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Impotence
Impotence, now referred as an erectile dysfunction (E.D.), is the inability of the male to attain or maintain an erection enough to satisfy coitus. Estimate of sexually active men affected are approximately 12-18 million.
Erectile dysfunction may also progress normally with age. Common causes of Erectile Dysfunction are:
Primary:
Anxiety
Fear
Depression
Situation
Secondary:
Most common cause of secondary ED is organic in nature because these patients could previously perform.
Common secondary causes are:
- Vascular. Mostly arteriosclerosis of penile arteries. In short, inadequate blood supply to the spongy tissue of the penis carvanosum results in no erection. Since diabetes, hypertension and smoking affect the blood flow in vessels, they do play major roles here.
- Hormonal. Certain hormones affect proper erection. These hormones are
- Prolactin excess
- Cortisol excess
- Low testosterone
- Some drugs notoriously cause ED. These are:
- Anti-hypertensive medications (blood pressure medications.)
- Anti-depression medications.
- CNS depressants, for example: Alcohol, cocaine, opiates, and narcotics.
- Some cancer medications.
- Neurological conditions such as:
- Stroke
- Seizures
- Multiple sclerosis
- Spinal cord disease
- Surgical procedures such as:
- Trans urethral resection of prostate
- Prostatectomy
Treatment
In cases in which the underlying cause is obvious, therapy is directed towards that cause. Other therapies are:
- Education, reassurance, partnership evaluation.
- Constriction ring - helps with venous leaks.
- Vacuum tumescent - draws blood into the penis.
- Penile injection with Acprostadil.
- Viagra
- Testosterone
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