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Azoospermia is defined as the total and constant absence of sperm found in the ejaculate. Two major etiologies are distinguished: obstructive (or excretory) azoospermia, approximately 40% of cases and non-obstructive (or secretory) azoospermia between 55 and 60% of cases.
Diagnosis
The most common test for finding a solution to male fertility is a spermogram. Which consists of collecting a sample of the ejaculate and examining it in the laboratory for a check on the concentration and mobility of sperm.
WHO referral rates for diagnosis:
- Azoospermia: no sperm in the ejaculate.
- Oligospermia: less than 15 million / ml.
- Asthenospermia: equal to or greater than 40% motile sperm (progressive and non-progressive)
- Cryptozoospermia: less than 100,000 sperm / ml.
It is considered that azoospermia is responsible for between 10 and 15% of cases of male infertility, the presence of teratozoospermia or oligospermia can lead to asthenozoospermia which is also responsible for almost 10% of cases of male infertility.
It is also useful to determine the levels of FSH hormones. This is produced by the brain and is responsible for the formation of sperm in the testes.
Causes
There are two reasons for the absence of sperm in the ejaculate:
- Secretory or non-obstructive azoospermia: the testes are unable to produce sperm.
- Obstructive azoospermia: sperm are present, but cannot be expelled during ejaculate.
For more information on the type of azoospermia, it is necessary to perform a testicular biopsy, which consists of obtaining a small fragment of each testicle and analyzing the presence or not of sperm, it will be easier to distinguish obstructive azoospermia. of a secretory.
The main causes of secretory azoospermia:
- Testicular problems
- Exposure to toxic substances
- Genetic disorders
- Hormonal disorders etc.
The most common causes of obstructive azoospermia:
- Absence of vas deferens (since birth, or after surgery).
- Inflammation or trauma of the testicle, vas deferens or prostate
DISORDERS OF MALE SEXUALITY
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Libido disorders
Libido, which is a form of sex drive, genital capacity and fertility.
We see, for example, that there are men who feel attracted to women, but who are unable to perform a sexual act (genital incapacity, impotence).
Decreased libido may be associated with normal genital capacity, on the contrary, normal libido and genital capacity may coincide with a lack of reproductive capacity.
Impotence (premature ejaculation, anorgasmia, etc.)
Impotence is defined as the inability of a man to achieve intercourse. Impotence, temporary or permanent, affects a high percentage of men.
Despite all the myths, physical strength and the outward signs of virility have nothing to do with sexual potency.
Impotence on the rise
Mental impotence is very common, and many studies show that in developed countries it seems to be on the rise. It is true that determining the real percentage of impotent like that of frigid women is a very difficult task; for even in our society which calls itself a sexually liberated and liberal society, few are those who speak sincerely about their true erotic capacity.
Nevertheless, it would be interesting to observe the statistics published on this subject. According to the data, impotence has the following incidence:
- At 20: 30%
- At 30: 45%
- At 40: 57%
- At 50: 63%
- At 60: 68%
- At 80: 95%
According to some doctors, the percentage of impotent is as follows:
- 75% of men over 50 and
- 80% of men over 60
According to Dr. Danillo Malgro, a professional urologist, impotence is currently the third or fourth most common cause of urology visits.
In a survey conducted by Dr. Malgro and colleagues, the question & lt; & lt; Impotence is defined as the absence of an erection or ejaculation. Are you or have you been helpless? & gt; & gt; :
- 87.5% answered negatively
- 7.8% did not respond or said they did not know it,
- 4.7% answered yes.
Causes of impotence
Several external or situational factors are at the origin of erectile dysfunction:
- Fatigue due to tension and stress,
- Consumption of alcohol, tobacco or other,
- Abnormal sexual behavior in a couple,
- The sexual inhibition of the campaign,
- Certain drugs,
- In 20% of cases, organic disorders (hormonal or neurological)
Types of impotence
A helpless man is one who suffers from a lack of erection in the face of erotic stimuli; but a man whose erection is insufficient or who cannot maintain it at the time of penetration is also considered helpless.
We distinguish;
- Primary impotence, when a man has never achieved a full erection or has never been able to maintain it long enough;
- Secondary impotence, when it occurs after a phase of more or less normal sexual activity.
- Ejaculatory impotence (very uncommon), when ejaculation of seminal fluid does not occur despite sufficient erection.
Erection and ejaculation disorders
Some disturbances of erection and ejaculation can be classified under the various types of impotence.
The various psychological and physical causes that can affect the functioning of the erection are:
- Decreased libido;
- Poisoning: alcohol, drugs, etc.
- Various lesions of the nervous system: paralysis, paraplegia, inflammation,
- Some cases of diabetes, drops
The main erection disturbances are as follows :
- Insufficient erection, the penis does not reach a sufficient degree of consistency to penetrate the vaginal opening.
- The unstable erection, when not maintained during intercourse, may present itself in the prelude, but falls off upon penetration,
- The capricious erection is one that does not appear, regardless of the individual’s will,
- Painful erections can occur when a man has urethritis or other genital infections
Causes and types of ejaculation disorders:
We distinguish several disturbances of ejaculation:
- Premature ejaculation. It occurs even before the intromission of the penis.
- Premature ejaculation. This is the one that occurs after penetration, but before thirty seconds.
- Late ejaculation. It translates differently from the previous one; ejaculation does not or does not occur. In this case there may or may not be a normal or weak orgasm, sometimes painful.
- With retrograde ejaculation, seminal fluid is forced back into the bladder. It is due to a failure of the bladder sphincters.
- Ejaculation without an erection, etc.
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Therapeutic solutions for impotence
It will be necessary to discover the reasons which trigger the impossibility of having normal sex, in order to find the most adequate solutions. While it is true that these clearly psychological disorders can go away with time or with a happy change in a person’s life, there are methods that can improve, even cure the pathological signs. If the solution to impotence is neither conventional medicine nor surgery, not being the consequence of a purely somatic disease, it may be necessary to resort to a sexological treatment directed by psychotherapists. specialties, which either applies to the individual or to the couple. There are various therapies originating from behavioral psychology which, along with the solutions proposed for the disorders of female sexuality, try to gradually restore the sexual function impaired by various conditioning.
Realism and acceptance
First, the helpless will have to accept for some time to be counseled by those who treat him and accept the care of his partner, faithfully following the instructions received.
Without it, you can’t do much,
Collaboration in the campaign is fundamental, if not decisive. The woman must be willing to give up on herself, on her own pleasure and think only of that of her companion, as long as the treatment lasts. Her main role is to reduce her husband’s tension and anxiety, avoiding at all costs directly or indirectly censoring his low level of achievement, and patiently awaiting a solution.
In these sexual education or re-education processes, whether the disorder affects men or women; the best stimulus is to be positive. Any success, any progress, no matter how small, is to be applauded.
A line of praise is always more stimulating than a bunch of reproaches
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