Impotence or Erectile Dysfunction is defined as the inability to achieve or maintain an erection sufficient for mutually satisfying intercourse. The incidence of impotence correlates with an individuals age impotence effects some 67% of men by the age of 70 years old. Impotence impacts more than a man's sexual activity. The emotions and uncertainties that coincide with this condition often have a significant effect on a man's self-esteem, as well as, his relationship with his partner. Although the incidence of impotence increases with age, it is not an inevitable result of aging. Impotence causes may be a secondary condition linked to many medical conditions.
Understanding the Cause of Impotence
The first step in treating impotence is that you understand the different causes of impotence including the psychology, physiology and anatomy responsible for the ability to achieve and maintain an erection. If you can comprehend the cause of impotence than we you can better understand the factors that are responsible for impotence and address the questions concerning male impotence treatment.
Impotence
causes can now
Normal Erectile Function
For something that appears so natural, an erection is a rather complicated process involving the coordination of the psychological, neurological and cardiovascular systems. The penis becomes erect following a series of events if any of these systems are compromised then impotence may prevail. In the normal erection process without impotence symptoms, first, the nerves are stimulated, a sensation known as arousal.
Next no matter what the nature of the stimulus, visual, mental or physical the brain coordinates the following series of events:
Nerve
impulses transverse the length of the spinal cord to the pudendal
nerve and on to the penis. Smooth muscle within the walls of the
penile arteries respond by relaxing. Subsequently, the penile arteries
dilate allowing up to eight times more blood to flow into the corpora
cavernosum, (two parallel cylinders that transverse the length of the
penis).
The
cavernosum become engorged with blood expanding and lengthening the
penis. The expanding tissue then exerts a positive pressure
compressing the veins that normally empty the blood from the penis,
maintaining the blood in the penile tissue. When ejaculation occurs or
when arousal is discontinued the penis returns to its non-erect state.
Historically, when you consulted your doctor concerning impotence you were usually informed there were no known physiological answers concerning his condition. Today, a generation of research has resulted in significant advances in both the diagnosis and treatment of impotence . Doctor now understand that approximately 85% of impotence is caused by physical/organic conditions while only 15% is due to psychological or mixed origin (both psychological and organic). Some important causes of physiological impotence are as follows:
Impotence Caused By Vascular Disease
Vascular
Disease is the leading cause of impotence. Vascular disorders include
arteriosclerosis (hardening of the arteries), hypertension, hyper-cholestremia
and other conditions which interfere with the blood flow to the penis.
Additionally, "venous leakage", a condition occurring when the penile
veins are unable to constrict efficiently during an erection, also
contributes to poor erections. When these veins "leak", blood escapes
to the periphery resulting in a poor erection.
Impotence Caused By Diabetes - is another common cause of impotence. Approximately 50% of men with insulin dependent diabetes experience some degree of impotence after 55 years old. Diabetes results in poor circulation and/or peripheral neuropathy. When the nerves are involved, sexual stimuli are not transmitted appropriately to or from the brain and impotence develops.
Impotence Caused By Neurological Diseases - such as multiple sclerosis, Parkinson's disease, spinal cord injuries and long term effects of diabetes can also result in impotence causes.
Impotence Caused By Endocrine System
Deficiencies in the Endocrine System are another cause of impotence.
Low levels of testosterone or thyroid hormone can interfere with the
stimulation process necessary in the erection sequence. Excessive
production of prolactin by the pituitary gland may contribute to
decreased levels of testosterone resulting in a lack of desire.
Diabetes once again enters the scenario as it is classified as an
endocrine disorder.
Prescription medications - often cause impotence as a side effect. Some two hundred known medications fall into this category including:
Impotence Caused By Anti-hypertensives Medications:
Beta-blockers
e.g. Atenolol, Propanolol and Tenorium.
Diuretics
medications e.g. HydroDiuril and Lasix.
Ace
Inhibitors/Calcium Channel Blockers medications e.g. Vasotec®,
Lotension®, Cardizem® and Norvasc® periodically cause Erectile
Dysfunction , however, they are generally represent an excellent
alternative medication for individuals with drug induced Erectile
Dysfunction.
