Child abuse and adult depression are related. Find out how sexual abuse as a child can lead to adult depression.

In the past ten years, research on depression has focused on the levels of physical and sexual abuse suffered by women in the United States. The recognition of the severity of this issue, in terms of its impact on both the lives of the abuse victims and on public health matters as a whole, cannot be understated. Various studies have established that more than one-fourth of women have experienced sexual abuse as a child and that roughly fifteen percent of respondents indicated that they had been raped at some point.

Statistically, women are ten times more likely to experience such abuse than their male counterparts.

Given the stark truth of those figures, medical experts wondered about the possible correlation between exposure to sexual and physical abuse during childhood and/or adolescence and the onset of clinical depression as an adult.

While women are believed to experience depression associated with childhood abuse twice as often as men, no risk factors could account for the difference between the genders. In a study performed by researchers from Harvard Medical School and the Brigham and Women's Hospital, this hypothesis was put to the test.

As part of a larger survey that was focused on the interrelationship between major depression and ovarian function, researchers submitted a questionnaire to 907 women between the ages of 36 and 45, of whom 732 responded. The group was chosen randomly from the greater Boston area over a two-year period. Utilizing accepted clinical tools to identify individuals who could be classified as having the disorder, the team then followed up with a secondary survey dealing specifically with exposure to violent acts.

The data that were obtained in the responses of the women brought home how severe this problem is: one out of two women indicated that they had feared or been a victim of some violent act, sexual or physical, during their early years. This same group also showed double the risk of developing depressive disorders when compared to the control group who had not been victimized. In reviewing the information, the researchers did note that in studies of this sort, some erroneous reporting by the subjects is possible. However, when compared to other studies dealing just with the exposure to personal violence, the findings were consistent as to the prevalence of those types of acts.

Clearly, the findings in this study support the conclusion that a link exists between abuse in early life and the onset of depression in later years. Further research is certainly warranted in this area, as is added attention by health care professionals to screening individuals at risk for these kinds of mental conditions due to a history of exposure to violence. It is past time to remove the stigma that has shrouded those who have suffered and to help them to heal, physically and mentally.

Source:

Wise, L., Zierler, S., Krieger, N., Harlow, B. (Sept. 15, 2001). Adult onset of major depressive disorder in relation to early life violent victimisation: A case-control study. The Lancet, 358(9285), 881-887.

For the most comprehensive information about Depression and Treatment, visit our Depression Community Center at HealthyPlace.com.

next: Child Abuse - The Hidden Bruises
~ all abuse library articles

Chapter 99 of the book Self-Help Stuff That Works

by Adam Khan:

YOU OFTEN COMPARE YOURSELF to others. We all do. You look at the way people look and sound and move, and you check how you measure up. When you stop at an intersection in your car, you watch people walk across the street and you pass judgment on the person's hairstyle, the way they dress, and so on, and you don't even try to do this. It is completely automatic.

You may not be able to stop yourself from doing it. But you can change the way you do it.

When you compare yourself to people, you look to see how they're different from you. And when you look at another and note your differences, it makes you feel superior if the comparison turns out in your favor and inferior if it turns out in their favor. When you feel superior, your feelings are communicated subtly through the way your body moves and through your voice tone, and this can make the other person feel inferior. All this mental nonsense creates a general feeling of alienation it affects your attitude and your relationships.

But there's another option. Instead of looking for differences, you can look for similarities.

Look and listen to people and notice how they are like you. Our feelings of friendliness toward people are affected by how alike we feel. When you know someone is from your home town or went to your college or is the same religion, you automatically feel more kinship with them. When you look for similarities you increase your feelings of compassion and affection toward that person. Where you once felt bad about yourself from an unfavorable comparison or made the other person feel bad because you found him to be inferior, there will now be good feelings.

Try it the next time you catch yourself judging a person or when someone annoys you. Force yourself to notice your similarities. Recall times when you acted in similar ways. Studies show we tend to think others' bad actions stem from personal motives, yet we tend to think our own bad actions are caused by circumstances beyond our control. This causes unnecessary anger between people, which is bad for health and doesn't help relationships much. Actively looking for similarities is the antidote. It's a new habit, so it will take some practice, but the process is enjoyable and the end result is too.

Notice how other people are similar to you.

