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Male Impotence Cause

Impotence is defined as the inability to achieve or maintain
an erection sufficient for mutually satisfying intercourse.
Per the diagram adjacent diagram one can see that the incidence
of impotence correlates with an individuals age effects
some 67% of men by the age of 70 years old. Impotence impacts
more than a man's sexual activity. The emotions and uncertainties
that coincide with this condition often have a significant effect
on a man's self-esteem, as well as, his relationship with
his partner. Although the incidence of Impotence increases
with age, it is not an inevitable result of aging.
Impotence is a secondary condition linked to many medical
conditions.
The
first step in treating Impotence is that the
individual understands the psychology, physiology and anatomy
responsible for the ability to achieve and maintain an erection.
If we can comprehend these events than we can better understand
the factors that are responsible for impotence and address the
questions concerning treatment.
Normal
Erectile Function
For
something that appears so natural, an erection is a rather
complicated process involving the coordination of the psychological,
neurological and cardiovascular systems. The penis
becomes erect following a series of events. First,
the nerves are stimulated, a sensation known as arousal.
No matter what the nature of the stimulus, visual, mental
or physical the brain coordinates the following series of
events:
- Nerve
impulses transverse the length of the spinal cord to the
pudendal nerve and on to the penis. Smooth muscle
within the walls of the penile arteries respond by relaxing.
- Subsequently,
the penile arteries dilate allowing up to eight times
more blood to flow into the corpora cavernosum, (two parallel
cylinders that transverse the length of the penis).
- The
cavernosum become engorged with blood expanding and lengthening
the penis.
- The
expanding tissue then exerts a positive pressure compressing
the veins that normally empty the blood from the penis,
maintaining the blood in the penile tissue.
- When
ejaculation occurs or when arousal is discontinued the
penis returns to its non-erect state.
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Causes
of Impotence
Historically,
when an individual consulted his physician concerning impotence
he was usually informed there were no known physiological
answers concerning his condition. Today, a generation
of research has resulted in significant advances in both
the diagnosis and treatment of impotence. Physicians now
understand that approximately eighty-five percent of impotence
is attributable to physical/organic conditions while only
fifteen percent is due to psychological or mixed origin
(both psychological and organic).
Some important causes of physiological male impotence
are as follows:
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Vascular
Disease

Vascular Disease - is the leading cause of impotence. Vascular
disorders including arteriosclerosis (hardening of the arteries),
hypertension, hyper-cholestremia and other conditions which
interfere with the blood flow to the penis. Additionally,
"venous leakage" also contributes to poor erections.
This condition occurs when the penile veins are unable to
constrict efficiently during an erection. When these
veins "leak" blood escapes to the periphery resulting
in a poor erection.
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Diabetes -
is another common cause of impotence. Approximately fifty
percent of men with diabetes (insulin dependent) experience
some degree of ED after the age of fifty-five. Diabetes
results in poor circulation and/or peripheral neuropathy.
When the nerves are involved sexual stimuli are not transmitted
appropriately to or from the brain and Impotence
develops. |
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Neurological
diseases - such as multiple sclerosis, Parkinson's
disease, spinal cord injuries, long term effects of diabetes
can also result in the disruption of the normal sequence of
events necessary for an erection to occur. |
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Deficiencies
in the Endocrine System - are another source of impotence. Low
levels of testosterone or thyroid hormone can interfere with
the stimulation process necessary in the erection sequence.
Excessive production of prolactin by the pituitary gland may
contribute to decreased levels of testosterone resulting in
a lack of desire. Diabetes once again enters the scenario
as it is classified as an endocrine disorder.
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Prescription
medications often cause impotence as a side effect.
Some two hundred known medications fall into this category
including:
Antihypertensives
medications significantly:
- beta-blockers
e.g. Atenolol, Propanolol and Tenorium.
- Diuretics
medications e.g. HydroDiuril and Lasix.
- Ace
Inhibitors/Calcium Channel Blockers medications e.g. Vasotec®,
Lotension®, Cardizem®, Norvasc® periodically
cause Impotence , however, they are generally
represent an excellent alternative medication for individuals
with drug induced impotence.
