impoanon

IMPOTENCE

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Dr.Joe's Data Base

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* Impotents Anonymous and I-ANON, a national network of over 50 support
groups for suffers and their partners. Call 1-(800) 669-1603 for
information on local support groups meetings.

* Call 1-800-867-7042 for names of physicians in your area who have special
interest in treating impotence.

Impotence Report - National Institute of Health
Center for Current Research Report
Sexuality in Later Life
A Female Perspective
Sex According to the Ancient Greeks

Not necessarily "Everything You Ever Wanted to Know About
Impotence", but interesting reading nevertheless. Please remember
to use your "Back" button to return.

Center for Current Research Report

GENERAL SUMMARY

Impotence is the inability of a man either to have an erection or to keep
the penis erect long enough to have sexual intercourse. This is a common
problem affecting as many as 10 million men in the United States. By the
time most men are 40 they have already experienced impotence at some time
in their lives.

When just a single incident occurs, the best thing to do is forget about
it. Problems arise when this difficulty starts occurring regularly.

According to an article published in early 1993 (review: Morley, 1993),
approximately 10 million men in the U.S. have problems with impotence.

Men afflicted with repeated impotence tend to be middle-aged and older,
with such a condition most common in men 60 years of age and older.
Regardless of the age, however, many men who have this problem can be
treated successfully.

Impotence can result from a wide variety of problems. As with any other
ailment, when a person begins having this problem repeatedly, he needs to
see a doctor. The doctor will want to rule out the possibility of disease,
injury, or side effects from medicine.

For example, cardiovascular problems, diabetes, injuries to the spinal
column, and side effects from high blood pressure medicine are among the
physical conditions that can lead to impotence.

If the problem is physical, there is a wide variety of treatment available
depending upon the cause and severity of the problem. If the physician does
not believe the problem is physical, he or she may suggest seeing a
psychologist, marriage therapist or psychiatrist. In such therapy, the
emphasis will probably be on explanation, education, and support, and the
wife may be asked to participate as well.

Sometimes both medical and psychological treatment are used together. If
medical and psychological therapy proves unsuccessful, a device can be
inserted surgically that will assist in allowing the man to have
intercourse. Although this may sound scary, such devices have been used
successfully in thousands of men. It is important that all such steps be
taken under a trusted physicianţs guidance.

Due to the many possible causes of impotence, it is impossible to provide a
definitive description of its prevention, especially since some causes are
unpreventable.

There are, however, a number of ways to minimize the possibility or
frequency of it. When a physician prescribes medicine or recommends a
surgical procedure, the patient should ask if there may be side effects or
complications that could influence him sexually.

Smoking appears to have a negative effect on a man's erection, while
exercise and good diet help to enhance anyone's sex life.

Since in perhaps half of the cases the cause of impotence is believed to be
psychological, there are some guidelines that are useful in minimizing such
problems. Generally speaking, psychologically based impotence results from
the man's feeling unsure about his ability as a lover, is under some form
of external pressure or emotional upset (for example, job stress or loss of
a loved one), or finds that his partner is not providing the type or extent
of sexual stimulation he wants.

Some men feel that they are under various pressures to "perform," or find
that their partner takes a rather passive role in love making. If both
parties can find a way to discuss such situations between themselves and
remove the obstacles that can arise, such problems can be reduced and
problems from impotence minimized.

CURRENT RESEARCH

A number of research projects involving experimental treatments have been
reported in current medical journals. Some of these treatments, or the
drugs involved, may not yet be available, however.

Fortunately for those afflicted with impotence, it is curable in most
instances. A simple test can help determine whether impotence is a physical
problem or a psychological one.

Although usually unaware of it, most men have frequent erections while they
sleep. Consequently, the patient can be given a specially designed plastic
band to place on his penis at bedtime. If the band is found to have broken
during the night, then the man is capable of having normal erections and
the problem is probably a psychological one.

If medical treatment is required, there are a wide variety of treatments
available. Certain medications when applied to the penis have been found to
assist in enhancing erection, such as nitroglycerin ointment (Nunez and
Anderson, 1993) and Minoxidil (Cavallini, 1991).

In some patients, the problem is found to result from obstructions in the
blood vessels of the penis that prevent them from filling properly, leading
either to partial erections at best or none at all. In such patients,
success has been reported in the use of injections of papaverine
hydrochloride, prostaglandin, phentolamine and atropine which the patient
can inject himself (Montorsi and others, 1993).

Where surgery is required to correct such vascular problems, outcomes
research indicates that almost 80% of patients can regain potency (Schramek
and others, 1992).

Another treatment possibility is the use of vacuum constrictive devices. A
survey sent to patients who had been provided such devices over a 5-year
period showed that both patients and their partners were quite satisfied
with the results of using them (Cookson and Nadig, 1993).

Penile implants are another therapy option. In one survey, 80-90% of
persons who received penile implants were found to be satisfied with the
results (Witherington, 1991).

BODILY EFFECTS

In very simple terms, the penis is a tube composed of two spongy cylinders.
An erection occurs when these cylinders fill with blood. Although
frequently unaware of it, most men normally have erections when they sleep,
in addition to those times when they are sexually stimulated.

Once the male has an orgasm or the stimulation subsides, blood drains out
of the cylinders in the penis and the penis becomes limp again.

Impotence occurs when something goes wrong with this process, namely, that
something interferes with the initial phase of excitement, or with the
ongoing sexual arousal during the sex experience, or with the ability to
have an orgasm.

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SOURCES

Cavallini, 1991. Minoxidil versus nitroglycerin: a prospective double-blind
controlled trial in transcutaneous erection facilitation for organic
impotence. Journal of Urology (July 1991), volume 146(1), pages 50-53.

Cookson and Nadig, 1993. Long-term results with vacuum constriction device.
Journal of Urology (February 1993), volume 149(2), pages 290-294.

Montorsi and others, 1993. Four-drug intracavernous therapy for impotence
due to corporeal veno-occlusive dysfunction. Journal of Urology (May 1993),
volume 149(5 Pt 2), pages 1291-1295.

Morley, 1993. Management of impotence: diagnostic considerations and
therapeutic options (review). Postgraduate Medicine (February 15, 1993),
volume 93(3), pages 65-67 and 71-72.

Nunez and Anderson, 1993. Nitroglycerin ointment in the treatment of
impotence. Journal of Urology (October 1993), volume 150(4), pages
1241-1243.

Schramek and others, 1992. Microsurgical arteriovenous revascularization in
the treatment of vasculogenic impotence. Journal of Urology (April 1992),
volume 147(4), pages 1028-1031.

Witherington, 1991. Mechanical devices for the treatment of erectile
dysfunction (review). American Family Physician (May 1991), volume 43(5),
pages 1611-1620.

**IMPORTANT NOTE** This information is provided solely for your education
and enrichment. It should NOT be relied upon for personal diagnosis,
treatment, or any other medical purpose. If you believe that a particular
therapy applies to YOU, please contact your personal doctor before trying
it.