How to enjoy your work more, ultimately get paid more, and feel more secure on the job.
Thousand-Watt Bulb

Make your boss a great person to work for.
The Samurai Effect

One way to be promoted at work and succeed on the job may seem entirely unrelated to your actual tasks or purpose at work.
Vocabulary Raises

This is a simple technique to allow you to get more done
without relying on time-management or willpower.
Forbidden Fruits

next: Send a Blessing

Children who are abused and neglected are at increased risk of becoming depressed adults, new research suggests.

The study, which appears in the January issue of the Archives of General Psychiatry, examined the relationship between abuse and neglect during childhood and depression in adulthood.

Researchers from the New Jersey Medical School tested their theory that abused and neglected children are at increased risk of depression as adults.

The study included 676 children who had been physically and sexually abused and neglected before age 11, and 520 children who had not been abused or neglected. The researchers followed the children into young adulthood.

"The current results show that childhood physical abuse was associated with increased risk for lifetime major depressive disorder," the authors wrote. "We also provide new evidence that neglected children are at increased risk for depression as well."

Children who were abused and neglected were 51 percent more likely to be depressed in young adulthood. Those who were physically abused and those who experienced multiple types of abuse had a 59 percent and 75 percent increased risk of being depressed during their lifetime, respectively, compared with children who were not abused or neglected.

Childhood sexual abuse was not associated with an elevated risk of depression. But, as the authors pointed out, the study participants who had been sexually abused reported significantly more symptoms of depression than the children who had not been abused or neglected.

The onset of depression started in childhood for many of the participants.

"Our age-at-onset findings reinforce the need to intervene early in the lives of these abused and neglected children, before depression symptoms cascade into other spheres of functioning," the authors wrote.

Source: JAMA/Archives, news release, Jan. 1, 2007

For the most comprehensive information about Depression and Treatment, visit our Depression Community Center here at HealthyPlace.com.

next: Child Abuse and Adult Depression: The Harsh Reality
~ all abuse library articles

Take our OCD screening test to see if you have the sympotoms of Obsessive-Compulsive Disorder. Check your results and then get detailed information about diagnosis and treatment of OCD.

PART A

Please select YES or NO.

Have you been bothered by unpleasant thoughts or images that repeatedly enter your mind, such as:

1. concerns with contamination (dirt, germs, chemicals, radiation) or acquiring a serious illness such as AIDS?
YES
NO

2. overconcern with keeping objects (clothing, groceries, tools) in perfect order or arranged exactly?
YES
NO

3. images of death or other horrible events?
YES
NO

4. personally unacceptable religious or sexual thoughts?
YES
NO

Have you worried a lot about terrible things happening, such as:

5. fire, burglary, or flooding the house?
YES
NO

6. accidentally hitting a pedestrian with your car or letting it roll down the hill?
YES
NO

7. spreading an illness (giving someone AIDS)?
YES
NO

8. losing something valuable?
YES
NO

9. harm coming to a loved one because you weren't careful enough?
YES
NO

Have you worried about acting on an unwanted and senseless urge or impulse, such as:

10. physically harming a loved one, pushing a stranger in front of a bus, steering your car into oncoming traffic; inappropriate sexual contact; or poisoning dinner guests?
YES
NO

Have you felt driven to perform certain acts over and over again, such as:

11. excessive or ritualized washing, cleaning, or grooming?
YES
NO

12. checking light switches, water faucets, the stove, door locks, or emergency brake?
YES
NO

13. counting; arranging; evening-up behaviors (making sure socks are at same height)?
YES
NO

14. collecting useless objects or inspecting the garbage before it is thrown out?
YES
NO

15. repeating routine actions (in/out of chair, going through doorway, re-lighting cigarette) a certain number of times or until it feels just right
YES
NO

16. need to touch objects or people?
YES
NO

17. unnecessary re-reading or re-writing; re-opening envelopes before they are mailed?
YES
NO

18. examining your body for signs of illness?
YES
NO

19. avoiding colors ("red" means blood), numbers ("l 3" is unlucky), or names (those that start with "D" signify death) that are associated with dreaded events or unpleasant thoughts?
YES
NO

20. needing to "confess" or repeatedly asking for reassurance that you said or did something correctly?
YES
NO

SCORING PART A:

If you answered YES to 2 or more questions, please continue with Part B.

