Showing posts with label impotence. Show all posts
Showing posts with label impotence. Show all posts

Impotence is a term that has mostly fallen out of use, in favor of the more descriptive and clinical term erectile dysfunction, although it is still used at times in both in popular culture and by some physicians when talking about sexual dysfunction in males (for example, there is still a medical journal called The International Journal of Impotence Research).

What Is Impotence?

The way it's used today, impotence refers in general to a man's inability to perform sexually, and specifically to his inability to get an erection. Of course, impotence has many other meanings, including powerless, helplessness, weakness, etc... The inaccurate idea that if a man can't get an erection, he has no sexual power, is what makes impotence such a dangerous but also popular term. It's a word that strikes fear in the hearts of those who are worried it might happen to them, and causes pain when it's directed at someone as an insult.

Impotence isn't an accurate term because the truth is that men have sex all the time with and without erections, and a man's sexuality or power isn't related to just one part of his body. When we confuse ability to get erections with ability to give and receive sexual pleasure, we make worse a complicated and common sexual complaint -- an inability to get an erection that is satisfactory for sexual pleasure.

In order to understand why erections don't work, you need to understand the basics of how erections work. Getting an erection involves multiple parts of your body, including your brain, nerves, hormones, muscles, and heart. Anything that interrupts this any of these systems may result in what gets called impotence.

Causes of Impotence

Because erections involve multiple systems, there are often multiple causes of impotence, even for one man. Causes of impotence are often broken down into different categories. These include:

Physical Causes:

  • Diabetes
  • High blood pressure
  • Multiple sclerosis
  • Parkinson's disease
  • Heart disease
  • Conditions that affect thyroid function and/or interrupt hormones in the body
  • Spinal cord injuries
  • Injuries to the groin (recent research also points to consistent but mild trauma related to cycling)
  • Colon surgery
  • Hemodialysis
  • Prostatectomy
  • Other treatments for prostate, penile, and rectal cancers, including some chemotherapy and hormone treatments
  • Medications for high blood pressure, heart disease, and some antidepressants
  • Alcohol
  • Marijuana
  • Cocaine
  • Tobacco

Psychological Causes:

  • Depression
  • Stress
  • Sexual performance anxiety
  • Relationship problems (which may or may not be related to sex)

Treatments for Impotence

Once you've determined the cause or causes, there are various treatment options, including:

What Should I Do If I Think I'm Impotent?

If you are experiencing difficulty with erections, the first step should be to speak with a doctor. Erectile difficulties may be an early warning sign of other potentially serious health problems -- your body's way of telling you that something else is going on. It's important to understand what might be causing the changes in your erections.

In addition to seeing a physician, you may want to consider speaking with a therapist or counselor, and perhaps a sex therapist. Sex therapists specialize in the diagnosis and treatment of sexual dysfunctions. If you see a sex therapist, you'll also need to get a medical exam, but a therapist will likely have more information than your regular doctor about the details of sexual dysfunction.

One of the most difficult aspects of erectile difficulties is the way that our thoughts and feelings can perpetuate our difficulties. We all have the right to use language we want to describe ourselves. But you may want to consider how describing this problem as impotence, or calling yourself impotent, is actually working against your goal of feeling positive about yourself and your ability to both give and receive sexual pleasure.

What Should We Call Impotence?

The term impotence is already in the process of disappearing from medical literature (although it's a slow process). Impotence is a problem in part because of the way it makes men feel, and also the message it explicitly sends about sexual power being only about erections. Impotence is also a problem because it isn't precise. This might be fine for literature, but if you're trying to isolate and solve a health problem, the more precise you can be, the better. So impotence should be called whatever it actually is. If it's erectile dysfunction, call it that. If it's premature ejaculation, call it that. If it's a bad relationship, or a bad year, call it that.

Source: About.com

Research has shown that the sexual effects of alcohol are different for men and women. This is likely the result of both physical and social differences in the way women’s bodies and men’s bodies react to alcohol and respond sexually.

Not surprisingly, the amount of alcohol consumed, and how often a man drinks, has an impact on whether there will be negative sexual effects of alcohol for men. Most of the research in this area has been with men who are, or were, alcoholics. Sexual effects in these studies include:

  • Difficulty getting and maintaining erections
  • Difficulty ejaculating/delayed ejaculation
  • Reduced sexual desire
  • Increased sexual aggression
  • Infertility

As with women and alcohol, men may find that small amounts of alcohol increase sex desire and sociability. But positive quickly turns to negative as the amount of alcohol consumed increases. One of the differences researchers often point out is that most men consider an erection necessary for sex, and consuming high amounts of alcohol usually has a negative effect on erectile function.

How common are sexual effects of alcohol for men?

Because most of the research relies on men recalling past sexual experience and performance, and because research studies differ wildly in their methodology, narrowing down prevalence isn’t easy.

Estimates for men having difficulty with ejaculation range from 5-25% in some studies. Some researchers estimate that as many as 54% of alcoholic men have difficulties getting and maintaining erections, and decreased sexual desire has been found in between 31-58% of men across several studies.

The impact on men who are not alcoholics, and men who are drinking low to moderate amounts of alcohol is likely much less than this. And while drinking enough alcohol to become intoxicated may very well result in not being able to get an erection, if the man isn’t a chronic drinker, the erection difficulties should not persist.

Alcohol’s impact on testosterone in men

Researchers debate the impact of alcohol on testosterone in men. Whether they are definitive or not, there are several studies that show a decrease in testosterone both in alcoholic men and in non alcoholic men who drink enough to become intoxicated. Alcoholism can result in hypogonadism. However, with men who drink occasionally, testosterone levels return to normal, and moderate amounts of alcohol are not associated with reduced testosterone.

Can sexual effects of alcohol be reversed?

We don’t know the point at which sexual effects of alcohol such as erectile and orgasm difficulties become irreversible. We also don’t know exactly how long after a man stops drinking that his normal sexual functioning may resume.

One study of over 17,000 alcoholic men found that after several years of no alcohol 50% returned to normal erectile functioning, and the other 50% were either partially or completely unable to get an erection, even when sexual desire returned.

Sexual dysfunction due to alcohol abuse may also be caused by the kinds of diseases made worse by chronic alcohol consumption (for example diabetes and heart disease).

Sources:

  1. Crenshaw, T.L. & Goldberg, J.P. Sexual Pharmacology: Drugs that Affect Sexual Function. New York: Norton, 1996.
  2. Muthusami, K.R. and Chinnaswamy, P. “Effect of Chronic Alcoholism on Male Fertility Hormones and Semen Quality.” Fertility and Sterility. Volume 84, Issue 4 (2005): 919-924.
  3. Seagraves, R.T. & Balon, R. Sexual Pharmacology: Fast Facts. New York : Norton, 2003.