Reasons For Impotence
There are various reasons for male impotence or erectile
dysfunction. Below is a quick list of reasons and pointers. It
is important to know what type of ED you may be suffering from
to know which treatment is right for you. * What is erectile
dysfunction? * Ageing * Phsycological reasons o Psychological
causes of ED * Physical causes of ED o Diabetes o High blood
pressure o Hormones o Other physical causes of ED What is
erectile dysfunction? The definition of impotence or erectile
dysfunction (ED) is the inability to achieve or maintain an
erection sufficient to achieve the kind of sex desired. The
Erection is a complex process with many psychological and
physical aspects. Therefore there are many ways in which ED can
be caused. As a result ED is one of the commonest forms of
sexual problem a man can have. ED is one of the most common male
sexual problems, with over 50 per cent of men bewteen 40 and 70
years old experiencing it to some degree. To read more about ED
click here Aging Age is a factor that increases the likelihood
of ED - 5 per cent of men aged 40 report complete inability to
obtain a satisfactory erection compared to 15 per cent at age
70. Many men therefore wrongly accept ED as a normal part of the
ageing process and the majority of men with ED do not seek or
receive adequate advice or treatment for ED.
Phsycological reasons It's now known that psychological reasons
alone account for about a third of ED cases, with the rest being
due to physical conditions or, much more frequently, to a
combination of physical and psychological causes. As ED commonly
gives rise to anxiety in men and can be a cause of stress in a
relationship it is probably true to say that all men with ED
have some degree of psychological component to their condition.
Fortunately both the public and the medical profession have
become better informed about ED, particularly in the past few
years because of the recent appearance of far better treatments.
Psychological causes of ED The presence of ED, for any reason,
will almost always cause some worry or anxiety in a man about
his ability to have sex, which in turn will make it more
difficult to get an erection next time - and so on.
This 'performance anxiety' is a common cause of temporary ED and
there can be very few sexually active men who have never
experienced it in their lives. Being aware of this vicious
circle and taking a more relaxed approach to sex will often
defuse the anxiety. If sex is only seen as the achievement of
penetrative intercourse, and a failure if that doesn't happen,
then it can be pretty certain that anxiety-related ED will keep
on happening.
Other commonly found psychological causes of ED include: *
relationship difficulties. These may result in ED, or vice
versa. Usually both co-exist. * unresolved gay feelings or other
hang-ups focussed on sex. * bereavement and depression. *
tiredness. * stress. Human beings are complex and don't usually
fall into neat categories. Someone who is depressed might also
for example be drinking too much alcohol , which in turn can
cause or worsen ED. The depression might be secondary to some
other condition or come directly from having ED and not knowing
where to go for help, or knowing that ED is treatable.
ED is however highly treatable and there are a range of methods
including medication, counselling, physical devices and surgery.
See ' Treatments for erectile dysfunction ' for a fuller
explanation of what is available.
It is clear from the many surveys that have been done on
erectile dysfunction that it is: * common * gives rise to much
stress and difficulty both at a personal and a relationship
level * under-diagnosed and under-treated. Some of the problems
lie in embarrassment about talking about ED or a feeling that ED
is not a 'valid' or 'proper' medical condition, despite the
obvious truth that the reverse is the case.
Although we have moved in the right direction concerning ED over
the past couple of decades we still have a bit to go before it
becomes a subject that everyone will necessarily feel able to
discuss openly even with their own partner or doctor . That said
however we have already reached a stage when effective treatment
for ED is available, and more men need to avail themselves of
it. Physical causes of ED The various biological processes
involved in an erection are explained in the factsheet on the
physiology of erection but in brief, erection occurs in response
to signals from the brain. The erectile tissue in the penis
consists of two cylinders of sponge-like material, largely
composed of muscle fibres, When the penis is flaccid, these
fibres are contracted and the sponge is 'wrung out'. When
pro-erectile signals arrive from the brain, the muscle fibres
relax and the sponge fills with blood, compressing the veins
that normally drain blood back out of the penis. As a result,
the penis expands and becomes rigid. Following ejaculation or
the withdrawal of sexual stimulation, a change in the signalling
from the brain causes the muscle fibres within the spongy tissue
to contract again, the draining veins open up, the pressure
within the penis falls and it once more becomes relaxed or
flaccid.
