Male Erectile Dysfunction / Impotence

It's been a hushed subject for years. Men won't even talk about it with their best friends,
much less their doctor. They think that they have some sort of mental or emotional
problem preventing them from successfully engaging in sexual intercourse.

The male withdraws from close contact with his partner, and figures he just has to live
with this problem. And his partner begins to think that she no longer excites him, and
maybe even that he's found someone else to satisfy his sexual desires.

She thinks it's her fault, and feels that their relationship is slowly falling apart. Does this
sound familiar? It accurately describes many situations. But it doesn't have to apply to yours.

In recent years, medical breakthroughs have changed what was once thought to be a
hopeless situation into an environment in which men have numerous options to
address their secret problem.


What is Impotence?

Impotence is a consistent inability to sustain an erection sufficient for sexual
intercourse. Medical professionals use the term "erectile dysfunction" to describe this
disorder, and to differentiate it from other things that can interfere with intercourse,
such as lack of sexual desire and problems with ejaculation and orgasm.

It can be a total inability to achieve erection, and inconsistent ability to do so, or a
tendency to sustain only brief erections. Impotence usually has a physical cause, such
as disease, injury, or drug side effects.

Any disorder that impairs blood flow in the penis has the potential to cause impotence.
There are many common causes of impotence, and diagnosis is painless. What's so
exciting is that there are proven treatments to help. Some of those treatments involve
new drugs, like Viagra, mechanical devices, or even implants.

Your physician --either through our online consultations service--or off-line can help
determine the approach that is most comfortable and appropriate for you. What are the
typical causes of impotence?


What cause Impotence?

An erection requires a sequence of events, and impotence can occur when any of the
events is disrupted. The sequence includes nerve impulses in the brain, spinal column,
and area of the penis, and response in muscles, fibrous tissues, veins, and arteries in
and near the corpora cavernosa, a chamber in the penis that holds blood during an
erection.

Damage to arteries, smooth muscles, and fibrous tissues, often as a result of disease, is
the most common cause of impotence. Diseases -- including diabetes, kidney disease,
chronic alcoholism, multiple sclerosis, atherosclerosis, and vascular disease -- account
for about 70% of impotence cases.

Other causes include: Overeating and drinking, which diverts blood to the
gastrointestinal organs Extreme fatigue Side effects of many common medicines, such
as high blood pressure drugs, antihistamines, antidepressants, tranquilizers, and
appetite suppressants Alcohol and drug abuse.

Surgery which injures nerves and arteries near the penis, such as prostate surgery Low
levels of the male hormone testosterone


What are the Treatments?

Sex counselling or sex therapy can be effective for the small percentage of men who have psychological
impotence. Counselling or therapy is most often successful when you have a cooperative partner willing to
attend sessions with you.

Yohimbine is an oral medication that can improve erections in the very small percentage of men who do not
have significant physical causes for their impotence.The effect of Yohimbine has never been scientifically
proven to be anything other than the placebo effect.

Hormone replacement therapy, in the form of testosterone injections, can be effective for the 3-5% of men
who are impotent due to a low level of male hormone.

Drugs for treating impotence can be taken orally, injected directly into the penis, or
inserted into the urethra at the tip of the penis. In March, 1998 the Food and Drug
Administration approved the first oral medication to treat impotence, marketed as
Viagra. Viagra enhances the relaxation of smooth muscles in the penis during sexual
stimulation, allowing increased blood flow.

While it improves the response to sexual stimulation, it does not trigger an automatic
erection as injection drugs do. Other drugs may also be effective. Oral testosterone can
reduce impotence in some men with low levels of this hormone. Many men gain
potency by injecting drugs into the penis, causing it to become engorged with blood.
Several drugs, included one marketed as Caverject, widen blood vessels.

There may be unwanted side effects, however, including persistent erection and
scarring. A system for inserting a pellet of a drug into the urethra, marketed as MUSE,
delivers the pellet about an inch into the urethra at the tip of the penis.

An erection will begin within 8 to 10 minutes, and may last 30 to 60 minutes. As with any
drug, there may be side effects. Vacuum Devices Mechanical vacuum devices cause
erection by creating a partial vacuum around the penis. This draws blood into the penis,
engorging it and expanding it. A cylinder is placed over the penis, a pump draws air out
of the cylinder, and an elastic band is placed around the base of the penis to maintain
the erection after the cylinder is removed and to prevent blood from flowing back into
the body during intercourse.


What are Some Other Treatments?

Surgery usually has one of three goals: To implant a device that can cause the penis to
become erect To reconstruct arteries to increase flow of blood to the penis To block
veins that allow blood to leak from the penile tissues Implanted devices can restore
erection in many men with impotence.

Malleable implants usually consist of paired rods that are inserted surgically into the
corpora cavernosa, the twin chambers running the length of the penis. The user
manually adjusts the position of the penis and, therefore, the rods. Adjustment doesn't
affect the width or length of the penis. Inflatable implants consist of paired cylinders that
are surgically inserted inside the penis and can be expanded using pressurized fluid.

Tubes connect the cylinders to a fluid reservoir and pump, also surgically implanted.
The user inflates the cylinders by pressing on the small pump, located under the skin in
the scrotum. These implants can somewhat expand the length and width of the penis.

Surgery to repair arteries can reduce impotence caused by obstructions that block the
flow of blood to the penis. Surgery to veins that allow blood to leave the penis usually
involves and opposite procedure-intentional blockage. Blocking off veins can reduce
the leakage of blood that diminishes rigidity of the penis during erection.