Impotence is the inability of the male to produce an erection and thus have an effective sexual encounter. It is also equated with the term erectile dysfunction, which means the inability to sustain an erection. In fact, it can be said that males with ED are impotent.
Though a man may be impotent, there are ways of remedying the situation and thus enable him to have a healthy sex life. It is treated by first delving into the factors that have caused it, and them giving treatment according to those underlying factors. Several previously impotent men have today become successful fathers owing to the methods of treatment available to them.
Weak erection is biologically called erectile dysfunction or impotence. It is a common male sexual ailment and is more observed in older males than in younger ones. It can be any one of the following two things:-
(i) The man is unable to get an erection at all
(ii) The man gets an erection, but is unable to retain that erection for penetration during sex.
Thus, ED can be both a physiological and a psychological ailment. A person with physiological ED will never have had an erection throughout his life; while a person with psychological erectile dysfunction will have erections, but will not be able to sustain them. In order to understand why some men have weak erections, it is first important to understand how erections occur.
How Do Men Get Erections?
The male organ is an organ that is made up of spongy tissue which runs in a chamber called as the corpus cavernosa. This chamber is surrounded by another chamber called the tunica albuginea. Erection is affected by the brain. When the man is sexually aroused, or when he is stimulated by touching it, then the corpus cavernosa relaxes. This makes the spongy tissues expand as they get filled by blood. Due to this the organ expands, and an erection is obtained.
When the arousal is lost, then the organ becomes flaccid, due to which the inflow and outflow channels of the blood are cut off. This disgorges the blood from the corpus cavernosa, and the erection is lost. A man can get erection within a few seconds spontaneously, and can lose it within a few seconds also. In normal males, (i.e. those who don’t have the problem of weak erections) it becomes hard and remains hard during the entire sexual act, meaning, until orgasm is achieved. Normal males can achieve multiple erections (and thus multiple orgasms) in a single sex session.
Diagnosis of Impotence
It can be easily diagnosed during the sexual encounter of the person. If the person is not able to get his erection, then it may be due to impotence. A description of the sexual encounter to the physician will help determine if the man is impotent.
There are other methods to diagnose the case. If the male organ does not respond to touch, then he is likely impotent. The physician may also examine external features, such as its shape when erect and the pattern of hair on it to come to a conclusion. Some male organs become curved when erect. This could be due to Peyronie’s disease. Though this does not interfere with the sexual act, some men might find it difficult to penetrate their curved organs. This can be also termed as impotence.
Generally, prior to physical examination, the patients are made to fill a questionnaire with details on their organ. This helps the physician to come to a preliminary conclusion.
Another method in use is to examine the male organ while he is asleep. In a healthy man, there are erections during sleep, especially during the Rapid Eye Movement stage of sleep. If the person does not get erections in his sleep, then he is most probably impotent.
Causes of Impotence and Risk Factors
Impotence can be caused due to several factors. The very phenomenon of getting erect involves various organs from the brain to the spongy tissues of the corpus cavernosa of the male organ. If there is a problem anywhere along this channel, then the man will not be able to get an erection. The following are some likely causes of impotence in men :-
(i) Disease – Some diseases can cause the man to become impotent. Diabetes is the most major disease in this category. About 35 to 50% of men who suffer from diabetes become impotent. Even atherosclerosis plays an important role in causing impotence. Other diseases are renal failure, multiple sclerosis, high blood pressure and prostate cancer.
(ii) Obesity – Though no fixed statistical pattern has yet been studied, it is well known that obese men have a very high probability of becoming impotent.
(iii) Peyronie’s Disease – A very small proportion of men are impotent due to Peyronie’s disease. Peyronie’s disease cause scarring in one region of the male organ, which causes it to curve in one direction. Ordinarily, this does not interfere with lovemaking; but if the curvature is too extreme, then the man will find penetrative sex very difficult.
(iv) Use of certain drugs – Many drugs are known to cause impotence as a side effect. Antihistamines, antidepressants, appetite suppressants, etc. can cause impotence. The drug used for treatment of ulcers, cimetidine, is also known to produce this effect.
(v) Addictions – Smoking and alcoholism both are known to cause impotence in men.
(vi) Hormonal causes – Men who have less testosterone in their blood are either unable to get an erection, or unable to sustain it if at all they get it.
(vii) Psychological factors – People who take lots of tensions and suffer from bouts of depression do lose their sexual drive over time. This is a huge cause of impotence in cities, where most men lead fast-paced lives. Some men are nervous (especially young men during their first sexual encounters) and are not able to have fulfilling sex.
Treatment of Impotence
Impotence is tackled by doctors according to its underlying cause. The following methods are generally adopted:-
(i) Counseling – Most men do not suffer from impotence itself; they suffer from either depression or nervousness, which causes the impotence. A good counselor can put them at ease and more confident about the sexual act. In this, the cooperation of the partner is also very important.
(ii) Correction – If the impotence is due to a physical defect in the penis, such as the male organ curve, then this is surgically corrected.
(iii) Medication – A list of commonly prescribed medicines to treat impotence in men are as follows:-
- Sildenafil citrate or Viagra
- Yohimbine hydrochloride
- Papaverine hydrochloride
Most of these medicines work by allowing the male organ to become engorged with blood, and hence cause an erection. However, critics have maintained that these medicines work by a placebo effect, i.e. they induce the patient to believe that the medicines will work, rather than actually producing any biological results.
(iv) Penis Pumps – Pumps in the shape of cylinders to be placed over the male organ are being used to treat impotence. These pumps cause suction over the organ, which causes blood to flow into it. However, most doctors believe the pump does more harm than treatment. The rim of the pump which clasps tightly around the base may damage the ligaments of the organ. Also, the penile tissues may burst if they are over-engorged with blood due to high suction.