Impotence

Impotence is the inability to attain or maintain an erection of the penis that is firm enough for sexual intercourse. To initiate and maintain an erection, the penis must fill with blood. One type of blood vessels open wide to allow blood into the penis. Meanwhile, a second type of blood vessel squeezes down to keep the blood from leaving the penis. Nerve signals cause the proper changes in the blood vessels.

  • Causes

    The following factors can cause erectile dysfunction:

  • Definition

    Impotence is the inability to attain or maintain an erection of the penis that is firm enough for sexual intercourse.

    To initiate and maintain an erection, the penis must fill with blood. One type of blood vessels open wide to allow blood into the penis. Meanwhile, a second type of blood vessel squeezes down to keep the blood from leaving the penis. Nerve signals cause the proper changes in the blood vessels.

  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. Expect questions about the frequency, quality, and duration of your erections. Your answers may help the diagnosis.

    Your bodily fluids may be tested. This can be done with blood tests.

  • Prevention

    To reduce your chance of becoming impotent:


    • Take medications to manage
      blood pressure
      , diabetes, or depression.
    • Ask your doctor about changing medications.

    • Maintain a
      healthy weight
      .

    • Eat a
      healthful diet
      .

    • If you smoke,
      quit
      . Smoking is significantly associated with impotence in older men.

    • Talk to a
      therapist
      or counselor.

  • Risk Factors

    Factors that increase your chance of developing impotence include:

    • Age: 65 and older
    • Race: Hispanic
    • Obesity

    • Medical conditions:

      • Diabetes
      • Hardening of arteries
      • Chronic kidney disease
      • Liver failure
      • Peyronie's disease—bending of the penis caused by scar tissue
      • Endocrine disorders

      • Neurological disorders such as
        multiple sclerosis
        ,
        peripheral neuropathy
        ,
        and
        stroke
      • Hypertension

      • Psychiatric disorders,
        such as
        anxiety
        and
        depression

    • Traumatic conditions:

      • Vascular surgery

      • Pelvic surgeries, particularly for
        prostate cancer
      • Spinal cord injury

    • Behaviors:

      • Alcohol use
      • Illegal drug use
      • Anabolic steroid use
      • Heavy smoking
      • Interpersonal conflicts with a sexual partner

    • Medications:

      • Antihypertensives—for high blood pressure
      • Antihistamines—common as allergy medication
      • Antidepressants
      • Tranquilizers
      • Antipsychotics

  • Symptoms

    Symptoms include:

    • A less firm penis
    • Fewer erections

  • Treatment

    Treatment options include: