2017-05-10 / Health Care

Common potential causes of impotence

By Dr. David Samadi

Just saying the word impotence sounds ominous. Saying or hearing it is one thing but having it another. Impotence also known as erectile dysfunction (ED), is when a man has difficulty achieving or maintaining an erection sufficient for sexual intercourse or to achieve orgasm.

Impotence can be caused by many factors which can include both emotional and physical disorders. It is not unusual at all for a man at some point in his life to experience impotence or ED. It is estimated that up to 30 million American men, including 30 to 50% of men between the ages of 40 and 70 will have their manhood fail them in some manner during sexual activity. Once or twice is bad enough and can shake men to their core. But when ED becomes the norm, it can not only have an understandably negative effect on a man’s sex life but also can result in additional stress, depression and low self-esteem.

Conditions causing impotence

Here are some common conditions a man may have that could be the root of his impotence. If a man suspects this to be the reason, he needs to discuss it with his doctor to begin finding a solution to resolve it:

Neurological and nerve disorders

If there are any issues with communication connections involving nerves throughout the body, this could be the reason why ED may be occurring. Conditions involving the nerves can affect the brain’s ability send out messages with the reproductive system. This would disrupt a man’s likelihood of being able to achieve an erection.

Some neurological disorders associated with impotence include:

• Alzheimer’s disease
• Parkinson’s disease
• Brain or spinal tumors
• Multiple sclerosis
• Stroke
• Temporal lobe epilepsy
• Some men who have had prostate surgery may experience nerve damage leading to impotence
Endocrine disorders

Disease of the endocrine system such as diabetes, hypogonadism and hyperprolactinemia may cause erectile dysfunction. This system of the body produces hormones that regulate metabolism, reproduction, mood, and sexual function, among other things.

Men with diabetes are a good example of how an endocrine disease can cause impotence. To get an erection, men need healthy blood vessels, nerves, male hormones, and a desire to be sexually stimulated. Diabetes can damage the blood vessels and nerves that control the ability of the penis to become erect. Therefore, a man with diabetes may be making normal amounts of male hormones and have the desire for sex, but can still have trouble achieving a firm erection.

Heart related conditions

Cardiovascular diseases are those that affect the blood vessels. These diseases include atherosclerosis, a condition that causes the blood vessels to become clogged, hypertension, and high blood cholesterol. Having these conditions can account for up to 70% of physical-related causes of ED resulting in restricted blood flow to the penis. Atherosclerosis alone accounts for 50-60% of ED cases in men over the age of 60.

A man with erectile dysfunction does not automatically mean he has underlying heart disease. However, research suggests that men with ED who have no obvious cause such as trauma, should be screened for heart disease before starting any treatment.

Certain medications

There are various medications a man may be taking that could be affecting blood flow leading to ED. Before stopping a medication, a man needs to discuss this with his doctor to know for certain if that is the cause for his impotence.

Some examples of medications known to cause impotence include:

• Diuretics and high blood pressure medications
• Antidepressants
• Antihistamines
• Non-steroidal anti-inflammatory drugs
• Parkinson’s disease medications
• Antiarrythmics
• Histamine antagonists
• Muscle relaxants
• Prostate cancer medications
• Chemotherapy drugs
• Cocaine and amphetamines
• Alcohol and alcoholism

Emotional disorders
If a man has any emotional issues affecting his life, it may be difficult for him to become sexually excited to achieve an erection.
Psychological issues contributing to ED are not as easy to detect, diagnosis, and treat. Here are some possible psychological causes of impotence: • Anxiety – this can increase heart rate, blood pressure and fatigue which in turn affects a man’s sexual performance. This often can be
one of the most common psychological causes of ED.
• Stress – whether stress is high or low, it can affect a man’s ability to achieve and maintain sexual performance.
• Depression – This is often caused by a chemical imbalance in the brain which can affect sexual desire and sexual function.
• Relationship problems – Arguments, poor communication, and anger can affect spill over into negatively affecting bedroom activities.
Working through these problems can help ease symptoms of ED.
• Fear of sexual dysfunction – Once a man experiences ED, he may have worries over regaining normal sexual function. This can lead
to low self-esteem which can affect the ability to achieve or maintain an erection.
In conclusion
Any man who is experiencing impotence is going to wonder why, and needs to discuss this with his doctor. This is not the time for any
man to be embarrassed or reluctant to talk about it. They need to let their doctor know what is going on. Once the doctor knows, they can
begin the process of figuring out why it is happening and to finding a solution to resolve it.

Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of

urology, chief of robotic surgery at Lenox Hill Hospital. He is a medical correspondent for the Fox News Channel's Medical A-Team. Follow Dr. Samadi on Twitter, Instagram, Pintrest, SamadiMD.com and Facebook

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