Impotence - better known these days as Erectile Dysfunction (ED) - is the inability to get and maintain a sufficient erection for satisfactory sexual intercourse. As distressing and embarrassing as the condition can be it’s also incredibly common. According to the *Sexual Advice Association the condition affects at least one in every ten men and is increasingly common as men get older.
The inability to obtain and maintain an erection.
What causes Erectile dysfunction?
The condition can be physical or psychological.
Physical causes: include high blood pressure (hypertension), high cholesterol or diabetes. These cause the blood vessels leading to the penis to narrow making it harder for blood to flow in to strengthen an erection..
ED can also result as a side-effect of prescribed drugs, or due to hormonal problems (such as low testosterone) injury, neurological disease or as a result of heavy smoking or alcoholism..
Psychological causes: include stress and anxiety, marital problems, depression, sexual boredom, fear of failure, or worries about sexual orientation. ED is likely to be due to a psychological issues if you are able to maintain an erection apart from with a partner.
How is the condition treated?
Treatment will depend on the cause. If the condition is due to narrowing arteries some lifestyle changes may help - including losing weight, exercising regularly and giving up smoking. You may also be prescribed drugs to lower cholesterol and or blood pressure. If ED is due to hormonal problems testosterone replacement therapy may be offered.
Impotence is also widely treated with ED medication called Phosphodiesterase-5 (PDE-5) inhibitors which work by temporarily increasing blood flow to the penis. PDE-5 inhibitors include: sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra). PDE-5 inhibitors are available on private prescription (or via an NHS prescription for patients with some pre-existing medical conditions).
ED can also be treated with a vacuum pump which increases blood flow to the penis. Surgery may be offered if all other treatments have failed.
Psychological treatments include: cognitive behavioural therapy (CBT) which changes set thinking patterns, sex therapy (including sensual touching exercises) and psychosexual counselling (relationship therapy where couples can work through emotional issues). These treatments are availably privately or via the NHS.