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 , Peter C. Françolin Training Grant Programs Orthopedics Zippe LD, Kedia AW, Kedia K, Nelson DR, Agarwal A. Treatment of erectile dysfunction after radical prostatectomy with sildenafil citrate (Viagra). Urology. 1998; 52(6): 963-6. Child Psychology NBC News Chairman Andy Lack could be on the chopping block Recreational drugs such as marijuana and cocaine Neurological conditions including or arising from dementia, multiple sclerosis, stroke, or spinal cord or back injury; Scientific editing If you suffer from joint pain, exercise may seem like the last thing you want to do, or need to do. My Trouble Words Millions of men struggle with it but shockingly few ever seek treatment. Bone Health and Osteoporosis Copyright 2002 - 2018 Virtual Medical Centre All Right Reserved. Rogers RS, Graziottin TM, Lin CS, Kan YW, Lue TF. Intracavernosal vascular endothelial growth factor (VEGF) injection and adeno-associated virus-mediated VEGF gene therapy prevent and reverse venogenic erectile dysfunction in rats. Int J Impot Res. 2003 Feb. 15(1):26-37. [Medline]. Montorsi F, Salonia A, Deho' F, Cestari A, Guazzoni G, Rigatti P, et al. Pharmacological management of erectile dysfunction. BJU Int. 2003 Mar. 91(5):446-54. [Medline]. Vascular disease includes atherosclerosis (fatty deposits on the walls of the arteries, also called hardening of the arteries), a history of heart attacks, peripheral vascular disease (problems with blood circulation), and high blood pressure. The Right Track: precision resources/treatment Patient & Visitor Information How is erectile dysfunction treated? Erectile Dysfunction: Diagnosis A problem in the nervous system may be involved if your penis does not respond as expected to certain touching. The ancients: Baby alligator heart and thistle All news topics Peyronie's Disease Domains & Structures Calculators Erectile dysfunction is the inability to develop or maintain an erection that is rigid enough to allow penetration of the vagina, and therefore functional sexual intercourse. Generally, the term erectile dysfunction is applied if this occurs frequently (75% of the time) over a significant period if time (several weeks to months). If this is the case, the term impotence may also be used. Devices and surgery Feldman, H.A. Journal of Urology, January 1994. , Alexander W. Pastuszak Help Fund a Cure Eat a healthful diet. Dealing with a cancer diagnosis » Quick Links ED isn’t just a man’s problem—his partner is affected as well. ED can cause a man to withdraw from sex and his partner. A female partner may blame herself, thinking that she is no longer desirable. She may also blame her partner and suspect infidelity as the cause behind his ED. A lack of communication can be destructive for couples dealing with ED. For men in relationships dealing with ED, talking with a partner is an essential part of managing the condition. Araujo, A. American Journal of Epidemiology, 2000. cocaine Blueberries, Citrus Fruits, Red Wine Associated With Reduced Erectile Dysfunction NCBI Information pain in the penis Reduces awareness of our physiological arousals leading to sexual dysfunction. © Prostate Cancer Foundation, 2018 China All studies demonstrate a strong association with age, even when data are adjusted for the confounding effects of other risk factors. The independent association with aging suggests that vascular changes in the arteries and sinusoids of the corpora cavernosa, similar to those found elsewhere in the body, are contributing factors. Other risk factors associated with aging include depression, sleep apnea, and low HDL levels. Min JK, Williams KA, Okwuosa TM, Bell GW, Panutich MS, Ward RP. Prediction of coronary heart disease by erectile dysfunction in men referred for nuclear stress testing. Arch Intern Med. 2006; 166(2): 201-6. Health Clinics Natural Treatments World Chlamydia Test Kit Science & Research Competitions Simple surgery Site Use and Privacy Please be aware that we do not give advice on your individual medical condition, if you want advice please see your treating physician. Facial Hair Removal Cream > U Generic Viagra: What Does It Mean for You? Staff Directory Structure (Molecular Modeling Database) Superdrug Today E - G Directions Drug Interaction Tool Check Potential Drug Interactions Both ED and low testosterone (hypogonadism) increase with age. The incidence of the latter is 40% in men aged 45 years and older. [15] Testosterone is known to be important in mood, cognition, vitality, bone health, and muscle and fat composition. It also plays a key role in sexual dysfunction (eg, low libido, poor erection quality, ejaculatory or orgasmic dysfunction, reduced spontaneous erections, or reduced sexual activity). [16] Ⓒ 2018 About, Inc. (Dotdash) — All rights reserved ineptness Women's Health Clinic > Start walking. According to one Harvard study, just 30 minutes of walking a day was linked with a 41% drop in risk for ED. Other research suggests that moderate exercise can help restore sexual performance in obese middle-aged men with ED. Copyright 2018 ScienceDaily or by other parties, where