Impotence – Causes & Treatments

Impotence falls into two broad categories, impotence caused by a physical condition and that caused by a psychological condition. Sometimes impotence due to a physical condition may be worsened by a psychological component. The treatment of impotence should always include treatment of the underlying cause as well.

Impotence may be treated with counseling, drugs, surgery, mechanical aids, or some combination of these. Psychological impotence lends itself best to counseling, though anyone with impotence can benefit from counseling on coping mechanisms and available treatment options. As far as drugs go, some drugs may cause impotence and replacing or removing them from an individual’s treatment plan may take care of the problem. If testosterone deficiency is the cause, replacement therapy can be started. Some drugs such as Viagra and Cialis, can be taken by mouth and act by relaxing smooth muscle in blood vessels, allowing them to carry more blood to the penis. Other drugs that also relax smooth muscle in blood vessels can be injected into the side of the penis with a tiny needle, or inserted into the tip of the male urethra in pellet form using a special applicator.

Surgical treatment options for impotence include different types of penile implants, surgery to slow down the flow of blood out of the penis, and surgery to improve the flow of blood into the penis. In some people, the use of a vacuum device or a penile splint may help the penis stay upright.

There are several lifestyle changes that may both treat impotence and prevent it. These include quitting smoking, losing weight, being physically active, treating high blood pressure and high cholesterol, and reducing stress. Besides improving sex drive and the ability to enjoy sexual intercourse, such changes can also help improve other underlying medical conditions.

Impotence may have a physical, lifestyle, or psychological cause. An underlying medical condition is the most common cause of impotence. Such conditions may interfere with the blood supply to the penis, the generation of nerve impulses involved in getting and maintaining an erection.

Some medical conditions that commonly cause impotence include diabetes, cardiovascular disease, atherosclerosis, or the hardening of the arteries, kidney disease, and diseases affecting the nervous system. Diabetes causes damage to both blood vessels and nerves. Cardiovascular and other vascular diseases reduce the flow of blood to the penis, and the veins that remove blood from the engorged penis may be leaky. Kidney disease may cause impotence through chemical changes that affect circulating hormones, blood supply, nerves and overall energy. Conditions that affect the brain or nerves, such as stroke, Alzheimer’s disease, or multiple sclerosis may all interfere with the flow of nerve impulses that are needed for an erection.

Besides medical conditions, surgery that involves the bladder or prostate and pelvic and spinal cord injuries may affect nerves supplying the penis or involved in maintaining an erection. Certain hormonal imbalances such as low testosterone levels can also cause impotence and several types of prescription drugs can cause impotence as a side effect.

Lifestyle factors implicated in impotence are lack of physical exercise, being overweight, and the use of alcohol, smoking and illegal drugs. Alcohol and tobacco cause damage to blood vessels and nerves. Lifestyle factors may exist alone or be accompanied by psychological factors such as depression.

Psychological causes of impotence include stress, anxiety, depression, or guilt. Sometimes, people who have been physically or sexually abused may suffer from psychological impotence. Another cause of psychological impotence is confusion about one’s sexual identity. Often, someone with an underlying physical condition may also be depressed or anxious, adding to the combination of factors causing impotence.