Impotence:
Erectile dysfunction, sometimes called impotence, refers to a man's consistent inability to get or maintain an erection sufficient to have satisfactory sex. It does not mean a lack of sexual interest or desire or the occasional difficulty achieving or maintaining an erection that affects all men at some time in their life.
Normally, an erection occurs when your imagination or one or more senses (vision, hearing, touch, smell, taste) are stimulated and you become aroused. Your central nervous system sends nerve impulses that increase blood flow to your penis. Four requirements for a normal erection are:
- A properly functioning nervous system that sends the necessary signals to the penis.
- An intact system of blood vessels to allow blood to flow into and out of the penis.
- Normal smooth muscle in the penis, which must relax so the penis can fill with blood and enlarge.
- The ability to trap the blood in the penis so that it stays firm.
See an illustration of the male reproductive system.
Erectile dysfunction can occur at any age but is more common in older men, who often have additional health problems or who may be taking medications that may interfere with normal erectile function. Treatment of erection problems in older men can be as effective as in younger men.
Doctors prefer to use the term erectile dysfunction instead of impotence. A man's sexual function involves more than an erection, and the term impotence often carries negative implications. For ease of reading, this topic uses the term erection problems to refer to erectile dysfunction.
Erection problems can affect your sexual life and your relationship. Discussing the issue with your partner and exploring other forms of intimacy can help improve your relationship and the erection problem.
What causes erection problems?
The cause of erection problems may be physical (such as injury to nerves or loss of blood supply to the penis) or psychological (such as anxiety or depression). Medications you are taking for other conditions, alcohol consumption, smoking, or illegal drug use also can cause erection problems.
Certain conditions may affect the nervous system or blood flow to the penis, increasing the risk for erection problems. These include diabetes, high blood pressure, high cholesterol, atherosclerosis, multiple sclerosis, and Parkinson's disease.
What are the symptoms?
The only symptom of an erection problem is the inability to have or maintain an erection that is firm enough to consistently have sexual intercourse. This inability may or may not be related to sexual interest or the ability to have an orgasm and to ejaculate.
How are erection problems diagnosed?
A health professional can diagnose an erection problem using a medical and sexual history and a physical examination. Your health professional will want to know whether the erection problem occurs all the time or occasionally. The initial exam, laboratory tests, and possibly psychological tests can help determine whether the problem is physical, psychological, or a combination of the two.
How are they treated?
Treatment often includes lifestyle changes, such as avoiding tobacco, drugs, and alcohol. Discussing the issue with your partner, participating in sensual exercises, and seeking counseling may help. Further treatment may include oral medications (such as Viagra, Levitra, or Cialis), vacuum devices, or injection of medications into the penis. Surgery to place an implant in the penis also is an option.
Do not take Viagra, Levitra, or Cialis if you are taking nitrate medications—such as nitroglycerin—for heart problems. The combination of nitrates and any of these medications can lower your blood pressure to a dangerous level. You also should not take certain alpha-blockers (used to lower blood pressure and to treat an enlarged prostate) with these medications because of the risk of a dangerous drop in blood pressure. Check with your health professional to see whether you can take Viagra, Levitra, or Cialis with your alpha-blocker.
Can I prevent erection problems?
To reduce your risk of developing an erection problem, avoid smoking, drinking too much alcohol, and using illegal drugs.
Because erection difficulties are most often caused by a physical problem, maintaining good health through diet and exercise is very important. A relaxed approach to lovemaking and good communication with your partner can help prevent erection problems caused by psychological factors.