Antidepressant/Antipsychotic
medications -of almost any label can also result
in Impotence e.g. Prozac®, Elavil®, Zoloft®,
Thorazine®, Haldol®. Note: Many other medications
in a variety of classes can periodically cause ED.
If you are taking a prescription medication or over-the-counter
medication, regularly, please consult with your physician.
However, never alter a dosage or discontinue a medication
without the advice of your physician.
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Smoking as a Cause of
Impotence
Smoking
as been linked to Impotence in numerous clinical
studies.
The
most common causes of the organic component in Impotence or impotence are vascular abnormalities associated
with atherosclerosis and diabetes mellitus. Atherosclerosis
causes 40% of cases of Impotence, and in cases
of diabetes mellitus the prevalence of Impotence
is 50%. Smoking is significantly associated with the development
of both atherosclerosis and diabetes mellitus.
The Epidemiology and Pathophysiology of Impotence.
The Journal of Urology 1999 Jan; 161(1):5-11
After
smoking two cigarettes, the diameter of the internal pudendal
artery narrows and the penile arteries almost completely
close. This evidence suggests that smoking can cause an
acute vasospastic constriction of the arteries in the penis.
These observations are supported by physiological evidence
that nicotine causes acute peripheral vasoconstriction.
Acute Vasospasm of Penile Arteries in Response to Cigarette
Smoking. Urology 1990; 36(1):99-100
Researchers
at Wake Forest University in Winston Salem, North Carolina
concluded that men who suffer from long standing hypertension
who smoked were 26 times more likely to be impotent
than those individuals
who do not smoke. The Journal of Family Practice. January
2000, Aside from impotence, smoking
as also been linked to the following negative effect concerning
male sexual health:
- Reduced
volume of ejaculate
- Lowered
sperm count
- Abnormal
sperm shape
- Impaired
sperm motility
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LH-RH
Analogs/Antiandrogen medications e.g. Lupron Depot®,
Eulexin®, Nilandron®, Casodex®, etc. These
medications are used in the treatment of prostate cancer.
They function by decreasing the production of testosterone
in the testes and adrennal glands. The decrease in testosterone
often results in Impotence. |
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Chemotherapy/Radiation
-therapy are also significant contributors to Impotence.
These drugs/treatments are used in the treatment of cancer.
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Substance
Abuse can also negatively effect male potency.
The chronic use of cocaine, marijuana, alcohol, steroids etc.
often results in Impotence, as well as a decrease
in desire. Excessive tobacco use can also attribute
to Impotence by accentuating the effects of other
risk factor such as vascular disease or hypertension. |
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Radical
Pelvic Surgery also result in Impotence.
Surgical procedures involving the prostate gland, bladder
or colon may interfere with the nerves involved in the erectile
response. Radiation therapy for cancer may also effect
the erectile process. |
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Psychological
ED is usually diagnosed when no physical causes
can be defined. Pure psychological Impotence
usually occurs suddenly without warning as opposed to physical
ED that may gradually develop over years.
Some
common causes of psychological Impotence are
as follows:
- Performance
anxiety is one of the most common causes of psychological
Impotence. When a man feels pressured
to achieve or maintain an erection, he will commonly become
anxious and nervous when in a sexually demanding situation.
Stress increases the body's production of catecholamines
such as adrenaline and nor- adrenaline, which act as erection
inhibitors. The release of these inhibitors further
contributes to failure resulting in more anxiety.
Therefore, the cycle begins, increased stress resulting
in increased catecholomines that further inhibits the
erectile process.
- Depression
is another cause of psychogenic Impotence.
Unfortunately, many of the popular antidepressant medications
(for a list see prescription medications in the next section)
have side effects which include erectile failure.
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Anatomical
Deviation of the Penis, Peyronie's Disease, may also cause
Impotence . This condition usually develops from an
inflammatory process and results in fibrous scaring of the
penis. (The cause of this process is not yet understood)
However, when an erection does occur, there is a bending of
the penis secondary to the scar tissue. This curvature
may interfere with erectile capacity and/or ejaculation. |
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