Many women report they have lesbian experiences or feelings, but do not think of themselves as lesbians... You should talk to your doctor about possible treatments. You may want to talk to other patients who have had the treatment planned for you. You also may want to seek a second doctor's opinion about surgery before making your decision. You may find it difficult to talk to your doctor about impotence. You will want to find a doctor who treats this condition and will help you feel comfortable talking about the problem and choosing the best treatment. You can also get more information by contacting your local National Kidney Foundation affiliate. The treatment of hypertension can cause dysfunction (most commonly, treatment with beta-blocker medications and thiazide diuretics, which have the biggest implication on ED). Summary: Medications for treatment of vascular disease It is not uncommon in new relationships, where a man might be nervous about a sexual encounter and eager to impress their partner. …about one-quarter of males are impotent by age 65, one-half by age 75, and three-quarters by age 80. One must remember, however, that some unknown but certainly substantial proportion of this impotence may be attributed to poor health.… Service: S Arai Y, Kawakita M, Okada Y, Yoshida O. Sexuality and fertility in long-term survivors of testicular cancer. J Clin Oncol. 1997; 15(4): 1444-8. Patient can inject medications directly into the corpora cavernosa to help attain and maintain erections. Medications such as papaverine hydrochloride, phentolamine, and prostaglandin E1 (alprostadil) can be used alone or in combinations to attain erections. All of these medications are vasodilators and work by increasing blood flow into the penis. Prostaglandin E1 (Caverject, Edex) is easier to obtain; however, it is associated with penile pain in some individuals. The use of combinations of two or three of these medications can decrease the risk of having penile pain. National Institute of Diabetes and Digestive and Kidney Diseases A newer investigational approach to the treatment of erectile dysfunction is gene therapy. As of late 2002, several preclinical studies have shown promise, but none of the gene-based strategies so far have yet been tested for safety. Multiple Sclerosis and Your Eyes Child Nutritional Needs https://www.betterhealth.vic.gov.au:443/about/privacy 10)  Dream Pictures/The Image Bank How Will You Treat Low T? Impotence, also known as erectile dysfunction or ED, is a condition in which a man is unable to get or hold an erection long enough to have a satisfactory sex life. Impotence is a common problem, affecting up to half of Australian men between the ages of 40 and 70 years. The risk of developing erectile dysfunction increases as you get older.In the past, doctors considered impotence to be a mainly psychological problem, caused by performance anxiety or stress. Now, doctors know that many cases of impotence have a physical cause, which usually can be treated. Often, a combination of physical and psychological factors contributes to erectile dysfunction.Physical causes of impotencePhysical causes of impotence can include:problems with blood to flow into and out of the penis;damage to the nerves that send signals from the body’s central nervous system to the penis; and, more rarely,a deficiency in testosterone or other hormones.Some medicines can contribute to impotence, as can some types of surgery and radiotherapy treatments.Blocked blood vessels to the penisA very common cause of impotence is when blood flow into the penis is reduced. This can be due to atherosclerosis, also known as hardening of the arteries. In atherosclerosis, the arteries are clogged and narrowed, resulting in reduced blood flow.Risk factors for atherosclerosis include:high cholesterol;high blood pressure;obesity;sleep apnoea;diabetes; andsmoking.If your erection problems are caused by atherosclerosis, there is a chance that the arteries in other parts of your body (e.g. the coronary arteries that supply your heart) are also affected by atherosclerosis. In fact, erection problems may be the first sign that you are at risk of coronary heart disease.Because the arteries to the penis are narrower than those to the heart, you may develop symptoms of erectile dysfunction before you experience any symptoms of heart disease, such as angina. So seeing your doctor about erection problems may be important for your overall physical health.Impotence can also be caused by a blood clot that prevents enough blood from flowing into the penis to cause an erection.Venous leakageIn some men, blood can flow in to the penis easily, but the problem is that it leaks out again, so an erection cannot be sustained. This is called venous leakage. Doctors aren’t certain of the cause of venous leakage, but they can