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Article by Jean-Marie Besnard

Impotence and erectile problems

Updated on 7 November 2023.

impotenceWhen a man experiences sexual arousal, a number of hormones, muscles, nerves and blood vessels activate and work in conjunction with other organs to signal arousal in the form of an erection.

Nerve signals sent from the brain to the penis stimulate the muscles so that they are relaxed and elastic, allowing blood to circulate through the penile tissue.

Once blood is distributed through the penis muscles, an erection is achieved. The available blood vessels in the muscle are locked, enabling it to maintain good rigidity. Once sexual arousal has passed, or the act is complete, the veins in the penis reopen, and blood can leave the penis so that the muscle relaxes.

At some point in his life, a man may experience difficulties in generating or maintaining an erection. Erectile problems occur when a man is unable to achieve an erection firm enough for sexual intercourse.

For most men, this problem occurs from time to time, which is nothing to worry about. However, if you’re unable to generate an erection at least 1 time out of 4, chances are you have a health problem that requires medical advice.

For your information, erectile dysfunction is also known by the following terms:

– Erectile dysfunction (ED)
– Impotence
– Sexual dysfunction
– Erectile dysfunction

What is impotence or erectile dysfunction?

Stimulated by both internal and external factors, the organ responsible for male reproduction – the penis – becomes engorged with blood, swells and hardens: this is known as an erection. But when this essential factor fails to occur, even under the influence of various stimuli, the result is dysfunction. What is it? What factors can influence this type of problem?

The erection mechanism

Erection is a natural part of a man’s sex life. It’s also an important and essential part of a couple’s sexuality.

It can be influenced by various factors, both physiological and psychological. It’s a time when the penis becomes gorged with blood, hardens and enlarges.

For an erection to occur, the man must have been subjected to numerous stimuli (sexual stimulation), and his body (the nervous and circulatory systems) must work in synergy to stiffen the penis.

It’s a complex chain of interactions, correlated with biophysiological and biochemical factors, that keeps the penis erect.

Causes of male impotence

Erectile dysfunction is a phenomenon that can be caused by many factors. It is, in fact, a man’s inability to get an erection or maintain the rigidity of an erection during sexual relations. It may be psychological or physiological in origin.

Psychological causes include :

– Stress caused by work, the incessant desire to succeed, or the loss of one’s job, for example ;
– Internal problems within the couple;
– Difficulties in expressing oneself to one’s partner (the man can’t express himself properly when it comes to the positions to adopt during sexual relations, for example);
– Lassitude and boredom with sexual relations;
– Hostility towards his partner;
– Lack of motivation;
– Fatigue;
– Financial difficulties;
– And many other reasons…
stress couple bed
Erectile dysfunction can also be physiological in origin. This is a dysfunction caused by a disorder of the genital organs or other structures involved in erection.

These include

– An abnormal blood system, cardiovascular disease, diabetes… are the main causes;
– The use of certain medications. Some drugs have the side effect of delaying erection. These include antidepressants and cimetidine;
– Surgery, as in the case of prostate removal for health reasons;
– Nervous system dysfunction;
– Smoking, which contributes to the development of cardiovascular disease.

Impotence: At what age? A few statistics to help you understand:

According to many studies, sexuality declines with age. And yet, even at 70, it’s still relevant.

Given the various factors that can influence erection, one in five men (1/5) is affected by erectile dysfunction.

Erectile dysfunction is not common among young men. Erectile dysfunction generally starts to appear in men in their fifties, and the risk of a man suffering from it increases considerably as time goes by. It even becomes common in old age. In fact, almost a third of men between the ages of 50 and 70 will experience erectile dysfunction in their lifetime!

However, it has been observed that the most frequent causes are psychological.

Anchored in our habits and predefined as a natural need, sexuality is an integral part of our lives. But when a man is under pressure and faced with psychological as well as physiological problems, he can fall victim to erectile dysfunction. That’s why it’s important to pay attention to our lifestyle so we can enjoy a fulfilling sexuality.

