ke masail dono par asar daal sakte hain, is liye agar aap bachche ki koshish kar rahe hain to apne urologist ko zaroor bataein.
Kya yeh mustaqil hoti hai?
Yeh wajah par mabni hai. Bohat se mard wajah ke ilaaj ya sahi ilaaj se kaafi behtar ho jate hain. Doosron ko lambe arse tak ilaaj ki zaroorat parti hai. Jab is ka mukammal ilaaj mumkin na ho tab bhi aam tor par isay sambhala ja sakta hai.
Kya jawan mardon ko bhi ED ho sakti hai?
Ji haan. Jawan mardon mein tension, fikr, tambaku, nashay ka istemal aur rishton ki pareshaniyan aam wajohat hain, lekin jismani wajohat ki bhi jaanch honi chahiye.
Kya is ka matlab hai ke meri shaadi mein koi masla hai?
Aam tor par nahi. ED zyada tar khoon ke bahao, nasoon, hormones aur tension ka masla hai. Saathi aksar uljhan mein hote hain ya khud ko qasoorwar samajhte hain, is liye sachchi aur narm baat cheet madad karti hai. Kuch jode urologist se saath mil kar baat karna madadgar paate hain.
What ED is
Erectile dysfunction (ED) means often having trouble getting an erection, or keeping it firm enough for sex. Everyone has an off night now and then, and that is normal. It becomes a medical concern when it keeps happening, or when it worries you or affects your relationship.
An erection is a team effort. The brain and nerves send a signal, the blood vessels widen so that blood flows into the spongy tissue of the penis, and the tissue holds that blood in. Hormones and your state of mind also play a part. If any step is disturbed, an erection can be harder to get or to keep.
ED is a medical problem. It is not a personal failing and not a sign that you are less of a man. Please do not feel ashamed: urologists talk about it with patients all the time.
How common it is
ED is common, and it becomes more likely as men get older. It is not only a problem of age, though. Younger men can have it too, often because of stress, anxiety, tobacco or an underlying health problem. Many men put up with it for a long time before asking for help. You do not need to.
Why it happens
There is usually more than one reason. The causes fall into three groups.
Body
- Narrowed blood vessels, often linked to high blood pressure, high cholesterol and heart disease.
- Diabetes, which can damage both blood vessels and nerves.
- Nerve problems, for example after an injury to the back or pelvis.
- Low testosterone (a hormone problem), which often lowers sex drive as well.
- Some medicines, including some used for blood pressure, low mood and the prostate. Please do not stop any medicine on your own. Talk to your doctor first.
- Surgery or radiotherapy in the pelvis, such as for the prostate or bladder.
- Lifestyle: tobacco, alcohol or drug misuse, being overweight, little exercise and poor sleep.
Mind
- Stress, anxiety and low mood.
- Worry about "performing", which can become a cycle: one difficult time causes fear, and the fear makes the next time harder.
- Tiredness, work pressure, or strain in the relationship.
A mix of both
Very often it is both. A small physical cause can lead to worry, and the worry makes things worse. That is why a good assessment looks at the whole person, not just the penis.
Please do not blame yourself. Knowing about tobacco, weight or diabetes is only useful because they can be improved.
Why it is worth checking
The blood vessels that supply the penis are very small, so a problem with blood flow can show up here before it is noticed elsewhere. ED can come before heart disease, high blood pressure or diabetes is found. For this reason your urologist will usually check your general health as well, and ED is worth taking seriously even if it does not bother you much.
The good news is that looking after the cause often helps your overall health as well as your erections.
How it is diagnosed
The most important part is a private, unhurried conversation. Your urologist will usually:
- Ask questions: when it started, whether it came on suddenly or slowly, whether you still wake with erections, your sex drive, your stress levels and your relationship, other health conditions, medicines (including herbal ones), and tobacco and alcohol.
- Check your general health, including blood pressure, and sometimes examine the genitals and the prostate.
- Arrange blood tests, for example for blood sugar and cholesterol, and sometimes for testosterone.
- Occasionally suggest further tests of blood flow, if the answer would change the treatment.
You are welcome to bring your partner if you would like to, as many couples find it helps. It is also perfectly fine to come alone. Be open about any medicines or products you have used, including ones bought without a prescription. Your urologist has heard it all before and is only trying to help.
Treatment options
Treatment depends on the cause, your general health, your preferences and your partner's. Many men need to try more than one approach. The main options are:
If your ED started after prostate surgery or radiotherapy, tell your urologist as early as you can, because there are things that can help.
Living with it: self-help
These simple steps can help, whatever treatment you are having:
- Talk to your partner. Silence can be mistaken for loss of interest. A gentle, honest conversation often takes a lot of pressure off both of you.
- Take the pressure off. Closeness does not have to end in intercourse. Less pressure often helps erections to return.
- Look after your heart. Walking and other regular exercise, a balanced diet and a healthy weight help blood flow everywhere.
- Stop all tobacco and keep alcohol low, especially before sex.
- Be wary of "miracle" products. Anything promising a permanent cure or guaranteed results should not be trusted.
- Be patient. It can take a few tries, or a change of treatment, to find what suits you.
Follow-up
ED treatment often needs adjusting, so your urologist will usually want to see you again to check how things are going and whether there are any side effects. Take your blood test results with you. If a treatment is not working, come back to discuss it rather than taking more than you were told or trying products from other sources.
Report new symptoms, such as chest pain or breathlessness when you exert yourself, as these need a proper check.
When to seek urgent help
Go to your nearest hospital emergency department straight away if you have any of the following:
- An erection that will not go down, especially if it is painful. This is called priapism. Do not wait to see if it settles, because it can permanently damage the penis.
- Chest pain, severe breathlessness, fainting or feeling very unwell during or after sex, or after taking a tablet for ED.
- Sudden loss of erections after a back or pelvic injury, or with numbness around the groin or inner thighs, weak legs, or trouble passing urine or controlling your bowels.
- Feeling hopeless, or having thoughts of harming yourself. Please tell someone you trust or go to a hospital now. Help is available.
Common questions
Do desi or herbal remedies, "sandha oil" or roadside "hakeem" products work?
There is no good evidence that they do, and some are risky. Products sold for "strength" can contain hidden medicines or steroids that are dangerous, especially for men with heart problems. Be careful with any advertisement that promises a permanent cure. Please tell your urologist what you have tried, and do not let a remedy delay a proper assessment.
Are tablets from a pharmacy counter or the internet safe?
Not without a doctor's advice. The right tablet is not safe for every man, and copies sold outside proper channels may contain the wrong ingredients. Ask your urologist first.
Does masturbation or something I did in the past cause ED?
No. Masturbation does not cause ED and does not weaken the body or the penis. It is a very common worry, and it is a myth. Guilt and anxiety can, however, make erections harder, which is another reason to talk about it.
Will it affect my chances of having children?
ED and fertility are different things. Fertility depends on sperm. Many men with ED can still father children, and there are ways to help. Some health problems can affect both, so tell your urologist if you are trying for a baby.
Is it permanent?
It depends on the cause. Many men improve a lot when the cause is treated or with the right treatment. Others need treatment long term. Even when it cannot be cured, it can usually be managed.
Can young men have ED?
Yes. In younger men stress, anxiety, tobacco, drug use and relationship worries are common causes, but physical causes should still be checked.
Does it mean there is a problem in my marriage?
Usually not. ED is mostly about blood flow, nerves, hormones and stress. Partners often feel confused or blame themselves, so honest, gentle talking helps. Some couples find it helps to see the urologist together.