What is Impotence?

When a man cannot sustain an erection long enough to have sex, or cannot have an erection at all, he is suffering from male impotence. Also known as erectile dysfunction, it affects over 15 million men each year in the United States. Men in their 40s may suffer an occasional incident of impotence, and in most cases, it is only a temporary condition. Impotence is sometimes caused by emotional or relationship problems, but if symptoms continue, you should make an appointment with your physician. Impotence treatment options will be explained to you by your physician, who can determine if it is being caused by psychological or physiological conditions.

When a man is suffering from male impotence, it may cause emotional pain and issues between him and his sexual partner. If left untreated, not only can it cause physical complications, but self-esteem problems as well. It is only natural to not want to discuss sexual problems with your partner or your physician, but open communication is the key to finding an impotence cure that works for you.

What are the causes of Impotence?

When an erection begins, the man's penis becomes filled with blood as blood vessels are enlarged to allow for an increased flow. Impotence, or erectile dysfunction, can sometimes occur when the erection process is interrupted. For an erection to take place, a precise series of events occur, which begin with nerve impulses in the brain, spinal column and in the area surrounding the penis itself. As those nerve impulses begin to signal interest in sexual activity, the muscles, fibrous tissues, veins and articles respond and an erection takes place. However, if any of those signals are disrupted, it can result in erectile dysfunction instead of an erection.

In some cases, impotence may be caused by a disease, such as diabetes, kidney disease, multiple sclerosis, vascular disease, chronic alcoholism, or neurologic disease. Other possible causes of male impotence include recent surgery, especially radical prostate or bladder surgery for cancer. If any areas surrounding the penis were injured during surgery, problems with erectile dysfunction could result.

Injury to the penis, spinal cord, prostate, bladder and pelvis can lead to erectile dysfunction by harming nerves, smooth muscles, arteries and fibrous tissues of the area around the penis.

Another common cause of male impotence are problems associated with prescription drugs that affect nerve centers. Blood pressure medication, antidepressants, antihistamines, tranquilizers and other prescription drugs can produce erectile dysfunction in men. In still other cases, the cause may be attributed to psychological factors, including stress, anxiety, guilt, depression, low self-esteem, or even fear of sexual failure.

Male impotence can also be caused by problems with the prostate, including an enlarged prostate, a prostate infection or prostate cancer. Every year, more than 2 million American men are diagnosed with prostatitis, a term that means "inflammation of the prostate." A few men with prostatitis have clear signs of a bacterial infection of the prostate. Doctors call this condition bacterial prostatitis. In roughly 90 to 95 percent of cases of prostatitis, however, there's no clear sign of infection. Doctors call this chronic nonbacterial prostatitis or chronic pelvic pain syndrome. Sometimes men suffering from prostate problems will have difficulty getting and sustaining an erection.

What are the symptoms of Impotence?

If a man begins to feel sexually aroused, but is unable to have an erection, or he is able to get an erection, but cannot complete sexual intercourse, he is exhibiting one of the main symptoms of male impotence, or erectile dysfunction. When these symptoms only occur once in a while, there is no cause for alarm. However, if the symptoms persist, then a physician should be consulted.

How is Impotence diagnosed or evaluated?

If you suspect you may be suffering from impotence, or erectile dysfunction, your physician can conduct a series of exams and tests to determine if that is the cause of your erection difficulties. The physician will begin by reviewing both your medical and sexual history. It is important to be honest with your physician, no matter how embarrassed you feel talking about the subject. Your physician is there to help you, so make sure you give all of the facts. For example, you may have problems associated with your sexual desires, your ability to maintain an erection, ejaculation or orgasm. Your physician will also review any other medical conditions that you may have that might be the cause of your male impotence, or erectile dysfunction. Drug interference with a man's ability to have an erection accounts for one-fourth of all male impotence cases.

Your physician will also conduct a physical exam. It is possible that your penis is not responding to touching, which could indicate a problem in the nervous system. In other cases, abnormal secondary sex characteristics, such as hair pattern or breast enlargement, can point to hormonal problems. If this is the case, your physician may suspect that your endocrine system is involved.

If your penis has a slight curve or bends to one side, your erection dysfunction could be the result of Peyronie's disease.

If your physician suspects other causes, lab tests will be ordered to help confirm the diagnosis of erectile dysfunction, or male impotence. Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. If your physician suspects there may be a problem with your prostate, he may collect a sample after massaging the prostate, in addition to a routine urine sample. This special sample will contain secretions from the prostate -- and, perhaps, a few clues to the condition. Among patients with chronic bacterial prostatitis, cultures from the post-massage urine sample may be positive for bacteria. If a patient has chronic nonbacterial prostatitis, the sample will usually have high levels of white blood cells, which are a sign of inflammation.

And finally, if your physician suspects that your erectile dysfunction problem may be psychological, a test, which includes an interview and a questionnaire, will reveal certain psychological factors to help uncover the reason for the problem. In addition, the man's sexual partner may also be interviewed, to help determine sexual expectations and perceptions during intercourse.

What are the treatments and drugs to treat Impotence?

In many cases of impotence, it is a matter of changing blood pressure medication to fix the problem. If other treatments are needed, most physicians will seek treatment ranging from the least invasive to the most invasive. Psychotherapy and behavior modifications may also be considered as a treatment, or, if the case warrants, prescription drugs may be prescribed.

The Food and Drug Administration recently approved several drugs that can assist in most cases of erectile dysfunction. Viagra was approved in 1998, and in 2003, Levitra was allowed on the market, followed by a third medication for erectile dysfunction, Cialis. These drugs work by enhancing the effects of nitric oxide, a chemical that relaxes smooth muscles in the penis during sexual stimulation and allows increased blood flow.