Impotence Treatment, Impotence Causes, Erectile Dysfunction

What is Impotence or Erectile Dysfunction?

Impotence or Erectile Dysfunction is the condition leading to problems in gaining or keeping erection for sexual activity. Impotence or erectile failure is thought to be due to psychological causes in the majority of cases.

Causes of Impotence, Erectile Dysfunction:

1. Psychological factors causing impotence

• Developmental- e.g. conflict in parent-child relationship.
• Affective- depression, anxiety, guilt and inter-personal relationship.
• Cognitional- e.g. lack of knowledge about sex.

2. Impotence due Endocrine factor

• Pituitary- tumor, acromegaly.
• Thyroid- hypothyroidism or hyperthyroidism.
• Diabetes mellitus.
• Addison’s disease.
• Testicular defects.

Eunuchoidism (deficiency of testes or of their secretion, with impaired sexual power), – Klinefelter’s syndrome, testicular feminization, interstitial cell tumor and aging can also be causes of impotence.

3. Local conditions causing impotence

• Priapsim
• Peyronie’s disease
• Phimosis.

4. Others Causes of Impotence

1. Extreme obesity.
2. Surgery e.g. prostatectomy, bladder surgery.
3. Drug abuse and chronic alcoholism.
4. Central nervous system disease- Parkinsonism, autonomic neuropathy and spinal cord injury.
5. Drugs e.g. some anti-hypertensive and anti-cholinergic.
6. Hepatic or renal failure.
7. Pelvic trauma – The incidence of this condition increases with age. Vascular diseases involving the internal pudendal artery or its branches are common in this people.

Diagnosis of Impotence, Erectile Dysfunction:

Full investigation is necessary to determine whether there is primary or secondary testicular dysfunction. If there is secondary hypogonadism then hypothalamic-pituitary function apart from that relating to gonads must be assessed. In some people hyperprolactinaemia without gonadotrophin deficiency will be present.

Secondary hypogonadism causing infertility can also be one of the reasons.

Treatment of Impotence / Erectile Dysfunction:

1. Androgen therapy will usually restore potency and libido.
2. In people with hyperprolactinaemia without gonadotrophin deficiency potency and libido will be restored with bromocriptine therapy.
3. If infertility is the problem then gonadotrophin or in some people gonadotrophin releasing hormone will usually be required.

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