PART B
The following questions refer to the repeated thoughts, images, urges, or behaviors identified in Part A. Consider your experience during the past 30 days when selecting an answer. Select the most appropriate number from 0 to 4.

1. On average, how much time is occupied by these thoughts or behaviors each day?
0 - None
1 - Mild (less than 1 hour)
2 - Moderate (1 to 3 hours)
3 - Severe (3 to 8 hours)
4 - Extreme (more than 8 hours)

2. How Much distress do they cause you?
0 - None
1 - Mild
2 - Moderate
3 - Severe
4 - Extreme (disabling)

3. How hard is it for you to control them?
0 - Complete control
1 - Much control
2 - Moderate control
3 - Little control
4 - No control

4. How much do they cause you to avoid doing anything, going any place, or being with anyone?
0 - No avoidance
1 - Occasional avoidance
2 - Moderate avoidance
3 - Frequent and extensive
4 - Extreme (housebound)

5. How much do they interfere with school, work or your social or family life?
0 - None
1 - Slight interference
2 - Definitely interferes with functioning
3 - Much interference
4 - Extreme (disabling)

Sum on Part B (Add items 1 to 5): ________

SCORING
If you answered YES to 2 or more of questions in Part A and scored 5 or more on Part B, you may wish to contact your physician, a mental health professional, or a patient advocacy group (such as, the Obsessive Compulsive Foundation, Inc.) to obtain more information on OCD and its treatment. Remember, a high score on this questionnaire does not necessarily mean you have OCD--only an evaluation by an experienced clinician can make this determination.

Copyright, Wayne K. Goodman, M.D., 1994, University of Florida College of Medicine

next: Anxieties Site Homepage
~ ocd library articles
~ all ocd related disorders articles

sex therapy

Thought Field Therapy has potential for the treatment of sexual disorders and sexual dysfunction. In a week-long couple's workshop, 16 couples in various stages of marriage presented many opportunities to see Thought Field Therapy in action.

In sex therapy, the basic strategy of treatment depends on the specific sexual dysfunction. While sensate focus is designed to reduce anxiety, it may increase anxiety in couples with underlying fears. Genital pleasuring can evoke negative feelings, defenses against the appearance, odors or secretions of the partner or person's genitals. For example, a woman in her 40's who had been married for 23+ years had a phobia about not wanting her husband's semen on her body, was disgusted at the thought of having semen anywhere near her face or mouth, and for any kind of oral stimulation of the penis.

I did a diagnostic TFT treatment on her. After the TFT session and home play, she reported the following: "I did not tell Larry anything about TFT prior to our home play. I was somewhat skeptical of TFT even though I really wanted it to work. To Larry's surprise, and I mean surprise, and to my amazement and delight the treatment worked. This was the first time in our years of marriage that I was able to be the 100% giver and it felt good to give back to him in ways I could never bring myself to do before."

"I later told Larry about TFT and he said it would be worth it to send me across the country for this treatment." Other sessions of TFT during the week involved successful therapy for a dislike of kissing, performance anxiety, inability to achieve orgasm, fears, and other phobic reactions. Thought Field Therapy's application in the arena of any phobic or fear response make it a viable treatment modality for many sex problems.

Most therapists find problems of sexual desire difficult to treat. Traditional sex therapy and marital therapy are the least effective in this area. In my work with a young man in his 30's, complaining of sexual boredom and passionless sex, two sessions of TFT with causal diagnosis has made a major shift in his response to women.

The strategy of sex therapy is to -modify the couple's transactions so as to eliminate fear, guilt, and anxiety,- (quote from Helen Singer Kaplan, The illustrated Manual of Sex Therapy, 1987) Thought Field Therapy is a non-threatening treatment approach that can eliminate all of the above.

What Thought Field Therapy does not propose to treat is the quality of the relationship of the couple, their ability for intimacy or their communication styles.

Victoria Danzig, LCSW, has the Thought Field Therapy Center of La Jolla where she does approved trainings in Callahan Techniques® TFT. Her web page is: www.thoughtfield.com.

Next, have you ever thought about self-help Sex Therapy?

next: Sex Therapy? Hang On! Maybe Self-Help Will Do

sexual problems

Erectile dysfunction, impotence, doesn't only affect men, it also affects partners of men like you. That's why it's so very important to keep the lines of communication between you and him open. You may already know from experience that erectile dysfunction (impotence) can be a difficult subject for some men. But the truth is, erectile dysfunction (impotence) is very common. About 30 million men in the United States suffer from erectile dysfunction (impotence) in some way. Erectile dysfunction (impotence) is nothing to feel embarrassed about or ashamed of.

