The most common cause of temporary impotence is anxiety.
What is impotence?
Impotence or erectile dysfunction (ED) means not being able to
get a good enough erection to have intercourse.
Temporary impotence is very common indeed, particularly in
younger men, and especially when they are either anxious, or have had too much
to drink.
If you're having erection problems, bear these points in mind:
the most common cause of temporary impotence is just anxiety -
not some serious disease!
impotence can be helped by medication, sex counselling,
mechanical aids, or - very occasionally - surgical treatment.
impotence may be a symptom of another, as yet undiagnosed,
disease requiring treatment; the most common of these is diabetes.
What causes impotence?
An erection happens when blood is pumped into your penis - and
stays there - making it stiff and hard. All sorts of things may affect this
complex process.
Psychological causes
Anxiousness about whether you can 'perform' will almost
certainly make it impossible to get an erection.
Problems in a relationship may affect potency.
Impotence may be caused by depression.
Bereavement: recent loss of a loved one is notorious for
causing impotence.
Tiredness.
Stress.
Hang-ups - for instance, guilt about sex.
Unresolved gay feelings.
Having an unattractive partner.
Physical causes
Problems with the chemical mechanism that makes erections
happen - very common in older men.
Vascular (blood vessel) disorders. Patients with
arteriosclerosis,
other
heart or vascular
diseases and
high blood pressure
are at greater risk of developing impotence.
Excessive drainage of blood from the penis through the veins
(venous leak) uncommon.
Diabetes often
creates erection difficulties.
Smoking increases the
risk of developing arteriosclerosis and, therefore, of suffering from
impotence.
Side effects from certain drugs, such as some
blood pressure (BP) treatments, some
antidepressants and some
ulcer healing drugs; BP drugs, in
particular, do this very frequently.
Side effects of non-prescribed drugs (tobacco,
alcohol, cocaine and
others).
Nervous system diseases - uncommon.
Major surgery, eg prostate surgery or other abdominal
operations.
Hormonal abnormalities - rare.
What to do if you've got potency problems
If you're having difficulty in getting erections, you should
definitely see a doctor for assessment.
We strongly advise you not to go to high-priced clinics, where
men in white coats pretend to be doctors while they extract large sums of money
from you!
Really, it's best to start with your own GP. But if you don't
feel you can face your doctor, other doctors can be found at:
family planning clinics.
genitourinary medicine (GUM) clinics.
clinics recommended by the Institute of Psychosexual Medicine,
the Impotence Association, or the British Association For Sexual and
Relationship Therapy (BASRT).
Brook Advisory Centres (for young people only).
(More details are supplied in the Further Information section at
the end of the article.)
Assessing your case
Whichever doctor you go to, he or she should carefully assess
you, by:
talking with you
examining you
doing any necessary tests - eg for diabetes.
How is impotence treated?
Treatments for impotence vary a lot and depend on the cause.
Psychotherapy/counselling: this is mainly for use where the
main cause is anxiety, guilt or a hang-up.
Lifestyle advice: this is mainly of help when the problem is
related to tiredness, stress, alcohol, nicotine or other drugs.
Alteration of medication: this is useful when the impotence is
due to pills that are being taken for high blood pressure or other disorders.
In the summer of 2001, an article in the American Journal of the Medical
Sciences claimed that changing men with a high 'BP' to a blood pressure
lowering drug called losartan (Cozaar) gave dramatically better potency. But
the company who manufactures the drug is so far unenthusiastic about this
research and makes no claims at all for its use in impotence.
Drugs for impotence have been developed very successfully in
recent years. They include, of course, Viagra (sildenafil). This is effective
in up to 80 per cent of patients (in diabetic patients the success rate is
around 60 per cent). It needs to be taken about one hour before intended
intercourse. It does not cause an erection unless the man is sexually
stimulated. Viagra is a very powerful drug and should never be taken
recreationally or purchased over the Internet. It is important that any man
taking Viagra is under the care of an appropriate doctor. Possible side effects
include flushing of the face, headache, indigestion, blocked nose, dizziness
and a short-term bluish tint to the man's vision.