Impotence Caused By Antidepressant/Antipsychotic Medications
-of almost any label can also result in impotence e.g. Prozac®,
Elavil®, Zoloft®, Thorazine® and Haldol®. Note: Many other
medications in a variety of classes can periodically cause
impotence. If you take a prescription medication or an
over-the-counter medication, regularly, please consult with your
physician.
However, never alter a dosage or discontinue a medication without
the advice of your physician.
Impotence Caused By Smoking
Smoking as been linked as an impotence cause in numerous clinical studies.
The most common causes of the organic component of impotence are vascular abnormalities associated with atherosclerosis and diabetes mellitus. Atherosclerosis causes 40% of cases of impotence, and in cases of diabetes mellitus the prevalence of impotence is 50%. Smoking is significantly associated with the development of both atherosclerosis and diabetes mellitus.
The Epidemiology and Pathophysiology
of Impotence.
The Journal of Urology 1999 Jan; 161(1):5-11
After smoking two cigarettes, the diameter of the internal pudendal artery narrows and the penile arteries almost completely close. This evidence suggests that smoking can cause an acute vasospastic constriction of the arteries in the penis. These observations are supported by physiological evidence that nicotine causes acute peripheral vasoconstriction. Acute Vasospasm of Penile Arteries in Response to Cigarette Smoking. Urology 1990; 36(1):99-100
Research
has shown that male smokers who suffer from long standing
hypertension are 26 times more likely to be impotent than those
individuals who do not smoke. January 2000, The Journal of Family
Practice.
Aside from impotence, smoking as also been linked to the
following negative effect concerning male sexual health:
Reduced
volume of ejaculation
Lowered
sperm count
Abnormal
sperm shape
Impaired
sperm motility
Impotence Caused By LH-RH Analogs/Antiandrogen Medications
- e.g. Lupron Depot®, Eulexin®, Nilandron®, Casodex®, etc. are
medications are used in the treatment of prostate cancer. They
function by decreasing the production of testosterone in the
testes and adrennal glands, which decrease in testosterone often
results in impotence.
Impotence Caused By Chemotherapy/Radiation therapy - is also a significant contributors to impotence. These drugs/treatments are used in the treatment of cancer.
Impotence Caused By Substance Abuse - can also negatively effect male potency. The chronic use of cocaine, marijuana, alcohol, steroids etc. often results in impotence, as well as a decrease in desire. Excessive tobacco use can also attribute to impotence by accentuating the effects of other risk factor such as vascular disease or hypertension.
Impotence Caused By Radical Pelvic Surgery - also result in impotence. Surgical procedures involving the prostate gland, bladder or colon may interfere with the nerves involved in the erectile response. Radiation therapy for cancer may also effect the erectile process.
Psychological Causes Of Impotence - is usually diagnosed when no physical causes can be defined. Pure psychological impotence usually occurs suddenly without warning as opposed to physical impotence that may gradually develop over the years.
Some common psychological causes of impotence are as follows:
Performance
anxiety - is one of the most common causes of psychological
impotence. When a man feels pressured to achieve or maintain an
erection, he will commonly become anxious and nervous when in a
sexually demanding situation.
Stress
- increases the body's production of catecholamines such as
adrenaline and nor- adrenaline, which act as erection inhibitors.
The release of these inhibitors further contributes to failure
resulting in more anxiety. Therefore, the cycle begins, increased
stress resulting in increased catecholomines that further inhibits
the erectile process.
Depression
- is another cause of psychogenic impotence. Unfortunately, many of
the popular antidepressant medications (for a list see prescription
medications in the next section) have side effects which include
erectile failure.
Impotence Caused By Anatomical Deviation of the Penis
Anatomical Deviation of the Penis, known as Peyronie's Disease, may also cause impotence. This condition usually develops from an inflammatory process and results in fibrous scaring of the penis. The cause of this process is not yet understood; however, when an erection does occur, there is a bending of the penis secondary to the scar tissue. This curvature may interfere with erectile capacity and/or ejaculation.
Fortunately, there are now very effective treatment options for the
various impotence causes for the latest in impotence treatment options
(click here for details).