perform surgery to help repair it.Medicines that can cause impotenceMany medicines can cause erection problems as a side effect, including:diuretics (sometimes known as ‘water tablets’ - often used for high blood pressure);high blood pressure medications;cholesterol-lowering medicines (including statins);some types of antipsychotics;antidepressants;cancer treatments;some medicines used to treat heartburn and stomach ulcers;antihistamines;some pain medicines; andcertain epilepsy medications.If you experience impotence after starting a new medication, tell your doctor, who may be able to prescribe a different medicine for you. Don’t stop taking a medicine without first consulting your doctor. You should also tell your doctor about any over-the-counter medicines or complementary remedies you may be taking.The following table contains a list of specific medicines that may cause or contribute to erectile dysfunction. This list may not cover all types of medicines that can cause erectile dysfunction, so always ask your doctor if you are in doubt. Also, for some of these medicines ED is a very rare side effect. Most men taking these medicines do not experience erectile dysfunction.Medicines that may cause erectile dysfunctionType of medicineExamplesACE inhibitorscaptopril (Capoten), enalapril (Renitec), perindopril (Perindo), ramipril (Tritace), and othersAntidepressantsamitriptyline (Endep), clomipramine (Anafranil), desvenlafaxine (Pristiq), fluoxetine (Prozac), paroxetine (Aropax), sertraline (Zoloft), venlafaxine (Altven, Efexor), and othersAnti-epilepticsclonazepam (Rivotril), pregabalin (Lyrica)Antifungalsitraconazole (Sporanox)Anti-ulcer drugscimetidine (Magicul), nizatidine (Tazac), ranitidine (Zantac), and othersBeta-blockerspropranolol (Inderal), metoprolol (Betaloc, Lopresor), and othersOther blood pressure-lowering medicinesclonidine (Catapres), lercanidipine/enalapril (Zan-Extra), losartan (Cozaar), perindopril/amlodipine (Coveram), olmesartan/amlodipine (Sevikar), telmisartan/amlodipine (Twynsta), valsartan/hydrochlorothiazide (Co-Diovan)Calcium-channel blockersdiltiazem (Cardizem), felodipine (Plendil), nifedipine (Adalat)Cholesterol-lowering drugsatorvastatin (Lipitor), ezetimibe/simvastatin (Vytorin), fluvastatin (Lescol, Vastin), gemfibrozil (Ausgem), pravastatin (Pravachol), simvastatin (APO-simvastatin, Lipex, Zocor), and othersDiuretics ('water tablets')bumetanide (Burinex), chlorthalidone (Hygroton), spironolactone (Aldactone), and othersSchizophrenia drugsamisulpride (Solian, Sulprix), haloperidol (Haldol, Serenace), olanzapine (Lanzek, Ozin, Zypine, Zyprexa), paliperidone (Invega), risperidone (Rispa, Risperdal), ziprasidone (Zeldox)Combination cholesterol-lowering and anti-hypertensiveamlodipine/atorvastatin (Caduet, Cadatin)Pain medicinesfentanyl (Denpax, Durogesic), hydromorphone (Jurnista), morphine (Momex SR, MS Contin), oxycodone (OxyContin, OxyNorm, Targin), tramadolMiscellaneousoestrogens, antiandrogens, anticancer drugs and some chemotherapy treatments, baclofen (Clofen, Lioresal); cyproterone (Androcur, Cyprohexal, Cyprostat), degarelix (Firmagon), etoricoxib (Arcoxia), finasteride (Proscar and Propecia), flutamide (Flutamin), rotigotine (Neupro), triptorelin (Diphereline)*The names in brackets are just some examples of the trade names each specific medicine is marketed under in Australia. The medicine may also be known by other trade names.Diabetes and erectile dysfunctionMen who have diabetes have a higher risk of developing impotence than other men. Diabetes contributes to impotence because it can damage blood vessels and cause a type of nerve damage known as peripheral neuropathy.Hormones and impotenceLow levels of the male hormone, testosterone, are more commonly linked to a lowered sex drive, rather than impotence itself. Only a small percentage of cases of impotence are caused by hormone deficiency.Low testosterone levels may be the result of a condition called hypogonadism, in which the testicles don’t produce enough testosterone. More rarely, low testosterone can be caused by the pituitary (a small gland at the base of the brain) not secreting sufficient hormones to stimulate the testes to produce testosterone. The pituitary is also sometimes affected by small benign (non-cancerous) tumours that secrete prolactin, another hormone that can cause impotence.Mildly decreased levels of testosterone are often not due to specific testicular or pituitary problems, but rather stress or depression. In this situation, testosterone replacement is rarely of any benefit.Other hormone problems, including thyroid disease, can also cause impotence.Prostate cancer and erectile dysfunctionThe advanced stages of prostate cancer can affect the nerves and arteries that are vital for an erection.Radiation treatment for prostate cancer can harm the erectile