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Causes of Impotence

Since an erection requires a sequence of events, impotence can occur when any of the events is disrupted. The sequence includes nerve impulses in the brain, spinal column, and area of the penis, and response in muscles, fibrous tissues, veins, and arteries in and near the corpora cavernosa.

Damage to arteries, smooth muscles, and fibrous tissues, often as a result of disease, is the most common cause of impotence. Diseases--including diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, and vascular disease--account for about 70 percent of cases of impotence. Between 35 and 50 percent of men with diabetes experience impotence.

Surgery (for example, prostate surgery) can injure nerves and arteries near the penis, causing impotence. Injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to impotence by harming nerves, smooth muscles, arteries, and fibrous tissues of the corpora cavernosa.

Also, many common medicactions produce impotence as a side effect. These include high blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug).

Experts believe that psychological factors cause 10 to 20 percent of cases of impotence. These factors include stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure. Such factors are broadly associated with more than 80 percent of cases of impotence, usually as secondary reactions to underlying physical causes.

Other possible causes of impotence are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as insufficient testosterone.

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Body temperature and Impotency

When you have a fever, the elevated temperature provides you with a sign that there's something wrong with your body. Usually it is a viral infection and the illness passes spontaneously or, if the fever persists, you go seek the assistance of your physician. Impotence or erectile dysfunction can also serve as a thermometer of illness occurring somewhere else in your body.

Erectile dysfunction is a common condition affecting nearly 30 million American men. Since the introduction of Viagra in 1998, hundreds of thousands of men have sought treatment and nearly 6 million prescriptions have been written for this drug that helps men engage in intimacy with their partners.

There are still millions of men who continue to suffer in silence. More importantly, there are millions of men whose suffer from erectile dysfunction which may serve as a thermometer of other life-threatening diseases such as heart disease, stroke, hypertension, high cholesterol, diabetes, depression, and cancer of the prostate gland.

In order for an erection to occur, there must be an integrated and coordinated function of the nerves, hormones and blood vessels that supply the penis. The diameter of the blood vessels that supply the penis are 1-2 mm in diameter. The blood vessels to the coronary arteries that supply the muscles on the heart are 5-6 mm. Therefore, any disease process like arteriosclerosis or hardening of the arteries is more likely to cause symptoms at the level of the penis before symptoms occur in the heart. That is why men who have difficulty obtaining and maintaining an erection should see their doctor as the erectile dysfunction may be an indicator of more serious heart disease.

Erectile dysfunction is more common in men with high blood pressure, high cholesterol levels and obesity. For example, men with 42-inch waists are nearly twice as likely to have impotence as men with 32-inch waists. Another risk factor is alcohol consumption. But not all alcohol is going to negatively impact a man's potency. As a matter of fact, 1-2 drinks per day have a protective affect against heart disease and erectile dysfunction. On the other hand those who drink more than 1-2 drinks per day are more likely to experience a decrease in their potency.

High cholesterol levels are also predictive of erectile dysfunction. In men with total cholesterol levels >200 mg, or high density lipoproteins (HDL), or good cholesterol, 40 mg, they are more likely to have erectile dysfunction. The reason is that cholesterol-like plaques are deposited on the lining of the blood vessels and reduces the lumen or size of the blood vessels and consequently decreases the blood supply to the organ or tissue supplied by that blood vessel.

Erectile dysfunction is also common in many men with diabetes. Nearly 50 percent of men with adult-onset diabetes mellitus will experience erectile dysfunction. Also erectile dysfunction may be the first manifestation of diabetes. In a significant number of men the onset of impotence may be the first presenting symptom of diabetes, a condition that can be controlled with diet and medication.

Here are 10 actions steps that you can use to prevent impotence:

Recognize the normal signs of aging. Remember, it may take longer to obtain an erection at age 60 than at age 20. More genital stimulation and foreplay are required as a man ages.
Beware of medications that can cause impotence. There are literally hundreds of medications associated with the side effects of impotence. These common medications include tranquilizers, medication for high blood pressure and ulcers.
Avoid tobacco. Tobacco is a performance-zapper because its effect on blood vessels can decrease blood flow to the penis.
Drink alcohol in moderation. 1-2 drinks per day may relax you and even protect your heart. More than 2 drinks per day may impact your sexual performance.
Timing can be everything. Sexual performance is influenced by body rhythms. Hormonal levels can vary at different times of the day. It is important to find that time of day or evening that is best - mentally and physically - for you and your partners.
Accept occasional failure. One episode of impotence - even if it lasts for weeks - does not mean that a man is permanently impotent. Stress and fatigue, and anticipation of failure, can paralyze your sex life. Accept occasional impotence as something that happens to every man at different times in his life.
See your physician at least once a year. If you are more than 50 years of age, the cause of your erectile dysfunction is usually physical and not due to psychological or emotional reasons. You need to be sure there are not more serious, life-threatening conditions lurking behind the sexual problem.
Balanced nutrition is important for sexual function. The American Heart Association states that a low-fat, a low-cholesterol diet prevents heart disease and arteriosclerosis which also affects a man's erection.
Excess stress. Excessive, long-term stress is "counter erotic" and affects both a man and his partner's capability to have a happy sexual relationship.
Get help. Persistent, chronic impotence needs medical attention before it interferes with relationships. Not treating erectile dysfunction may result in more severe illnesses including heart disease, stroke and diabetes.

Bottom line:

If you or your loved one is suffering from erectile dysfunction, see your physician because help is available and no one needs to "suffer the tragedy of the bedroom." If you want to keep it up, get a checkup!

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Content reprinted with permission from Neil Baum, MD, neilbaum.com.

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