Of course, we do have “breakdowns” from time to time… But how can we tell the difference? How do you know if you’re dealing with underlying erectile dysfunction?

How do you diagnose impotence?

A temporary erectile problem, if it only happens to you once in a while, shouldn’t worry you. Every man has a so-called “failure” in this area at some point in his life. You could even call it a temporary breakdown. Likely causes of the occasional inability to get (and maintain) a good, hard erection include, among others:

– Anxiety;
– Fatigue
– Stress;

Why consult a doctor rather than someone else?

For a proper diagnosis of impotence, it’s not a good idea to go to just anyone!

Here’s why…

– Only a doctor can assess your state of health and decide whether you have a medical problem;
– Only a doctor can carry out tests that may be necessary to assess the problem;
– If it becomes necessary to prescribe medication, only a doctor can do so.

So, what type of doctor should you see?

There are different types of doctors you could consult.

Talk openly to your GP about your erectile dysfunction!

As a good starting point, talk to your GP. After all, he/she knows you personally, knows your antecedents and has access to your medical records.

So, if you’re afraid of his or her looks or judgment, don’t worry, it’s his or her job. What’s more, there’s nothing shameful or funny about impotence. And, as a doctor, he/she is obliged to maintain “secrecy”; professional ethics do not allow him/her to divulge any information about you.

What’s more, if your doctor can’t really help, he/she will refer you to another doctor qualified to treat your case.

However, many men are very embarrassed to discuss this problem with their GP. If this is the case, you should talk to another GP. Or go and see another type of doctor, for example:

– A doctor in a multidisciplinary consultative clinic;
– A doctor in a genitourinary clinic;
– A private doctor – sexologist, or urologist (a surgeon who treats the genital and urinary systems).
Seeing a sexologist for impotence

Deciding to go to the doctor to diagnose erectile dysfunction

You may feel embarrassed or even frightened at the idea of going to see a doctor, but doctors are used to dealing with this kind of case. These days, erectile dysfunction is so common that some doctors see half a dozen cases a week. It’s a matter of course for them.

The best thing is to plan your consultation in advance, so that you know what you’re going to say beforehand.

Some men feel quite petrified at the idea of expressing the problem aloud. Others are embarrassed, prudish or simply too shy to say the right things, and for many, it has to be said, it’s a question of ego.

But understand two things:

1/ It’s a problem with a solution that needs to be dealt with. Don’t let your ego or your shyness destroy your sexuality!

2/ There’s really nothing to worry about. Your doctor has seen it all! All you need to say is: “Doctor, I think I have erectile dysfunction!”

Questions you could ask the doctor:

– What’s the cause of my erectile dysfunction?
– Can it be treated?
– What treatments are available?
– What changes do I need to make to my lifestyle?
– Do I need pills?
– Would you be willing to see my partner and explain the situation to him/her?

Don’t pretend you have something else!

Many men are so ashamed of their erectile difficulties that they pretend they have something else instead. Don’t do it: you’d be shooting yourself in the foot!

They go to their doctor about some real or invented pain, like backache, and when the doctor has dealt with that problem – just as they’re about to leave – the patient decides to speak up and says: “Oh, there’s something else, Doc: I think I’m impotent…”

Qualified doctors are familiar with this ploy, which they encounter regularly, but we can only advise against it! It’s best to get straight to the point. It’s the best way to diagnose impotence.

It’s much simpler and quicker to tell the doctor right at the start of your consultation that you think you’re suffering from erectile dysfunction.

What will the doctor do to treat your impotence?

A doctor who is used to treating erectile dysfunction will take the time to talk to you about the problem.

If your doctor is not accustomed to treating erectile dysfunction, he or she should refer you to someone who is more qualified in this field.

The doctor will ask you a series of frank questions about erection and sex. You shouldn’t be surprised. We’ll tell you what those questions are, so you can be prepared to answer them.