The big myth is that erectile dysfunction (impotence) is all in his mind. In most cases, erectile dysfunction (impotence) is associated with a treatable medical condition. As his partner, you are in a unique position to encourage him to seek treatment for erectile dysfunction (impotence) and support him through what can be a difficult time for some men.

One treatment option for erectile dysfunction (impotence) is Viagra - a pill produced by Pfizer that taken an hour before sexual activity that helps most men obtain an erection in response to sexual stimulation. By letting him know that Viagra and other medications are out there to help him, you can help your partner take action. Let him know that you support him, are interested in his treatment and are willing to participate in all manners that will help him find a solution.

More: how impotency affects relationships.

next: National Institutes of Health Consensus Development Impotence Conference Statement

teenage sex

What is acquaintance rape?

Acquaintance rape occurs when one individual forces, coerces or manipulates another individual he or she knows to have sexual intercourse against the other's will and without consent. It is one of the most common types of sexual assault and one of the least understood. It is rape if:

• Your attacker is an acquaintance, date, good friend or spouse.
• You engaged in sexual touching and kissing, but then were forced to have intercourse against your will.
• You have had sex with that person before, but this time said no.
• You froze and did not or could not say no or were unable to fight back physically.
• There was no weapon involved.

If you have been sexually assaulted, you are not to blame, even if:

• You were drinking or using drugs. Being high does not give another the right to assault you.
• You were wearing clothes that others may see as seductive. Remember, rape is an act of violence, not sexual gratification.
• You have been sexually intimate with that person or with others.

Everyone has the right to decide when she or he wants to be sexual.

Read some myths about acquaintance - date rape

next: Specific Drugs Used in Sexual Assault

In my former life, I was a rabid perfectionist. Swirling around inside my head were images (where did they come from?) about the way reality was supposed to be. These images centered around home life, career, church, other people, and myself. The only trouble: reality seldom, if ever, conformed to my idealized mental images and expectations. And try as I might, I could not force or control or change reality into conforming to my standards. Eventually, I began to expect disappointment, which I always got, thus setting myself up for depression, anxiety and frustration.

Even worse, I rarely lived up to the perfectionist ideals I set for myself. My words and actions never matched what I should have done or said. Consequently, I spent inordinate amounts of time berating and demeaning myself for circumstances beyond my control. I obsessively measured myself against my perfectionist ideals and invariably came up lacking. Again, causing myself needless frustration and bitterness.

Perfectionism is not a healthy way to live.

Eventually, I gave in to an imperfect world and imperfect self. The truth, as I see it now, is that reality is supposed to be imperfect! Life is difficult so that I can grow. And as for myself, giving up false expectations about myself is possibly the best thing I've ever done to raise my self-esteem. I learned how to forgive, to accept, to be compassionate, and to see other perspectives beyond my own nose.

Surrendering to an imperfect universe freed me to simply enjoy life as it unfolds. Accepting my personal limitations freed me to be comfortable with myself and freed others to be comfortable around me. There is tremendous power and serenity in surrendering and accepting. There is a lasting joy and happiness living in the present moment, without expectations, without filtering people or events through idealistic, judgmental attitudes.

There is much beauty (and even perfection) in people and things just the way they are. Just being aware that life is beautiful and good and acceptable goes a long way toward curing the unhealthy desires I used to feel compelled to fix, change, control, coerce, and alter.

For me, letting go of perfectionism was a giant leap along the path to lasting serenity.

next: Becoming Whole

Interview with Jo Lee Dibert-Fitko

Jo Lee Dibert-Fitko drew her first cartoon in 1990 when hospitalized with spinal meningitis and a pituitary tumor. Once released from the hospital, she self-prescribed cartooning as a tool for healing and wellness. Combining art, writing, and photography talents into a business, Dibert-Fitko Diversions emerged. You can visit her website at www.dibertdiversions.com

Jo Lee's work has appeared in over 100 publications nationwide as well as in Europe. A graduate of the University of Michigan, she has been a featured speaker in Michigan and Illinois, as well as a consultant on the healing art of humor. Jo Lee has received awards from the Poetry Society of Michigan, Quincy Writers Guild (IL), Rockford Art Museum (IL), Zuzu's Petals (PA), Excursus Literary Arts Journal (NY) and Portals Magazine (WA). She has been a registered social worker for over 20 years and currently counsels pituitary tumor patients. Additionally, she is a member of the Flint Institute of Music (MI), Flint Festival Chorus, Tall Grass Writers Guild (IL), the Society for the Arts in Healthcare, the American Association for Therapeutic Humor, the Saginaw YMCA (MI) and the Pituitary Support and Education Network of Michigan.