For all this to happen there needs to be an intact system of
nerves and blood vessels to the penis as well as connections
within the spinal cord between the nerves that are connected
with the penis and the higher centres in the brain. Conditions
that affect either the nerves or the blood vessels are therefore
also a common cause of ED. Diabetes Diabetes is the condition in
which the level of blood glucose (sugar) is too high and for
reasons that are not completely understood a high glucose level,
if present for years, can damage the function of muscle fibres
within blood vessles and vascular tissues, including the
erectile tissue of the penis, and of the small nerves and
arteries throughout the body. Thus ED can affect many men with
diabetes, with some studies reporting that up to 60 per cent of
diabetic men will eventually develop the problem. Although the
chances of this occurring are reduced by good treatment of the
diabetes they cannot be reduced to zero. A further and
increasingly common problem is that the type of diabetes
commoner in older people (called Type 2 or non-insulin dependent
diabetes) can be accompanied by relatively few symptoms in the
early stages, which mean that many people with Type 2 diabetes
already show some damage to the nerves and arteries by the time
they have their diabetes diagnosed. In the Massachusetts study
28 per cent of treated diabetic patients had complete ED. High
blood pressure People with high blood pressure are more likely
than average to develop 'hardening of the arteries'. The medical
term for this is atherosclerosis (or arteriosclerosis). In
atherosclerosis the arteries throughout the body tend to develop
thicker walls and become narrower inside, so reducing the flow
of blood through them. If this develops in the arteries going to
the penis then it will be more difficult for the penis to fill
with blood and so ED may result.
Smoking is the other major factor that increases the chance of
atherosclerosis developing and smokers have an increased risk of
developing ED.
Many of the medicines used to treat high blood pressure might
also cause ED as a side effect, particularly those called
diuretics (water pills) and beta-blockers. High blood pressure
is however a very important problem that needs to be treated
too, and it is essential never to stop taking prescribed
medication for it (or any other condition) without discussing
the matter with your doctor. Many men who think that they have
ED as a side effect of the drugs they are taking do not mention
the problem to their doctor, who in turn may omit to ask if ED
is happening.
It is therefore important to mention ED either before your start
taking treatment for high blood pressure, or if it develops
after you have been given medication for it, as quite often a
medication change will be possible and cause fewer side effects.
Hormones Testosterone is important in the development of the
unborn male foetus and in the growth and development of the
genitals and other sexual characteristics around puberty. In the
mature man, it plays a role in maintaining sexual desire and
affects nerve signalling within the brain and nervous system.
However, a lack of testosterone alone is only very rarely the
cause of ED. In such cases, the man will usually notice a marked
reduction in sexual desire and an absence of night-time or early
morning erections. However, this has not stopped testosterone
being widely promoted as a treatment for ED and a range of other
conditions by unscrupulous or poorly informed (or both) outlets.
The Internet allows such uncontrolled advertising on a wide
scale and anyone who uses email regularly will probably be
familiar with unsolicited 'spam' messages promoting this type of
treatment and its availability by mail order. Taking unnecessary
testosterone is potentially harmful - it can adversely affect
cholesterol levels or accelerate the growth of a pre-existing
prostate cancer for example, so should be strictly avoided. Your
doctor can check whether a lack of testosterone is a problem.
Other physical causes of ED Any condition in which the nerve or
blood supply to the penis is damaged can potentially cause ED so
it can arise, for example, following prostate surgery or after
some types of prostate cancer treatment. It could also possibly
occur after injury to the genital area or pelvis. Surgery to the
lower abdomen (within the pelvis) can carry the risk of
unavoidable damage to these nerves.
Multiple sclerosis is a disease of the nervous system in which
the function of many nerves throughout the body can become
impaired, usually over the course of many years. Spina bifida
can also cause ED, although this will have been a lifelong
problem if it were the sole cause. Spinal cord injury, renal
transplantation and renal failure are also possible causes of
ED.
Polio, Parkinson's disease, and single gene neurological
disorders are conditions that are unlikely to cause ED but are
relevant as they are listed as conditions in the presence of
which the National Health Service will allow GP prescription of
certain ED treatments.