Impotence is a condition where a man cannot get or maintain an erection that is hard enough to have satisfactory intercourse for a long time. An impotent person might not have erection at all or may lose erection during intercourse before you are completely satiated. Erectile dysfunction not only damages your self-esteem but also degrades your relationship with your partner. This problem is common in adult men. Erectile problems might not be persistent, but if you have trouble in having erections more than 30 % of the time, then it is the case of impotence. Usually impotence is confused with premature ejaculation (having orgasm too quickly) and infertility (inability to produce sperms that can fertilize an egg). However, all these three are different issues and need different treatments. Earlier impotence was thought to be purely psychological. But now it has been found that physical problems are usually the main causative agent of impotence. A person having morning erections or 3-4 night time erections each lasting up to 30 minutes is an indicator of psychological cause.
An erection involves the central nervous system, the brain, blood vessels, hormones and the penis. When there is a problem with the normal functioning of any of these parts, erectile problems might be generated. Causes of impotence could be mental or physical. Physical cause is common in aged men (50 and above). Psychological causes are more common in younger men.
Physical causes of impotence include nerve damage from prostate surgery, spinal injury, excessive use of alcohol, nicotine, drugs such as cocaine, severe pelvic injury, renal failure and dialysis, spinal bifida, prostectomy, side-effects of certain medications (sleeping pills, heart medications, peptic ulcer medications, antidepressants, blood pressure medications etc.), nervous system diseases (such as parkinson's disease), poor blood flow, heart or thyroid problems, diabetes and high blood pressure etc. Low level of testosterone could also cause impotence.
Psychological causes include anxiety, fear, doubt, failure, poor communication with partner, unrealistic sexual expectations etc.
As impotence problem has similar symptoms to most other genital problems, specialized tests are done to confirm the condition. They include blood tests (PSA, hormone profile, complete blood count, metabolic panel), urine analysis, psychometric testing, rigidity monitoring, penile ultrasound to check for blood flow problems, NPT to check for night tome erections, nerve testing etc.
Treatment methods for Impotence:
Oral Erection-aiding medications:
Three common pills comprising of phosphodiesterase-5 inhibitors are usually prescribed by the doctors: Viagra tablets, levitra tablets and Cialis tablets. They start their effect within 15 to 30 minutes and are widely used. However it is imperative to consult a doctor before consuming these pills as they may react with other pills comprising of nitroglycerine leading to muscle pain, heart attack etc. People with uncontrollably high blood pressure, uncontrollable diabetes and people with recent heart attack or stroke should refrain from consuming these pills.
A small pellet containing a medicine called alprostadil is placed near the urethral opening or near the penile opening. The medicine gets inserted into the urethra or the penis and improves blood to the penis within 10 minutes. This works better than oral medications.
A vacuum pump is a plastic cylinder associated with a pump that you put over the penis and suck out the air in the cylinder. This pulls blood rapidly to the penis. Thus the penis is sucked into an erection. Thereafter a special rubber band is used to retain the erection during sexual intercourse. The erection may last till the band is removed (which must be removed within 25-30 minutes).
In case of people with low testosterone levels, using skin patches or injections into the muscle could be beneficial for treating impotence.
Rings are specially designed structures that are used to prevent the blood from coming out of the penis. A ring is usually used in association with a vacuum pump and is placed around the base of the penis.
If the cause of impotence is venous leaks, the leak position can be identified with X-ray imaging. Then suraerv could be done by an uroloaist to seal the leak. In case of other reasons, internal splints (firm rods).