tissues of the penis, and prostate cancer surgery can cause nerve or artery damage to the penis.Treatment for advanced prostate cancer often includes medicines that counteract testosterone, and commonly cause erectile dysfunction as well as loss of sexual interest.Peyronie’s diseasePeyronie’s disease is an uncommon condition that affects a man’s sex life because his penis curves abnormally and causes pain when he has an erection. He might also be unable to have a hard erection. The curvature of the penis is caused by a scar, called a plaque, that forms in the penis.Other physical causes of impotenceSeveral other factors and conditions can contribute to erectile dysfunction, including the following.Depression. Many men find that when they’re suffering from depression, they lose interest in sex and can’t get or keep an erection. Asking your doctor for treatments for depression may help alleviate your erection problems as well.Smoking contributes to vascular disease (disease of the blood vessels), so it can contribute to erectile dysfunction by affecting blood flow to the penis. Giving up smoking often has a beneficial effect on erectile function.Excessive alcohol use. Alcoholism can cause permanent nerve damage, resulting in impotence. This nerve damage is called peripheral neuropathy. Long-term alcohol use can impair the liver’s ability to function, resulting in a hormone imbalance in which a man has too much of the female sex hormone, oestrogen. On a day-to-day level, alcohol dulls the central nervous system, adversely affecting sexual response.Illicit drug use. Illicit drugs such as marijuana, cocaine, heroin, barbiturates, and amphetamines act on the central nervous system, impairing the body’s ability to respond sexually.Certain exercises. Nerve and artery damage can be caused by prolonged cycling, rodeo riding, or use of a rowing machine, resulting in the inability to get an erection. Often, minimising the use of hard bicycle seats and exercise machine seats, as well as correct positioning of the seat, will help restore sexual function.Surgery to organs near the nerve pathways of the penis, such as the bladder, rectum and prostate, can cause nerve or artery damage to the penis, resulting in the inability to have an erection.Injuries. Impotence can be caused by spinal cord injury; injury to your sex organs; or a pelvic fracture, which can cause damage to the nerves of the penis, or damage the blood vessels, resulting in reduced blood flow to the penis.Conditions affecting the nervous system. Multiple sclerosis (MS) and other degenerative diseases of the nervous system, such as Parkinson’s disease, can damage the nerves involved in erections.Psychological causes of impotenceMost cases of impotence have physical causes, but, in some men, psychological factors are the main contributors to impotence.Impotence that’s triggered by psychological factors is more common in men who are sexually inexperienced. Psychological erectile dysfunction may only occur when you’re with just one particular person. You’re also more likely to have morning erections, and be able to have an erection when you masturbate, than men whose impotence has a physical cause.Here are some psychological factors that can have an impact on your erections.Stress and anxietyWhen you’re stressed and focusing on other issues apart from sex, you might find that you don’t want to have sex as often and there might be a drop in your ability to perform when you do try. You might find that tackling the source of your stress can have benefits in the bedroom as well.Fear of failureAnxiety about your sexual prowess (commonly called performance anxiety) can, in itself, contribute to failure. By putting pressure on yourself, you become too anxious to get an adequate erection.Most men experience isolated episodes of erectile failure. Even when the transient physical cause has passed, anxiety that it may recur is sufficient to prevent erection. Anxiety, whether about something specifically sexual or part of a wider anxiety syndrome, is never helpful to good sexual function.Problems with your relationship and impotenceImpotence may be a manifestation of a poor relationship, or a problematic time in a relationship. Sexual boredom, tension or anger among partners, and lack of intimacy and communication are all possible triggers of erectile dysfunction. In these cases, seeing a counsellor may help.It’s worth remembering that impotence is a complex medical condition, which may have more than one cause. For example, if impotence is the result of a side effect of medicine or an underlying disease, the anxiety caused by lack of performance may perpetuate the erectile dysfunction even after the physical cause has been dealt with.Almost any chronic (ongoing) physical or mental health disorder, including those with no direct effect