Many other oral drugs are on the way, and one called Uprima was
launched on June 21st of this year (2001). Because you take it under your
tongue (rather than swallowing it), it works much faster then viagra. It should
also be cheaper to buy than Viagra - provided you shop around! However, Uprima
has not been evaluated as fully as Viagra, and unsuspected side-effects may
still emerge. At present, there are many known side-effects - which include:
nausea, headache, dizziness, yawning, nose and throat inflammation, flushing,
sweating, cough, alterations in taste, sleepiness, pain and fainting. However,
most men tolerate the drug very well.
Other medications that may become available soon are Cialis and
vardonafil.
Injection therapy: the patient is trained to inject a chemical
into the penis thus causing an erection. The treatment is effective for about
75 per cent of men. The injection is given 10 minutes before intercourse and
the erection lasts one to two hours. Several different preparations are
available. There are possible side effects. Prolonged erections (more than four
hours) are rare but require urgent hospital treatment.
Transurethral therapy: a small pellet containing a drug similar
to that used for injection therapy is introduced a few centimetres into the
urethra (urine passage) using a special disposable applicator. The drug is
absorbed through the wall of the urethra into the erectile tissue.
Hormones: very occasionally men with impotence may have a
deficiency of testosterone, and replacement therapy may be helpful.
There are also mechanical aids.
Pubic ring: a rubber or bakelite ring that is put around the
base of the penis. It is claimed to be effective for men who can't maintain an
erection for very long.
Vacuum pump: a tight-fitting cylinder, in which low pressure
can be created, is placed over the penis. The resulting suction gives an
erection. Unfortunately, the penis tends to look blue in colour, and feels cold
to the touch.
Finally, there are surgical treatments.
Splinting: this treatment involves the insertion of a flexible
synthetic or metal rod (prosthesis) into the penis to cause a mechanical
erection. There are several different types of prosthesis. It is important to
realise that this treatment cannot be reversed without more surgery, so it will
not normally be used unless other methods have failed.
Sealing a vein leak: unfortunately, this is not always very
effective.
It's also important to note that whatever form of treatment a
man receives, sex counselling may be required. In cases that are entirely due
to psychological causes, counselling alone can cure the problem. But even in
the other methods, counselling is often necessary as a supplement to the main
treatment.
Who can receive treatment on the NHS?
The NHS has a limited budget for drug therapy and the government
has declared that only certain patients can receive treatment on the NHS. The
three main groups who qualify for NHS prescriptions are:
men with the following conditions: diabetes, prostate cancer,
severe pelvic injury, kidney failure, multiple sclerosis, spina bifida,
Parkinson's disease, poliomyelitis, spinal cord injury, single gene
neurological disease, or those who have had prostate or radical pelvic surgery.
men who are severely 'distressed' as a result of impotence -
this is rarely allowed.
men who were diagnosed as suffering from impotence and who were
receiving treatment on the NHS on or before 14 September 1998.
The availability of surgical treatment varies in different parts
of the country, For more information contact one of the agencies listed
below.
Further help
The Impotence Association. Helpline: 0208 767 7791.
Family Planning Association. Helpline: 0845 310 1334.
Brook Advisory Centres. Helpline: 08000 185023. This service is
only for young people who are 25 and under.
Relate: 01788 573241. Low-cost psychosexual counselling
available nationwide.
British Association For Sexual and Relationship Therapy. An
association of highly trained private counsellors/therapists. Email for more
details: info@basrt.org.uk.
Institute of Psychosexual Medicine. An association of private
therapists who are also medically qualified doctors. Website:
www.ipm.org.uk.
BACK
How to give up smoking
The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care or attention by a qualified practitioner. The materials in this web site cannot and should not be used as a basis for diagnosis or choice of treatment. Conditions for use
Font size