Impotence – Causes & Treatments

A lot of good information and help for impotence is available to people who need it. The popularity of recent treatment has also helped remove some of the stigma associated with discussing impotence as more people realize it is often treatable at all ages.

Keeping in mind that there is usually an underlying physical condition that explains impotence, one’s doctor may be the best person to seek advice from. A doctor can determine whether an underlying physical condition, lifestyle factors, a prescription drug side effect, a psychological factor, or some combination of these is responsible for the impotence. He or she does this by taking a detailed personal and medical history, performing a physical examination, making a psychological evaluation, and running laboratory tests if necessary.

This information is then used to plan the best treatment. Urologists, or doctors who specialize in diseases of the urinary tract, are usually the ones who provide such treatment. A gynecologist, often in consultation with an urologist, may treat female sexual dysfunction.

Counseling can be tremendously helpful, particularly for psychological impotence. Counseling may help couples improve communication skills and communicate their sexual needs better, or provide practical tips for making sex physically fulfilling to both partners. If someone has suffered from abuse or post-traumatic stress disorder, counseling can help inculcate coping skills. People whose impotence is linked to depression, anxiety or stress can also benefit from counseling by a skilled professional and guidance on treatment that may offer relief for both the underlying psychological condition and for impotence.

There are several free and reliable sources on the Internet such as the American Urological Association website, that provide detailed information on the causes and treatment of impotence. These sources may be useful for both the person suffering from impotence and their sexual partner.

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.