on penile nerves or blood supply, can have a powerful effect on sexuality, sexual self-image and erectile function.If you’re worried about your sexual response or the quality of your erections, don’t be afraid to talk to your doctor, who has access to treatments that can help. Last Reviewed: 16 December 2016 Common non-medication ways of treating erectile dysfunction include vacuum devices and penile implants. /* myDr Main GA account */ Symptoms of ED include: The medications are extremely effective, which is very good. And the medications are, for the most part, extremely well-tolerated. But there are, like with any medications, a potential downside. The one absolute downside to the use of any of these erection what we call PDE5 medications is if a patient is using a nitroglycerin medication. And nitroglycerins are used for heart disease and for angina, for the most part, although there are some recreational uses of nitrites. And that’s important because your blood vessels will dilate and your blood pressure will drop. And that is an absolute contraindication. Hypogonadism Low levels of reproductive hormones, especially testosterone. Sexual interest in a man is largely dependent on having adequate testosterone levels. So low levels may significantly reduce desire for sex or ability to maintain an erection. Men who use a testosterone treatment must use it indefinitely to get and keep the full effect. Editions Testicular cancer - hormonal therapy that may be used to treat your cancer, or following surgery, you may have difficulty with your sexual organs. Chemists Make Breakthrough on Road to Creating a Rechargeable Lithium-Oxygen Battery Encourage the inclusion of presentations on erectile dysfunction at scientific meetings of appropriate medical specialty associations, State and local medical societies, and similar organizations of other health professions. getroman.com Vitamin D Deficiency PSA test Wikidata item Men who use a testosterone treatment must use it indefinitely to get and keep the full effect. External link. Please review our privacy policy. An analysis of 14 studies involving more than 90,000 patients with ED confirmed the relation between ED and an increased risk of cardiovascular events and mortality. [56] Compared with patients without ED, those with ED had a 44% increased risk of cardiovascular events, a 25% increased risk of all-cause mortality, a 62% increased risk of MI, and a 39% increased risk of cerebrovascular events. Treatment of ED, either through lifestyle interventions or by pharmacologic means, may improve prognosis and reduce risk. Desperate housewife The likelihood of erectile dysfunction increases progressively with age but is not an inevitable consequence of aging. Other age-related conditions increase the likelihood of its occurrence. • Peyronie’s disease Text Viagra Turns 20: The History of the “Little Blue Pill” Massage Therapy Vodka for Breakfast: On the Melancholy of Cheever's Journals Erectile dysfunction (ED) is often a symptom of another health problem. Heart Disease View all the latest top news in the social sciences & education, Share Eat right. In the Massachusetts Male Aging Study, eating a diet rich in natural foods like fruit, vegetables, whole grains, and fish — with fewer red and processed meat and refined grains — decreased the likelihood of ED. s Men with diabetes are more prone to problems with erectile dysfunction or impotence... Pelvic radiation Download our free Chrome extension, Britannica Insights. A lot goes into achieving an erection. When you're turned on, nerves fire in your brain. Blood then flows into your penis. If all goes well, you’re ready for sex. Counseling: You have other symptoms along with erectile dysfunction Visit WebMD on Pinterest Professor of Urology Emotional (psychological) problems Persistence of nocturnal erections China Economy Top Sellers 3 comments Chemocare Swindle RW, Cameron AE, Lockhart DC, Rosen RC. The psychological and interpersonal relationship scales: Assessing psychological and relationship outcomes associated with erectile dysfunction and its treatment. Arch Sex Behav. 