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Impotency: Causes & Solutions

Prostate Cancer Awareness Week (pcaw.org) has compiled information on the causes and solutions for impotency.

Impotence: Causes and Solutions

Impotence: Causes and Solutions


Impotence affects about one out of every ten American men, yet many of them don't seek help because they're embarrassed, they think there's no solution or they believe the problem is "all in their minds." Unfortunately, these men are missing out on a wide variety of treatment options.

Impotence, the persistent inability to achieve and maintain an erection for intercourse, affects as many as 18 million men in the United States between the ages of 40 and 70. Until recently, doctors thought impotence was mainly rooted in psychological causes. Now it is believed that 50 to 70 percent of all cases are caused by physical problems. Erection difficulties tend to increase with age, but that is not the only or even the most important factor. Your general physical and psychological health, as well as lifestyle habits and certain medications, can all cause impotence, but you don't have to live with this problem. In most cases, impotence can be successfully treated.

How Does an Erection Occur?

In order to get an erection, several parts of the body must work together. The brain sends a message of sexual arousal through the nervous system to the penis. This message causes the muscles along the penis to relax. At the same time, the artery to the penis dilates to twice its diameter, increasing the blood flow sixteen-fold, and the veins which carry blood away from the penis are blocked. As a result, the two spongy-tissue chambers in the shaft of the penis fill with blood and the penis becomes firm. A breakdown in any of these systems makes getting or keeping an erection difficult.

How is Impotence Diagnosed?

Virtually all men occasionally fail to get an erection. That's normal. But if a man has trouble getting or maintaining an erection about 25 percent of the time, he should see an urologist. These physicians specialize in disorders of the kidneys, bladder, prostate, penis and urethra.

Usually, after asking questions about when and how the impotence developed, the urologist will give the patient a complete physical exam to determine if his hormone levels are normal and if the blood vessels, nerves and tissues of his penis are working properly. If this initial work-up doesn't pinpoint the cause of the problem, a nocturnal penile tumescence test can be done.

Men with no physical abnormalities almost invariably have nightly erections during sleep. The patient may spend a few nights in a sleep laboratory where a gauge that measures the frequency and duration of nocturnal erections is attached to the base of the penis. A home version of this, the snap-gauge test, can also be used. Before going to sleep, the patient attaches the gauge to the base of his penis. During the night, the gauge will break at different degrees of penile rigidity and show whether a partial or full erection has taken place during sleep. If nocturnal erections do not occur, the impotence is most likely physical. Additional testing is then required to identify the precise cause of the problem.

To Help Prevent Impotence

What Are the Physical Causes of Impotence? 

Physical impotence occurs when there is a problem with any of the systems needed to get or maintain an erection. The good news is that potency can usually be restored when a man is treated for underlying medical conditions, when medications are adjusted or when lifestyle habits are changed.

Here are some of the top causes of impotence:

What Are the Psychological Causes of Impotence?

A man who is depressed, under stress, or worried about his "performance" during sex may not be able to have an erection. Qualified therapists or counselors who specialize in the treatment of sexual problems can often help diagnose and sort through these problems. Some impotence problems can be solved when a man understands the normal changes of aging and how to adapt to them. For example, as men get older they generally need more direct stimulation to achieve an erection. They may also have less firm erections, take longer to ejaculate and need more time between erections.

Aging and Impotence

Level of Impotence (%)
Age
Complete
Moderate
Minimal
None
40
5
17
17
61
45
7
21
17
56
50
8
23
17
52
55
10
26
17
47
60
12
28
18
43
65
13
32
18
37
70
15
34
18
33

Relationship woes can interfere with potency and so can job stress, depression or financial worries. Impotence may also be the result of deep-seated emotional trauma, such as having been sexually abused as a child. Qualified psychotherapists can diagnose such problems and help men understand and overcome them.

What are the Treatment Options?

When treatment of underlying physical or psychological problems fails to restore potency, a man and his sexual partner can consider one of the following solutions:

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