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What every adult needs to know about impotence.
It is stated, that few people are aware of the fact that the causes of impotence are rather physical than psychological. And it is
curable in most cases.
Sexual impotence is perhaps the most poorly understood and mismanaged of all medical disorders. There are two factors responsible
for sexual dysfunction:
Ignorance, myths, superstition, guilt and the stigma and taboo attached to anything sexual in the minds of the laity.
Abysmal sexual ignorance among most doctors who continue to believe that impotence is something that is largely
psychological in origin.
These factors prove that most cases of impotence are not acknowledged and even if they are, doctors do not manage them in a proper
way. That is why, many men have the impression that this disease has psychological etymology and cannot be cured.
And this is awful, because not only reasons may be various, not only psychological, but it may be cured!
Doctors prefer to call impotence an erectile dysfunction. It always was and is nowadays a very common disease. It is stated that
about 10% of men experience this disorder. Despite this figure, only some cases become acknowledged.
Contrary to popular belief, impotence is almost never an "all or none" phenomenon. Most men think that they can have either very
good erection or not at all. But the fact is that it is very far from the truth! The fact is that many men with erectile dysfunction
have a normal sexual desire and they can achieve an erection, but this erection is not hard enough for sexual intercourse.
Therefore, for such a kind of problems the term erectile is preferred, because it means partial loss of ability, whereas impotence
suggests complete loss. And it also should be mentioned that usually reasons are physical than psychological.
In as many as 80-90 percent of cases of chronic impotence, the cause is not in the mind but in the body.
Although, the tendency seems to be changing with the course of time. This is due to some researches which proved that in 80-905 of
cases the cause of impotence lies in the body but not in mind. These causes may be defined with the help of different investigative
modalities and then treated using totally non-psychological methods.
It is very unpleasant that in the time of some developed medical treatment, the sphere of male reproductive system researches are
still not very well studied and in some way neglected. For example, the branch of obstetrics and gynecology (the female analogue of
andrology) which deals with disorders of the female reproductive system has been with us for several decades now and is a well
recognized specialty. In fact, so advanced in the understanding of the subject that today in most countries gynecologists restrict
themselves to sub-specialty areas within their subject such as gynecological oncology, high-risk pregnancies, female infertility
etc. because it is so difficult to keep pace with all the developments in the subject.
The masculine ego would not admit that there could be something wrong with the male reproductive organs - that would be demeaning
to 'manhood'.
It may be of interest to our readers to deliberate in passing on the reasons for this laggardness in andrological research.
Clinical States associated with impotence
Primary Impotent since birth
Secondary Impotence sets in after years of normal sex
Causes of Secondary Impotence
- Diabetes mellitus
- Hypertension (high blood pressure)
- Atherosclerosis
- Renal (kidney) failure
- Heart disease
- Neurological disorders - multiple sclerosis, stroke, paraplegia, spinal cord lesions, Parkinsonism, etc.
- Injuries - sudden - e.g. pelvic and perineal
- Injuries - gradual - as in bicycle-riders etc.
- Surgery-operations on bowel, rectum, bladder, rectroperitoneum, spine, urethra, prostate etc.
- Local e.g. Peyronie's disease
- Medication e.g. drugs administered for duodenal ulcer, hypertension, mental disease etc.
There are two major factors. The first one is male chauvinism, because most of our societies through the whole history were
patriarchal and male-dominated. That is why for men it would be something terrible to admit that they have some problems with
reproductive system. That will be demeaning to ‘manhood’. Two factors are predominant. The first of these is male chauvinism.
Throughout human history, most of our societies have been patriarchal and male-dominated. The masculine ego would not admit that
there could be something wrong with the male reproductive organs - that would be demeaning to `manhood'. Ironically, it is these
very men who researched the female reproductive system and helped evolve the branch of gynecology and obstetrics. But they refused
to look into themselves.
The second is the misinterpretation of the teachings of Sigmund Freud. This led to the erroneous conclusion that most male sexual
problems had their roots in the mind.
Whereas most branches of medicine have taken their roots from biology - the study beginning with an understanding of the anatomy
and physiology of that part and proceeding to then figure out what happens when anatomy or physiology goes wrong thus causing
disease, the male reproductive system alone took its roots from psychology, thus causing tremendous damage.
This explains why most people know that it takes a complex series of neuromuscular phenomena to lift a little finger but fail to
realise that equally complex phenomena are needed to lift the penis!! Most think that all that is needed for the latter event to
occur is a naughty thought.
Then, what are the causes for impotence? There are only few mechanisms which may cause impotence, though this disease is rather
common and may affect anyone at the age of 13-90 plus. And any of the factors causing impotence can be identified with the help of
modern andrological investigative techniques.
Current treatment options for impotence.
Nowadays there are several treatment options used to for impotence. Here you may find some general descriptions of the options.
Sexual Counseling
Usually this kind of therapy is used when the cause of impotence is psychogenic. Sex therapy gives some knowledge and relieves the
symptoms of sexual dysfunction. Using marital and personal counseling, doctors help couples and individuals to relieve their
psychological and emotional dysfunctions.
Oral Medication
when the cause of the disease is psychological or undetermined, doctors suggest using Yohimbine, which improves libido and sexual
desire in about 30-40% of men. Effectiveness may be enhanced when used with trazodone. Among side effects we observe mild dizziness,
nausea, nervousness, and headaches.
Trazadone, an antidepressant, has recently been found to be helpful in treating some patients with psychogenic symptoms. This drug
is most effective when combined with yohimbine. Recently, sildenafil, oral phentolamine and a few other drugs have shown promise as
oral agents.
Hormone Replacement Therapy
Testosterone is the major male hormone that gives men their sexual characteristics (deep voice, beard, chest hair). With the course
of time, the level of this hormone decreases and this may have a negative influence on sexual performance. In this case man may take
injections or oral prescriptions of testosterone, which may enhance potency and improve sex drive. But only a small number of men
respond to this kind of treatment and also there can be some serious side effects, which may affect liver, prostate and heart.
External Vacuum Devices
According to statistics, this kind of therapy is the most successful, having the least number of recorded injuries and it is the
least expensive. It involves the use of an external vacuum device, and one or more tension rings. This therapy is effective for over
90% of the men who use it. In fact, most can technically master its use in one day, and can use it to maintain erections for up to
30 minutes, even after ejaculation and/or orgasm.
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About impotence
