Impotence Basics

I thought we'd start with the basics, especially since there are so many misconceptions about impotency aka erectile dysfuction.

Myths about impotence

• Impotence is uncommon. This is untrue - most men simply don't talk about it. There are probably 20 million impotent men in the USA, and 2-3 million in the UK. A survey sponsored by the drug company Pharmacia & Upjohn found that more than 1 in 4 of the UK male population over the age of 16 have experienced erectile disorder to some degree. Of these, over half experienced the problem as one-off incidents and a quarter suffer erectile disorder most or all of the time.
• Impotence is usually psychological. This is an old-fashioned view: impotence is most commonly due to a physical cause.
• Testosterone injections / patches are a good cure for impotence. Testosterone is of use only in the uncommon situation where there is a proven shortage of testosterone.
• Viagra works for everyone. Viagra is successful in only 50-80% of those with impotence problems.

Smoking and impotence

• Smokers are much more likely to develop impotence than non-smokers. This is because if you are a smoker your arteries are likely to become clogged (atherosclerosis). During an erection the penis swells because it fills with blood. If your arteries are clogged, the blood cannot flow in efficiently and your erection will not be as good.
• A study of 4462 Vietnam war veterans, aged between 31 and 49, showed that smokers had a 50-80% increase in the risk of impotence compared with non-smokers. Another study has shown that for every year you smoke 20 a day, you increase your risk of impotence by 2-3%.
• According to a British Medical Association report, about 120,000 men in the UK in their 30s and 40s are impotent as a result of smoking.

Drugs that can cause impotence (erectile failure)

• Cimetidine (for duodenal ulcer)
• Some drugs for hypertension (for example, thiazide diuretics, methyldopa, beta-blockers, some ACE inhibitors)
• Finasteride (for prostate enlargement or baldness)
• Phenothiazines (for some psychiatric conditions)
• Alcohol, marijuana
• Drugs used for prostate cancer (for example, some GnRH analogues and anti-androgens)
• Antidepressants (read this)

additional medications that cause impotence info

NOTE: DO NOT DISCONTINUE use of prescription drugs without first verifying with your doctor.

Tests usually carried out

• Blood or urine glucose, to check for diabetes.
• Blood testosterone (male hormone) level can be measured. However, it is unusual for impotence to be caused by a low testosterone level, so the result is usually normal. The exception is when there has been a reduced sex drive for some time before any problem with erections; in this situation a testosterone test is worthwhile.
• Blood prolactin level is sometimes measured if erectile failure was preceded by a reduced sex drive; a high level of this hormone is extremely rare but may be associated with impotence, and can be an indicator of other diseases.

Conditions that can cause erectile failure (impotence)

• Diabetes
• Hypertension (high blood pressure)
• Vascular disease (clogged arteries) - linked with smoking
• Severe liver disease
• Thyroid disease
• Neurological conditions (for example, spinal injury, multiple sclerosis)
• Depression
• Peyronie's disease (Bent Penis)
• After some prostate operations (especially radical prostatectomy)
• Renal failure

Read more here.

Finding Treatment For Impotence

The best way to find an impotence specialist is to look for a board certified Urologist with an interest or additional training in impotence. Usually, after identifying a Urologist in your area, a call to the office will help you decide if the physician has the interest and compassion to treat the problem.

It is important that you feel comfortable and trust your Urologist, so don't be intimidated to ask to speak to the doctor to see if the "fit" is right. Always ask about credentials and if the physician regularly attends conferences to keep up on the changes. Usually, a physician who is involved in clinical research is on the cutting edge. Here are a couple of resources:

• Impotence Anonymous and I-ANON. Call 1-800-669-1603 for information on local support groups.
• Call 1-800-867-7042 for names of physicians in your area who have a special interest in treating impotence.
• In general, the local hospital or clinic will have a listing of the support groups that can best provide the right sources to help the individual suffering from impotence.

Here are the available treatments for impotence. And find out why, even if you get your erection back, you may still have problems.

Last updated: 8/05

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