2004; 33(1): 19-30. Archaeology Prevention & Treatment Assessing reflexes and toe position Erectile dysfunction signs: reasons you may suffer Web Design by www.titanweb.com.au Retinitis pigmentosa (a condition that affects the retina of the eye and can cause blindness) Urology Program Division of Kidney, Urologic, and Hematologic Diseases Top Picks Erectile dysfunction is incredibly common, but many men fail to learn even the basics about exactly what it is, what causes it, and what can be done. Keep reading to learn more about this condition and how you can best manage it. The sensitivity of the skin of the penis to detect vibrations (biothesiometry) can be used as a simple office nerve function screening test. This involves the use of a small vibrating test probe placed on the right and left side of the penile shaft as well as on the head of the penis. The strength of the vibrations is increased until you can feel the probe vibrating clearly. Although this test does not directly measure the erectile nerves, it serves as a reasonable screening for possible sensory loss and is simple to perform. More formal nerve conduction studies are only performed in selected cases. Medical Products Sildenafil (Viagra) About NOVA Learn the basics about erectile dysfunction—from causes, to treatment options, and relationship issues—with ASHA’s brief fact sheet, Ten Things to Know About Erectile Dysfunction. Diabetes Overview Urological problems A new app can help you chose herbal supplements wisely » Celebrity Galleries A doctor may ask for the following laboratory tests in the evaluation of erectile dysfunction: Erectile dysfunction is divided into two etiologic categories: psychogenic and organic. Most causes of erectile dysfunction were once considered to be psychogenic, but current evidence suggests that up to 80 percent of cases have an organic cause.1 Organic causes are subdivided into vasculogenic, neurogenic and hormonal etiologies. Vasculogenic etiologies represent the largest group, with arterial or inflow disorders being the most common. Abnormalities of venous outflow (corporeal veno-occlusive mechanism) are much less common. Regardless of the primary etiology, a psychologic component frequently coexists.5 p diseases of the male reproductive organs. Exercise has been shown to have a protective effect. Prostheses: Many different types of penile prostheses are available, in three categories: rods, inflatable prostheses, and self-contained prostheses. Semi-rigid or malleable rods are the simplest and least expensive of all. Their main disadvantage is that the penis remains constantly erect, which may cause problems with concealment. Getting Started Erectile dysfunction (ED) occurs when a man can’t get an erection to have sex or can’t keep an erection long enough to finish having sex. This condition used to be called impotence. ED can occur at any age, but it is more common in men older than 75 years of age. But where do you start? Just walk! Walking uses almost every bone and muscle in your body. 20 mins a day is a great (aka “doable”) daily goal. If you’re into measuring your progress, 10,000 steps a day is a great goal to get your heart (and your penis) in better shape. Related Conditions and Diseases News Licensing RELATED TERMS Showbiz & TV If anticholinergics, used to treat ​urinary problems, may also be a problem External Vacuum Therapy Safe Clinical Case Conferences (Non-CME) Partnerships Reclaiming Male Sexuality: A Guide to Potency, Vitality, and Prowess Impotence is the state of being weak or unable to accomplish something, like the impotence a broom in clearing a foot of snow from your sidewalk. Prostate Enlargement (Benign Prostatic Hyperplasia) Getting an erection is a complicated process. There are two tubes of spongy tissue that run along the length of the penis. A tough fibrous, partially elastic outer casing surrounds this spongy material. See more synonyms for impotence on Thesaurus.com Mayo Clinic: “Erectile dysfunction.” Is it just midlife, or is your thyroid slowing down? Stay positive and focus on solutions. There are many treatment options available and professionals, including healthcare providers and therapists, who can help. Infectious Disease Taxonomy Diagnosis and Staging Vitamin D: How Much is Enough? Search More Lee KE , et al Spranger MAG, Te Velde A, Aaronson NK, Taal BG. Quality of life following surgery for colorectal cancer: A literature review. Psychooncology. 1993; 2(4): 247-59. What’s the Average Penis Size? That means your erection may take a hit years before you might suffer chest pains or other symptoms of heart disease. References: Although erectile dysfunction increases progressively with age, it is not an inevitable consequence of aging. Knowledge of the risk factors can guide prevention strategies. Specific antihypertensive, antidepressant, and antipsychotic drugs can be chosen to lessen the risk of erectile failure. Published lists of prescription drugs that may impair erectile functioning often are based on reports implicating a drug without systematic study. Such studies are needed to confirm the validity of these suggested associations. In the individual patient, the physician can modify the regimen in an effort to resolve the erectile problem. Inman BA, Sauver JL, Jacobson DJ, McGree ME, Nehra A, Lieber MM, et al. A population-based, longitudinal study of erectile dysfunction and future coronary artery disease. Mayo Clin Proc. 2009 Feb. 84(2):108-13. [Medline]. [Full Text]. 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