What is impotence?

Impotence or erectile dysfunction refers to the inability to have or maintain a satisfactory erection, or the inability to achieve successful sexual intercourse. Impotence can be total or partial and it can affect men of different age groups. It is estimated that 20 to 30 million men in the United States, almost 2 in every 10 men, are affected by this condition. The good news is that impotence can almost always be successfully treated.

Causes of impotence

An erection is an involuntary reaction in response to sexual, psychological, sensory, and nerve stimulation. This stimulation causes a rapid increase in the amount of blood flowing into the penis. An erection occurs when blood becomes trapped and held in the two cylindrical chambers that make up most of the shaft of the penis. As the chambers rapidly fill with blood, they expand and the penis becomes firm and elongated, resulting in a successful erection.

Many men may face impotence at certain times in their lives. Stress, fatigue, and excessive alcohol consumption may lead to temporary impotence, which is generally no cause for serious concern. However, if impotence persists, this could be a symptom of an underlying medical condition. Some medical problems that may cause impotence include illnesses like: alcohol or substance abuse, arteriosclerosis (hardening of the arteries), diabetes, hormonal imbalances, kidney disease, neurological diseases and injuries, or pelvic fractures. Also certain medications, although they help with other illnesses, can cause sexual impotence as a side effect. Occasionally, men who have undergone surgical procedures like radical prostatectomy, certain colon, and blood vessel surgery have a higher rate of loss of sexual function.

Men who experience impotence that persists or interferes with normal sexual activity should consult their doctor. Some of the symptoms of impotence are:

Diagnosing impotence

Initially your doctor will want to talk with you about your past medical history including any information about previous operations, illnesses, injuries, and medications. It is very important for your doctor to understand your development and social history to help in the treatment of the problem. There may be some aspects of a person’s life that is affecting their impotence. The doctor will also need to do a physical examination of the penis and scrotal area to see if there are any physical problems that may be causing the impotence. In some cases, the doctor may have diagnostic studies such as blood tests, ultrasounds, and x-rays done to help in the diagnosis.

Treating Impotence

The good news is that most men with impotence can have their sexual function restored with proper treatment.

There are many different treatments for impotence, ranging from taking a pill prior to sexual activity to having surgery. Your doctor will work with you to select the best course of treatment available. These treatment options are for men diagnosed with impotence, they are not designed to increase or enhance sexual desire in non-impotent patients.

• Medication taken orally (pills) is one of the newest treatments for male impotency. Common names for those currently available are VIAGRA, LEVITRA and CIALIS. These medications are called PDE5 Inhibitors. These medications are taken before sexual activity and can help achieve an erection. The medications do not cause an erection but enable men to have an erection when sexually stimulated. You can not use VIAGRA, LEVITRA or CIALIS if you are taking any Nitroglycerin or nitrate related medication for heart problems. If you are taking any Alpha Blockers for prostate problems or high blood pressure then you can take VIAGRA or CIALIS under certain restrictions but you can not take LEVITRA if you are taking an Alpha Blocker. Each of these medications have other side effects and your physician and you will determine which medication is right for you.
• Injection Therapy: With this procedure, the patient can inject the prescribed medication [Caverject™, EDEX™] directly into the corpus cavernosum of the penis, where the erection forms. Injection therapy usually produces an erection in 5 to 20 minutes. This process is virtually painless and well tolerated by most patients.
• Transurethral Suppositories: Medicated Urethral Suppository (M.U.S.E.) is a newly developed treatment that consists of a very small medicine pellet inserted into the urethra (tube inside the penis). The medication is absorbed by the surrounding tissue and causes an erection by relaxing the smooth muscle in the penis and allowing blood to enter and become trapped in the penis.
• Vacuum Devices: This procedure utilizes a mechanical device that allows for the expansion of the penis using an external vacuum pump and then, when an erection is achieved, placement of a rubber ring at the base of the penis to sustain the erection.
• Penile Prosthesis: This treatment uses the surgical placement of implants or penile prosthesis that offers predictable erections using mechanical methods. This treatment is not recommended until other treatments have been tried first.
• Hormone Treatments: If blood tests indicate there is a decrease in testosterone then hormone treatment may help. Depo-testosterone is an injection in the hip given every three to four weeks. Testosterone patch (Androderm) worn on the skin is a method of delivering testosterone on a daily basis and allows for more consistent delivery of medication.