indicated. All rights controlled by their respective owners. Quizzes Earthing Surprising Health Benefits of Sex document.body.appendChild(replacement) Viagra (sildenafil) facts. (n.d.). Retrieved from https://www.bpas.org/more-services-information/erectile-dysfunction/viagra/ Unusual characteristics of the penis itself could suggest the cause of ED. Your MNT 17 Jul 2018 - 11:19pm 56 The penis contains two cylindrical, sponge-like structures (corpora cavernosa). When a male becomes sexually aroused, nerve impulses increase blood flow to both cylinders. This sudden influx of blood causes an erection by expanding, straightening and stiffening the penis. Call us on 0203 5880 293, Mon - Fri, 9am to 6pm, Sat, 9am to 5pm Pennsylvania State University College of Medicine Genetics may also play somewhat of a role, although lifestyle factors are also almost always involved. Neurologic causes. Several neurological problems can lead to ED. For instance, multiple sclerosis, stroke, and spinal cord and nerve injuries. Nerve damage from pelvic surgeries can cause ED. Your information are hosted on AWS and Rackspace servers in the EU, both ISO 27001 compliant and submitted to the strictest security requirements. In the fast paced urban lifestyle, it is not uncommon for young men who face the challenges of work and family pressure, to encounter occasional obstacles to "rise to the occasion" in the bedroom. When the occasional failures turn out to be the regular norms, it is crucial to examine the hard facts of the causes and impact of the deficiency. The American President, Theodore Roosevelt, often considered a driving force for the progressive era, once said: "I think here is only one quality worse than hardness of heart and that is softness of the head". When Dr. G is put on the spot on why hard young men are going soft between the sheets, his response is: "There is one quality worse than the softness of the hard and that is the hardness of the ego head. It is usually a matter of time for the young hard ego heads to accept the softness of the other head needs hardening up!" An unsatisfactory sex life Families In one study, 9.6% reported ‘occasional’ erectile dysfunction, 8.9% reported erectile dysfunction occurring ‘often’, and 18.6% reported erectile dysfunction occurring ‘all the time’. Of these, only 11.6% had received treatment.In another study, only 14.1% of men reported that they had received treatment, despite experiencing erectile dysfunction for longer than 12 months. quality Research | 02 August 2018 There are several forms of male sexual dysfunction, including poor libido and problems with ejaculation. But ED refers specifically to problems achieving or maintaining an erection. Men with ED often have a healthy libido, yet the body fails to respond. In most cases, there is a physical basis for the problem. Parenting Guide subscriptions Nervousness Mission In general, the cause of erectile dysfunction is divided into two types. Many men will have both , Yuanyuan Zhang Dyslipidemia 25 / 25 Legal Credit: istockphoto Credit: istockphoto 9 Things You Didn't Know About Male Anatomy Morales A, Johnston B, Heaton JW, Clark A. Oral androgens in the treatment of hypogonadal impotent men. J Urol. 1994 Oct. 152(4):1115-8. [Medline]. sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called
non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking Sildenafil and call your healthcare provider right away if you
have any sudden vision loss Patient & Visitor Information Who is at risk for erectile dysfunction? › Erectile Dysfunction In a prospective study from the Prostate Cancer Prevention Trial database, Thompson et al reported that men presenting with ED had a significantly higher chance of developing a cardiovascular event over a 7-year follow-up period. [55] The hazard ratio was 1.45, which is in the range of risk associated with current smoking or a family history of MI. SCMP ePaper Edition Biothesiometry Anatomy of the Lower Urinary Tract and Male Genitalia. Campbell-Walsh Urology 9th edition. Philadelphia: WB Saunders.; Newsroom A penile implant is another option. There are two types: one of them, called a semi-rigid penis implant, keeps the penis erect all the time, though it can be bent downward when you aren't having sex. The other type, a hydraulic penis implant, includes a pump that's implanted in the scrotum and can be squeezed in order to make the penis erect.  subjects What's to know about erectile dysfunction? Stress Management Psychotherapy and/or behavioral therapy may be useful for some patients with erectile dysfunction without obvious organic cause, and for their partners. These may also be used as an adjunct to other therapies directed at the treatment of organic erectile dysfunction. Outcome data from such therapy, however, have not been well-documented or quantified, and additional studies along these lines are indicated. Erectile dysfunction-South Carolina Kershaw Bethune 29009 SC Erectile dysfunction-South Carolina Lee Bishopville 29010 SC Erectile dysfunction-South Carolina Chester Blackstock 29014 SC
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