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Estimated to affect about 15 to 30 million individuals, male impotence is commonly noted in individuals above the age of 65 years. Although considered as a disorder of old age it can also affect men at any age after puberty.

Causes of male impotence

Male impotence, also known as erectile dysfunction refers to the inability of a man to attain an erection or maintain it until the completion of the sexual intercourse. This disorder can be devastating to both men and their sexual partners. Estimated to affect about 15 to 30 million individuals, male impotence is commonly noted in individuals above the age of 65 years.

Although considered as a disorder of old age it can also affect men at any age after puberty. Male impotence is thought to occur either due to physical or psychological causes.

There are several modalities of treatment available for this disorder and it has been generally proposed that male impotence can be treated at any age.

Generally known as a disorder of old age, male impotence can occur due to a number of reasons. Broadly speaking, male impotence can occur either due to physical or psychological causes. Physical causes refer to factors such as injury, while psychological causes refer to anxiety, depression or fear.

To better understand the causes of impotence it is necessary to understand how erection occurs. Penile erection is the consequence of a number of events that occur in a particular sequence. This includes presence of an excitatory situation following which the nerves send signals to the brain, which responds by sending signals to the tissues of the penis. This is followed increased blood flow to the tissues of the penis, which when filled causes erection. Disruption at any of these stages can result in impotence.

Physiological and physical causes of impotence

Male impotence during old age is generally attributed to presence of underlying diseases that affect the blood supply and the nerve conduction, injury or adverse effects of certain medications.

Disorders such as diabetes, kidney disorders, atherosclerosis, nerve disorders and conditions such as chronic alcoholism can affect the blood supply and hence cause impotence.

Lifestyle factors such as smoking, overweight or obesity, lethargic lifestyle can also affect the rate of blood flow and cause impotence. Hormonal deficiency can also result in male impotence.

In some rare instances where, injury to the penis or nearby structures or to the blood or nerve vessels that supply the penis occurs, impotence can be noted. Similar affects can be noted following surgeries in this region.

Consumption of certain groups of medications can also lead to male impotence. Medications such as antidepressants, blood pressure reducing agents, antihistamines, appetite suppressants can others are known to affect the blood supply to the pelvic region resulting in male impotence.

Psychological causes

About 10 to 20% of the individuals suffer from psychological impotence. This type of male impotence can be noted at any age. Some of the common psychological factors that may cause male impotence include: depression, stress, anxiety about impotence or sexual encounter, guilt, low self esteem, and fear.

Risk factors of male impotence

Any factor that affects the blood flow or the nerve supply to the penile tissues is considered as a risk factor of male impotence. Some of the commonly noted risk factors of male impotence include:

  • Age above 60-65 years
  • Presence of underlying disorders such as diabetes
  • Obesity
  • Smoking
  • Lethargic lifestyles
  • Consumption of medications
  • Testosterone deficiency
  • Presence of psychological disorders or conditions such as anxiety, depression or other similar disorders

These risk factors affect either the blood flow or the transmission of nerve signals to result in impotence. Some or many of these factors may act in harmony to cause impotence in a few individuals. While age is considered as the factor with the highest risk of impotence, it is not the only one. On the contrary individuals who are older than 70 years of age have reported successful erections and sexual intercourse.

Symptoms of male impotence

According the definition of erectile dysfunction, an individual is said to be suffering from erectile dysfunction or male impotence if he cannot bring about an erection or is unable to sustain the erection until the completion of the sexual intercourse. Men are said to be suffering from impotence if they have difficulty in attaining an erection or maintaining it more than 25% of the times they attempt to have a sexual intercourse.

Normally men are able to get an erection following various kinds of stimulation such as seeing, listening, touching or smell. Sensations such as these result in the generation of the excitatory signals from the brain leading to increased heart rate and increased supply of blood to the tissues of the penis. Once the blood fills within the tissues of the penis, erection occurs. These processes are affected in individuals with impotence. As a result they are not able to attain an erection or may not be able to attain complete erection.

Once an erection occurs, the tissues and blood vessels within the penis constrict and prevent the return of blood from the penis. Theses tissues do not relax until ejaculation occurs; once a man ejaculates, the stored blood clears and the blood flow returns to normal. A man is able to enter the women during the sexual intercourse only if the penis is erect and stays hard. In individuals suffering from impotence, this stage of erection either lasts for a very short duration or does not occur at all. This leads to inability of the man to penetrate the women during sexual intercourse.

Based on the symptoms of erectile dysfunction/impotence has been categorized into three categories:

  • Mild impotence: decreased ability to attain or maintain an erection with intermittent satisfactory sexual performance
  • Moderate impotence: decreased ability to attain or maintain an erection with infrequent satisfactory sexual performance
  • Severe impotence: decreased ability to attain or maintain an erection with rare or absent satisfactory sexual performance

Individuals suffering from mild impotence may be able to attain an erection and have an intercourse with ejaculation in many instances. However, the frequency of such encounters may vary. In case of moderate impotence, such encounters or occasions are much lesser. In severe cases, men are rarely capable of having a sexual intercourse.

The affected men may also suffer from depression, anxiety or irritability due to an inability to have sexual intercourse.

  • kidney.niddk.nih.gov/kudiseases/pubs/impotence/
  • familydoctor.org/online/famdocen/home/men/reproductive/109.html
  • www.emedicinehealth.com/impotenceerectile_dysfunction/page2_em.htm
  • www.nlm.nih.gov/medlineplus/ency/article/003164.htm