Impotence – Causes & Treatments

There are a number of drugs available for the treatment of impotence. They can be taken by mouth, injected into the side of the penis, or inserted into the male urethra. Impotence drugs should only be taken as prescribed by a physician. It is important to understand who can take these drugs safely and who should avoid them.

Viagra, Cialis, and Levitra are the brand names of some commonly prescribed oral impotence drugs. They all act by relaxing the smooth muscles in the penis, thereby increasing blood flow into the penis during sexual stimulation. While Viagra has been used the longest and has the most safety data available, all three drugs are safe and comparable in efficacy.

Cialis has the longest duration of action, up to 48 hours, and has been nicknamed the ‘weekender’. These drugs should never be taken with nitrates, a group of drugs used to treat heart disease, as drug interactions can result in a dangerous drop in blood pressure. There are a number of conditions in which taking any of these drugs is contraindicated. Some common side effects such as headaches, flushing, diarrhea, and a stuffy nose may be experienced with any of these drugs. Labels for all three drugs are currently being modified to add nonarteritic ischemic optic neuropathy, a condition in which blood flow to the optic nerve is blocked resulting in vision loss as a rare side effect.

Alprostadil (Caverject), papaverine (Pavabid), and phentolamine (Regitine) can be injected into the side of the penis with a tiny needle. These drugs act by increasing blood flow into the penis, and their dosage can be varied depending on how long they are required to act. The MUSE, or medicated urethral system for erections, involves the application of a small pellet containing alprostadil into the tip of the urethra.

Mental stimulation plays a major role in sex, both in its overall enjoyment and in mediating the physiological pathways of arousal. There are a number of reasons for psychological impotence. Often, stress or exhaustion may be possible explanations for impotence. Anxiety, depression, or post-traumatic stress disorder also may result in impotence, as can a history of sexual or physical abuse. Guilt associated with a sexual relationship or encounter or problems in a relationship may also contribute. One often-overlooked reason for psychological impotence is confusion over one’s sexual identity.

Unfortunately, most people are unaware that the vast majority of impotence cases are the result of an underlying physical disorder. If someone is unaware of this disorder, anxiety and stress may build up over a period of time to worsen impotence and in turn cause more stress. It is therefore always a good idea to rule out a physical explanation for impotence before evaluating psychological reasons. For many people, psychological impotence may be situational or only with a certain sex partner. It is important to differentiate between situational and ongoing psychological impotence, as the approaches taken in treating these may be very different.

A person suffering from true psychological impotence may benefit greatly from counseling. This may help identify if the underlying reason can be removed or its effect reduced through appropriate treatment. For example, people suffering from depression or anxiety may need treatment to improve their condition. People who have suffered from post-traumatic stress disorder or abuse may need counseling on coping skills and may also be depressed. For those whose impotence is worsened because they don’t understand the physical condition that’s causing it, a simple explanation of the underlying condition and reassurance that impotence is treatable may suffice. An evaluation of psychological impotence should assess the person’s sexual identity, as confusion in this area may be the cause.