In order to get an erection, several parts of the body must work together. The brain sends a message of sexual arousal through the nervous system to the penis. This message causes the muscles along the penis to relax. At the same time, the artery to the penis dilates to twice its diameter, increasing the blood flow sixteen-fold, and the veins which carry blood away from the penis are blocked. As a result, the two spongy-tissue chambers in the shaft of the penis fill with blood and the penis becomes firm. A breakdown in any of these systems makes getting or keeping an erection difficult.
Virtually all men occasionally fail to get an erection. That's normal. But if a man has trouble getting or maintaining an erection about 25 percent of the time, he should see an urologist. These physicians specialize in disorders of the kidneys, bladder, prostate, penis and urethra.
Usually, after asking questions about when and how the impotence developed, the urologist will give the patient a complete physical exam to determine if his hormone levels are normal and if the blood vessels, nerves and tissues of his penis are working properly. If this initial work-up doesn't pinpoint the cause of the problem, a nocturnal penile tumescence test can be done.
Men with no physical abnormalities almost invariably have nightly erections during sleep. The patient may spend a few nights in a sleep laboratory where a gauge that measures the frequency and duration of nocturnal erections is attached to the base of the penis. A home version of this, the snap-gauge test, can also be used. Before going to sleep, the patient attaches the gauge to the base of his penis. During the night, the gauge will break at different degrees of penile rigidity and show whether a partial or full erection has taken place during sleep. If nocturnal erections do not occur, the impotence is most likely physical. Additional testing is then required to identify the precise cause of the problem.
- Exercise regularly
- Limit the amount of fat and cholesterol in your diet
- Drink only in moderation
- Don't smoke
Physical impotence occurs when there is a problem with any of the systems needed to get or maintain an erection. The good news is that potency can usually be restored when a man is treated for underlying medical conditions, when medications are adjusted or when lifestyle habits are changed.
- Vascular Disease. Hardening of the arteries can affect the artery leading to the penis so that it cannot dilate enough to deliver all the blood necessary for an erection. Impotence can also occur if the nerves that control blood flow to the penis are damaged.
- Diabetes. One out of every four impotent men has diabetes, which can cause nerve deterioration (diabetic neuropathy). Impotence may result if nerves or blood vessels that control the flow of blood to the penis are affected. In some cases, keeping the diet and blood sugar under control can decrease impotence. But permanent nerve damage can result in a chronic problem.
- Disease of the Nervous System. Some conditions, such as multiple sclerosis, Parkinson's disease and spinal cord injuries, can affect or cause impotence.
- Cancer Surgery. Surgery to remove cancer from the prostate, bladder, colon or rectal area can cause impotence if the nerves and blood vessels that control erections are damaged in the process of removing cancerous tissue.
- Medications. Some prescription medications for high blood pressure, depression, spinal cord injury, diabetes and other conditions can cause temporary impotence by interfering with the nerve impulses or blood flow to the penis. Doctors may be able to adjust the dosage of a drug or change the medication to reverse or minimize the problem.
- Smoking. A recent study at the New England Research Institute in Watertown, Massachusetts, found that impotence was equally common among smokers and non-smokers in general. However, among men with certain health problems, those who smoked were much more likely to have potency problems. For example, 56 percent of smokers with heart disease were completely impotent compared with only 21 percent of non-smokers with the disease.
- Alcoholism. Excessive alcohol consumption disrupts hormone levels and can lead to nerve damage. This type of impotence may be reversible or permanent depending on the severity of the nerve damage. Some clinical studies suggest about 25 percent of all alcoholics become impotent -- even after they stop drinking.
- Hormone Imbalance. Abnormal testosterone levels are rare, but they can cause impotence. In addition, other illnesses, such as kidney failure and liver disease, can disrupt the balance of hormones.
A man who is depressed, under stress, or worried about his "performance" during sex may not be able to have an erection. Qualified therapists or counselors who specialize in the treatment of sexual problems can often help diagnose and sort through these problems. Some impotence problems can be solved when a man understands the normal changes of aging and how to adapt to them. For example, as men get older they generally need more direct stimulation to achieve an erection. They may also have less firm erections, take longer to ejaculate and need more time between erections.
Impotency and Viagra
The penis is a vascular organ which requires exercise. A healthy male will normally experience 3 to 4 erections during their sleep which may last a hour or more each. They are a normal body function whose purpose is to oxygenate the penile erectile tissue. Its inability to achieve and maintain an erection suitable for vaginal intercourse is called "male erectile dysfunction" (ED) or impotency, for short. Impotency affects over 30 million men and their partners. To some men impotency is a symbol of the loss of their manhood, and can be critical to a man’s ego and self-image. And often, because of this, some men are afraid to seek help. And, often when he does, the physician feels uncomfortable or is unable to help because many aren’t aware of the options. If the truth were known, however, virtually 100% of impotency problems can be successfully diagnosed and treated, whether physical or emotional, unless there is permanent injury or severance of the nerves and or vascular supply necessary in the erectile process.
The appropriate treatment for impotence depends upon whether the cause is physical or psychological. A man whose impotence is psychologically based generally still has erections during sleep, whereas an individual whose impotence is physical in origin usually does to. One easy, inexpensive way to test for nocturnal erections is with postage stamps. Glue a strip of stamps around the shaft of the penis before going to bed. If the ring of stamps is broken in the morning, the cause of the impotence is likely psychological. If the strip is unbroken, the impotence is likely physiological. You can also purchase a kit called Snap Gauge from UroHealth Corporation. This test is designed to detect the measure the rigidity of erections experienced during sleep. Call 800.328.1103 for more information.
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