Jo Lee has received feature coverage in the Flint Journal, Saginaw News, Kalamazoo Gazette and Muskegon Chronicle, and has appeared on WPON radio in Detroit and Public Television.

Mrs. Dibert-Fitko fondly refers to her pituitary gland as the "cartoon storage area."

Tammie: I want to thank you first Jo Lee for taking the time to talk with me and for sharing your amazing story.

Jo Lee: Thank you, Tammie. It's my pleasure.

Tammie: I can only imagine how frightening it must be to be given a diagnosis of pituitary brain tumor and spinal meningitis. What was your initial response when your doctor delivered the news?

Jo Lee: Actually, Tammie, the previous one-and-a-half years of chronic and unexplained physical and emotional symptoms before receiving a diagnosis was the more frightening part. So when I was told specifically what I had, I felt somewhat a sense of relief. It was the prognosis that disturbed me more. Yet ironically, or perhaps not so, the first words to my doctor were, "I'm going to beat this." At that moment, I had no idea how I would do so. I only knew that I would. Those words sparked the beginning of a new journey.

Tammie: How would you describe your road to recovery?

Jo Lee: When lying in a hospital bed, the one thing you have plenty of time to do is think! My road to recovery was indeed one that required determination, direction and constant "mind over weakened matter" reinforcement. The extreme fatigue, dizziness, visual disturbances, severe depression and debilitating pain were challenges. I was prescribed various medications to provide some relief. To the frustration of the medical staff and myself, none were effective. I decided a positive attitude and strong faith were going to have to be my illness-conquering tools. I also recalled Norman Cousin's book "Anatomy Of An Illness", and how he used humor and laughter to help him through a critical illness. I couldn't seem to muster up my own laughter so I decided the least I could do was to start smiling and at a time when that was the LAST thing I felt like doing . I began smiling at patients and staff alike. And I laughed. "You need a spinal tap." Smile. "Time for more lab work". Smile. "Just one more MRI." Smile. My developing sense of humor was met with more than one suspicious look. Even my family questioned my newfound technique. I suspected my medical chart was reviewed to see if I was on some sort of prescription drug whose side effects included "smiling at inappropriate times" and "laughing while in pain." When they sent me down the hall for an EEG (electroencephalogram), it was a turning point in my hospital stay. All those wires glued to someone's head would in many patients induce fear, anxiety or at least a visual flashback of Boris Karloff playing Frankenstein. When they wheeled me back to my bed, I flipped over the bed stand placemat, retrieved a pen and drew my first cartoon. When I presented it to the lab technicians they laughed out loud and taped it up on the wall. It was all the incentive I needed. Pretty soon everything became a cartoon...the medical tests, other patients, and the English language itself. I was provided a stack of white paper and a black marking pen. I soon discovered this self-prescribed cartoon medicine was a wonderful tool for healing and recovery...and it changed my life.

Tammie: Leaving the security of a corporate job when you were single and self-supporting in order to pursue an uncertain future writing and cartooning had to take an enormous amount of courage. How did you manage to muster the courage to take that big of a risk? And what kept you going?

Jo Lee: It did take courage and it was a risk but the much larger risk would have been to stay in a career where I was very unhappy, unfulfilled and stressed out, factors that contributed to my illness to begin with. Besides, they had taken away my health insurance and reclassified my position, making my choice easier. For the first time in my life , I decided to make ME a priority. Many of us are raised to believe that placing ourselves first is selfish, when actually it is the most unselfish thing you can do. If you do not take care of your own physical, mental and spiritual health, if you don't love yourself, you will never be able to fully give of yourself and your talents to others. It took a major illness for me to discover this. What kept me going? The fact that my health was improving was a major factor and I was truly excited about my cartooning. I also decided to reintroduce my love of writing and singing back into my career, two "joys" that I had abandoned for almost twenty years. I felt then and continue to feel and know I was given the gift to cartoon for a reason. When you are blessed with a talent that changes your status from life-threatening to life-affirming, how could I possibly choose otherwise!

