In medical terminology it can be defined as the inability to have an erection of the penis adequate for sexual intercourse also called erectile dysfunction which affects as many as 18 million men in the United States between the ages of 40 and 70. Until recently, doctors thought impotence was mainly rooted in psychological causes. Now it is believed that 50 to 70 percent of all cases are caused by physical problems. Age is not the only factor for Erection difficulties, as it’s true that Erection tend to increase with age but still there are so many other reasons i.e. your general physical and psychological health, as well as lifestyle habits and certain medications, can all cause impotence, but you don’t have to live with this problem. In most cases, impotence can be successfully treated.

How Does an Erection Occur?
A process in which the penis becomes stiff and hard due to augmented blood flow. Erections may happen in response to physical or emotional stimulation, or sometimes an erection happens for no reason at all. Erection also enables sexual intercourse and some other sexual activities, though it is not essential for all of them.

How it occurs?
The penis contains two chambers called the corpora cavernosa, which run the length of the organ A spongy tissue fills the chambers. The corpora cavernosa are surrounded by a membrane, called the tunica albuginea. The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora cavernosa and is surrounded by the corpus spongiosum. Erection begins with sensory or mental stimulation, or both. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the spaces. The blood creates pressure in the corpora cavernosa, making the penis expand. The tunica albuginea helps trap the blood in the corpora cavernosa, thereby sustaining erection.

When muscles in the penis contract to stop the inflow of blood and open outflow channels, erection is reversed. Arteries and veins penetrate the long, filled cavities running the length of the penis–the corpora cavernosa and the corpous sponglosum. Erection occurs when relaxed muscles allow the corpora cavernosa to fill with excess blood fed by the arteries, while drainage of blood through the veins is blocked.


What Causes Impotence
Since an erection requires a cycle of events, impotence can occur when any of the cycle events is disrupted. These events include 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.

Disease: Some Diseases like Damage to arteries, smooth muscles, and fibrous tissues, are 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 and 35 and 50 percent of men with diabetes experience impotence.

Surgical Cause: Surgery (for example, prostate surgery) can damage nerves and arteries near the penis, causing impotence. Damage 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.

Medication Causes: Many common medicines produce impotence as a side effect. These include high blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug).

Anxiety & Depression: Experts believe that psychological factors may also 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.

Smoking: Since smoke affects blood flow in veins and arteries, and hormonal abnormalities, such as insufficient testosterone.

What are the Treatment Options?

When physical or psychological treatment fails to restore Impotency, then some other alternates can be considered:

ED Pills: Phosphodiesterase E5 (PDE5) drugs such as Viagra (sildenafil), Levitra (vardenafil) and Cialis (tadalafil). These drugs are considered to be the most significant prescription treatment of erectile dysfunction today.
Injection: Injection of medication was the principal form of treatment for impotence before Viagra was approved. Injection therapy helps up to 90 percent of men with impotence, and doctors often recommend it for men who do not respond to Viagra.

Suppositories: Marketed under the brand name MUSE (the medicated urethral system for erection) these suppositories containing the drug alprostadil are inserted about two inches into the urethra, the opening of the penis. Sometimes a rubber band placed around the base of the penis is needed to sustained erection. About two-thirds of men respond to alprostadil suppositories.

Vacuum Devices: A hand pump is used to create a vacuum in a plastic tube that has been placed over the penis. Once blood has entered the penis, a tension band is slipped around the base of the penis to trap the blood. The apparatus is removed for sexual intercourse to take place. There is no waiting for medications to take effect or wear off when finished.
Surgery: Penile implants are the primary surgical option for impotence, albeit a costly treatment, that is usually recommended after other methods have been unsuccessful.
Hormonal Therapy: This is an uncommon option, because only about 5 percent of men have a testosterone deficiency linking their lack of sexual performance to erectile dysfunction.

Testosterone is usually administered by patch, topical gel or injection. While oral testosterone can reduce impotence in some men with low levels of natural testosterone, it is generally not recommended, because possible side effects include damage to the liver. When a hormonal basis is suspected for erectile dysfunction, Dr. O’Leary says routine blood testing is necessary to confirm that suspicion. Such tests may rule out or indicate some other underlying illness as the cause.

Points to Remember:
– Impotence is a consistent inability to sustain an erection for satisfactory sexual intercourse.
– Impotence affects 18 millions (approximate) American men.
– Impotence usually has a physical cause as well as psychological.
– Impotence is treatable in all age groups.
– Treatments include psychotherapy, drug therapy, vacuum devices, surgery and others

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What Causes Impotence in Men

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