Impotence
What is impotence?
Impotence (also called erectile dysfunction) is a condition in which an individual is unable to reach and maintain an erection and therefore prevents him from having sex. The individual may still have a normal sex drive, but cannot achieve a complete erection. During normal arousal, the blood vessels that drain blood out of the penis are closed. The spongy tissue in the penis (corpora cavernosa) then fills with blood and the penis hardens. After ejaculation, the vessels are opened again, the blood drains back into the body and the penis goes limp. Impotence affects most men at some time in their life, but it is usually short-lived and if it affects you, you should not worry. However, 10 per cent of men suffer from permanent impotence. This number increases to 38 per cent in men aged over 60.
What causes impotence?
Impotence can have both physical and psychological causes, but most impotence is probably caused by a combination of these. Apart from obvious causes like accidents and surgery to the genital area, physical factors include: diabetes (52 per cent of men with diabetes are impotent), obesity, damaged or diseased veins or nerves, and low or abnormal hormone levels. Some drugs can also cause physical impotence, including anti-depressants, tranquillisers and treatments for hypertension. Regular abuse of alcohol, nicotine or opiates is also a common cause of impotence. Psychological causes include: stress, anxiety, guilt, sexual hang-ups, losing interest in your partner or a partner who finds sexual intercourse painful. If you have impotence, but still have early morning erections and can still masturbate, then your impotence may well result from psychological stress.
What tests will my doctor do?
Your doctor is most likely to ask you about your sex life and sexual history. He or she may check your blood pressure, heart and pulse. You may be asked to have a full physical examination and the doctor will probably take blood and urine samples from you. However, it is most likely that your doctor will refer you to a specialist. The specialist may be a urologist, counsellor or psychiatrist.
Can impotence be treated?
Approximately 90 per cent of impotence problems can be treated. There are a variety of treatments, depending on the reasons for your impotence.
If it is caused mainly by psychological factors, talking through your problems with a counsellor or psychiatrist may be helpful.
The most common treatment for physical impotence is the injection of a drug into the side of your penis. This gives you an erection for about one to four hours. Your doctor will inject the first dose and assess your erection to. find the correct dose for you and to show you how to inject yourself. The injection can be used up to twice a week, but there is a risk of very long-lived and sore erections (priapism) and the injections may leave small bumps on your penis.
If your impotence is caused by a drop in your male hormone (testosterone) level, testosterone capsules, tablets, or patches can restore it to a normal level.
There are a variety of suction devices and condoms available that enable you to have an erection. These create a suction pressure that draws blood into your penis, while a rubber ring around the base of your penis keeps the blood in to maintain an erection.
There are also implants available. These take the form of two semi-bendable rods which are inserted surgically into the sides of your penis and can be repositioned to form an erection. Alternatively, you can have a pump implant, where you squeeze a small pump in your scrotum to pump up your penis.
Help yourself
- Try to eat a well-balanced, low cholesterol diet; high cholesterol levels may cause impotence.
- Get more exercise; regular exercise increases libido, keeps your body healthy, and improves your self-image.
- Avoid smoking and bouts of heavy drinking.
- Try and reduce stress and get more sleep.
- Tell your doctor exactly what medication you are taking.
Further information
The Impotence Association
PO Box 10296
London
SWl7 7ZN
Tel: 0181 767 7791