What is impotence?
Impotence, or erectile dysfunction, is the inability of a male to attain and keep an erection sufficiently firm to engage in or complete sexual intercourse. Although it is more common in older men, impotence can occur at any age. Impotence is not a normal consequence of aging. About 70% of erectile dysfunction is due to diseases such as diabetes and atherosclerosis, another 10% to 20% is due to psychological factors, and the remaining percentage is related to medications, lifestyle factors, and injury (Source: NIDDK).
Achieving an erection is a complicated process, requiring transmission of sensations from the genital area to the nervous system and the return of nervous impulses to the muscles and blood vessels of the penis. Anything that interferes with this interchange, such as disease or injury of the blood vessels, muscles, or nerves, can make achieving and maintaining an erection difficult. Psychological factors, such as anxiety and depression, can also interfere with erectile function. Anxiety and depression may also develop as a consequence of impotence.
Fortunately, impotence is usually treatable. A thorough evaluation starting with a history and physical exam is needed to help diagnose the underlying cause. Once the cause of impotence is determined, treatment can be tailored to target that cause and any other contributing factors. Treatments used for impotence may include medications, vacuum devices, surgery, and psychotherapy.
Because impotence can be due to health problems that can affect the whole body, and because it can interfere with one’s quality of life, it is important to talk with your doctor if you have trouble attaining or maintaining an erection. With increasing discussion of impotence in the media, coupled with advances in treatment, men are now much more comfortable talking with their doctors about impotence. It is currently estimated that between 15 and 30 million men in the United States are affected by impotence (Source: NIDDK).
It is very important to s eek prompt medical care if you are experiencing impotence, not only because impotence can be due to underlying health problems, but because treatment can improve your quality of life. Impotence is not a medical emergency, but it may be associated with diseases that can have serious complications.
What are the symptoms of impotence?
Impotence, or erectile dysfunction, is the inability of a male to attain and keep an erection sufficiently firm to engage in or complete sexual intercourse. Impotence manifests differently in different individuals. You may find you are unable to achieve an erection at all, or you may be able to achieve an erection, but only briefly.
Common symptoms of impotence
Common symptoms of impotence include:
- Inability to achieve an erection
- Inability to maintain an erection
Symptoms that might indicate a serious condition
In some cases, impotence can be associated with health problems that can lead to serious, even life-threatening, complications. Seek prompt medical care if you experience the new onset of, or recurrent symptoms of, impotence.
What causes impotence?
Most of the time, impotence has a physical cause. Achieving an erection is a complicated process requiring your body to transmit sensations from the genital area to the nervous system and return nervous impulses to the muscles and blood vessels of the penis. Anything that interferes with this interchange, such as disease or injury of the blood vessels, muscles, or nerves, can lead to impotence. Psychological factors such as anxiety and depression can also interfere with your erectile function.
Causes of impotence
A number of factors may cause impotence including:
Abnormally low testosterone levels
Atherosclerosis (buildup of plaque on the walls of arteries; atherosclerosis is a common cause of cardiovascular disease)
Depression or anxiety
Medication side effects
Penile or testicular trauma or surgery of the bladder or prostate
Peripheral neuropathy (disorder that causes dysfunction of nerves that lie outside your brain and spinal cord)
Spinal cord injury or tumor
Trauma or structural injury (prolonged bicycling or bicycling accident)
Many factors may increase your risk of developing impotence. Not all people with risk factors will develop impotence. Risk factors for impotence include:
- Advancing age
- Alcohol abuse
- Cardiovascular disease
- Cigarette smoking
- Neurologic disorders
- Overweight or obesity
- Psychological conditions
- Substance abuse
Reducing your risk of impotence
You can play an active role in lowering your risk of impotence by:
- Controlling your blood pressure if you have high blood pressure
- Controlling your blood sugar if you have diabetes
- Discontinue illicit drug use
- Decreasing or eliminating alcohol use
- Eating a healthy diet
- Increasing physical activity
- Maintaining a healthy weight
- Participating in counseling to address emotional or psychological issues
- Quitting smoking
How is impotence treated?
Treatment of impotence begins with a lifelong program of regular medical care, which allows your health care professional to provide early screening tests. Regular medical care also provides an opportunity for your health care professional to promptly evaluate symptoms and your risks for developing impotence. Treatment of impotence is based on its cause.
Common treatments of impotence
Common treatments of impotence include:
Alprostadil urethral pellets (MUSE) to relax blood vessels of the penis
Couples therapy to develop techniques that improve intimacy
Injectable medications such as alprostadil (Caverject, Edex), papaverine, and phentolamine to relax blood vessels of the penis
Oral phosphodiesterase (PDE) inhibitors such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra) to improve blood flow to the penis
Psychotherapy to decrease anxiety
Surgery to improve blood flow to the penis
Surgery to prevent blood leakage from the penis
Surgical implants to cause erection
Testosterone replacement if a low testosterone level is a contributing factor
Vacuum devices to pull blood into the penis and cause engorgement
What you can do to improve your impotence
There are steps you can take that may mitigate your impotence. These steps include:
Decreasing or eliminating alcohol use
Discontinue illicit drug use
Eating a healthy diet
Increasing physical activity
Maintaining a healthy weight
Participating in counseling to address emotional or psychological issues
Taking medications as prescribed to control blood sugar and high blood pressure
Complications of untreated diseases that contribute to impotence can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of impotence include:
- Relationship difficulties
- Unfulfilling sex life