Impotence

Impotence (Erectile dysfunction) - Causes and Risk Factors

The causes of erectile dysfunction may be physical or psychological.

Physical causes include:

cardiovascular disorders affecting blood supply to the penis
nerve damage
hormonal disorders
a physical abnormality of the penis
certain prescription drugs
drug abuse

Psychological causes include:

depression
stress
performance anxiety
traumatic experiences

Age	Prevalence
45 years	5%
65 years and older	15 – 25%
75 years and older	50%

Impotence (Erectile dysfunction) - Diagnosis

Screening and Testing

Blood tests may be carried out to check on the level of male hormones in the blood and to check for other medical problems that cause erectile dysfunction. Other tests that may be performed include:-

Ultrasonography

This helps determine if the blood circulation to the genitals is sufficient for an erection.

Neurological tests

A physical examination is performed to check if there is any nerve damage.

Blood pressure tests

A dye is injected in the blood vessels so that your doctor could determine if there are any abonormalities in the flow of blood through the penis.

Impotence (Erectile dysfunction) - Treatments

The treatment options, once psychological causes have been ruled out, are:-

Oral therapy

Sildenafil (Viagra) may be prescribed. The medication enhances the ability to attain and maintain an erection in up to 60% of trial subjects. Patients will be advised to comply strictly with the prescription recommendations, especially for persons with heart problems

Intracavernosal injections

Prostaglandin E1 (Alprostadil) is self-injected by the patient to achieve an erection. There are risks involved, including prolonged erection and formation of fibrous tissue at the site of injection.

Trans-urethral agents

This involves the delivery of a pellet of Prostaglandin E1 Alprostadil) into the urethra.

External suction devices

This involves the use of suction devices to pull blood into the penis so as to attain and maintain an erection for intercourse.

Surgery

Penile prosthesis (implants) can be fitted for selected patients. Vascular ligature is performed in patients with blood flow problems causing erectile dysfunction.

Impotence (Erectile dysfunction) - Other Information

Prevention

Steps that can be taken to reduce the possibility of erectile dysfunction are:-

limiting the use of alcohol or drugs
not smoking
maintaining a healthy lifestyle
maintaining good mental health (reducing stress, dealing with anxiety and depression)