Tammie: What ever prompted you to write your first book, "You Never Asked For This!"?

Jo Lee: Part of my recovery and healing process was the essential realization that I needed to share my gifts with others, particularly other patients. I started visiting hospitals and giving out cartoons to patients and staff alike. It was incredibly satisfying for all of us. Small presses started accepting my cartoons for publication. I received phone calls daily from people requesting cartoons.. for a loved one who was ill, for someone who was having a tough time at work, someone going through a divorce or someone who simply needed a smile in their day. The reasons were endless. Because of the whimsical/childlike drawing style of my cartoons, I knew early on I wanted to do a cartoon/coloring book...but I wanted it for adults. We need to reintroduce laughter to our lives and simple pleasures like coloring. The title of my book came from two sources of inspiration, the first, a general comment voiced by many an adult claiming much of what happens to us in this life are "things we never asked for." And most of the time we don't mean that in a positive light. The other source was from a gentleman I never met who received a sampler of my cartoons per a friend's request. He called me and announced, "I sure never asked for these, and I am so glad you sent them!"

Tammie: I loved the coloring book and could immediately appreciate its value to anyone facing an illness, particularly those who are bed ridden and afraid. What kind of response have you been getting from readers?

Jo Lee: The response from readers has been incredible! To see a smile on the face of someone who said "there is nothing to smile about in life" and then to see them get out crayons and chuckle is incredible medicine for both of us. It is also a great motivational factor for me. It makes me draw more cartoons. I find medical personnel and family members are equally "lightened up" with the humor. I often hear "Boy, did I need that!" Children enjoy the cartoons and physicians, therapists and patients are now endorsing the book.

Tammie: You write so beautifully and compellingly about the power of humor, how would you say your own use of humor has served you in your personal life?

Jo Lee: Humor and laughter and the arts have made an amazing difference in my health. When an MRI revealed the pituitary tumor was gone, I was not surprised, I was expecting it! The spinal meningitis ran it's course and has not been invited back, not even for a brief visit! I have some vision loss in my left eye, but I've decided it is temporary. Humor and laughter are incredibly contagious and addictive, so I like to "infect" as many people as I can. One brain tumor patient I counseled told me she felt very awkward and uncomfortable when she decided to start smiling and laughing more. But she noticed the difference in herself and with those around her. Now she tells me it would feel uncomfortable NOT to laugh!

Tammie: What would you say are the most significant differences between the Jo Lee before her illness, and the Jo Lee now?

Jo Lee: Besides a wonderful improvement in my physical health, I have found my emotional and spiritual health have become wonderful allies. I am optimistic, hopeful, enthusiastic and patient with myself and others. My self-esteem has soared upward. I live my day without centering on worry, regrets and guilt. I don't allow the little things to get me down nor overwhelm me. When challenges present themselves, I look for new opportunities and learning. I no longer think we should just count our blessings...we should celebrate them. And of course, I smile and laugh a lot and I pass it on to others. Making a difference in the lives of others has made an incredible difference in my own.

Tammie: What is the primary message that you want to deliver to those who face uncertainties and are discouraged and afraid?

Jo Lee: Life is full of uncertainties and fear, but we can make a choice not to let those events and emotions consume us. If you spend your time regretting the past and worrying about the future, you can not experience nor enjoy the present. I often think about my father's words to me shortly before his death. We were sitting in the Allegheny Mountains of Pennsylvania on a clear, starry night. Although I did not know it, the brain tumor was growing in me. I was very unhappy in life and with my work and felt a sense of confusion and anxiety about the future. As he pointed up to the night sky he said," This universe is huge. It's infinite. And you and I are but specks of dust." He paused, then continued," When some people hear that they feel overwhelmed or hopeless or say why bother, what difference does it make? Others, however, hear those same words and say, I'm just a speck of dust but I can make a big difference in myself and the world around me ...and that's one powerful tool!" I smile and say, "Indeed."

next:An Interview with Judith Orloff, M.D.

male sexual problems

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.

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