Impotence in men (Part one)

Definition

By impotence, we understand the condition when a man cannot have an erection (raising of the male organ) to that level and with that strength necessary for performing sexual intercourse. Having erection problems from time to time is not necessarily a cause for concern; but if this happens continuously, then it can become a cause of stress, relationship problems with the partner, and loss of self-confidence.

It is thought that approximately 1 in 10 adult men will suffer from long-term impotence. Many people have occasionally experienced erection problems that could have various reasons, such as drinking a large amount of alcohol, stress, or extreme tiredness.

Signs

The signs of impotence include the following continuous disorders:

• Difficulty in having an erection
• Difficulty in keeping the erection for a long time
• Decrease in sexual desire

Risk factors

Over the years, it takes longer for a man to have an erection; also, the penis does not become as hard as in younger age. A man needs to touch his penis more to have an erection and to keep it for a longer time. This situation is not a consequence of being old but usually as a result of other illnesses and taking medications that are common at these ages.

The factors that contribute to the appearance of erection are:

• Medical causes, especially diabetes and heart diseases.
• Smoking, which restricts blood flow in the veins and arteries. Over time, smoking can cause chronic diseases which in turn lead to impotence.
• Being overweight, especially obesity.
• Certain medical treatments such as prostate surgery or radiotherapy for prostate cancer.
• Injuries, especially when the nerves that control erection are damaged.
• Medications, which may include antidepressants, antihistamines, blood pressure lowering drugs, painkillers, or those used for prostate cancer.
• Psychological factors, such as stress, anxiety, or depression.
• Use of drugs and alcohol, especially in those who use it for a long time or in large quantities.
• Long-term use of a bicycle, which can press nerves and disrupt blood flow to the penis, may lead to temporary impotence.

Complications

The consequences that may accompany impotence are:

• A sex life that does not provide pleasure
• Stress or anxiety
• Low self-esteem
• Marital or partner problems
• Inability to impregnate the partner

Tests and diagnosis

For many men, a physical exam and taking the medical history before giving treatment is sufficient. If the doctor suspects the involvement of other diseases, or when the patient has chronic diseases, then further tests and examinations may be required, or it is recommended to be seen by the relevant specialist.

These examinations include:

• Physical examination. This means a careful check of the penis, testicles, and the sensitivity of the nerves.
• Blood tests. This is necessary to see if there are signs of heart disease, diabetes, low levels of testosterone (male hormone), and other health problems.
• Urine tests. Just like blood tests necessary to see signs of diabetes or other diseases.
• Ultrasound. Used to check the blood circulation in the penis. Sometimes it is performed in combination with injecting drugs inside the penis to determine whether the blood flow increases normally after the injection.
• Nocturnal erection test. Most men have erections during sleep but do not remember it. This simple examination consists of placing a band around the penis before going to bed. If the band is broken in the morning, this indicates that there were erections several times during the night. This shows that the cause of impotence is mainly psychological and not physical.
• Psychological examinations. The doctor may ask questions to find out signs of depression or other psychological problems that may be causing impotence.