So here are some questions the doctor should ask you:

– Can you get an erection, in general?
– If so, is it strong enough for penetration?
– Do you lose your erection after penetrating your partner? And if so, can you get it back afterwards?

Next, there will almost certainly be questions about your lifestyle.

– Are you married?
– Are you heterosexual, homosexual or bisexual?
– How many partners do you currently have?
– Does the erection problem only produce with one of them, or with all of them?
– Do you have morning erections?
– Can you get an erection if you masturbate?
– How many cigarettes do you smoke a day?
– How much alcohol do you drink per week?
– Are you currently taking any medication?

It’s important to answer these questions honestly. Remember: what you tell the doctor is completely confidential.

He will also ask you questions about your general state of health.

Physical diagnosis

The next step is a physical examination. A good doctor will always do a brief physical examination for erectile dysfunction. The doctor is mainly looking for any bodily disorders that could be the cause of your problem.

He should examine your penis and testicles. Some doctors even do a rectal examination to further investigate the prostate.

If there’s a possibility that you might have a neurological (nerve) disorder, the doctor’s examination should also check your reflexes and see if you can feel things like wool, cotton or a pin applied directly to the skin.

The doctor should also check your blood pressure, and make an assessment of your general state of health.

What about tests to detect sexual impotence?

In most cases of erectile dysfunction, very few tests are necessary – unless the doctor’s examination suggests that you might have a physical illness (which is rare).

You should have a blood pressure test and a urine analysis to check for sugar (its presence suggests diabetes) and protein (its presence suggests kidney problems). Some doctors believe it’s better to do a blood test for diabetes.

A minority of doctors will ask for other tests in addition to blood tests to check your male hormone levels, but some experts think this is unnecessary – unless the patient has obvious physical signs of low testosterone, such as lack of body hair or the presence of certain rather feminine features.

What happens next?

On the basis of his interview, as well as his examination and tests, the doctor should probably be able to give you the most likely cause of your erectile dysfunction and, depending on the situation, treat you or refer you to a colleague. In short, if you feel that it’s really starting to bother you, don’t hesitate to ask for an impotence diagnosis to screen for your erectile dysfunction.

To find a solution to a problem, you first need to identify its cause. What causes impotence? What causes erectile dysfunction?

Causes of sexual impotence

ImpotenceImpotence, poor erection, erectile disorder, erectile dysfunction… so many terms to define one and the same thing that has haunted men since the dawn of time. Erectile dysfunction affects 1 in 3 men, though it’s rarely or never talked about.

So what are the main causes of erectile dysfunction? What can cause a man to lose the strength of his penis during intercourse?

Physical impotence

The causes of erectile dysfunction can also be physical. In fact, this is due to disorders that can affect the nerves and blood vessels responsible for the appearance of an erection.

Physical causes of erectile problems include:

– Cardiovascular disease;
– Atherosclerosis (hardening of the arteries);
– Hypertension;
– Diabetes;
– Obesity;
– High cholesterol ;
– Parkinson’s disease;
– Multiple sclerosis;
– Peyronie’s disease (development of scar tissue in the penis, causing a painful erection);
– Use of certain medications, including diuretics, muscle relaxants or antidepressants;
– Alcoholism or drug addiction;
– Smoking;
– Trauma or injury to the spinal cord or genital region;
– congenital problems, such as hypospadias or epispadias;
– Complications of circumcision;
– Liver or kidney disease;
– treatment for prostate problems.

This list is not exhaustive. It does, however, cover the main physical causes observed by doctors.

Impotence: psychological causes

From a psychological point of view, 40% of men complaining of erectile problems are between the ages of 25 and 45. The psychological problems that tend to distract men during the sexual act are legion, and include :

– Anxiety about not being able to achieve or maintain an erection.
– Prolonged emotional distress linked to economic, professional or social worries.
– Relationship problems.
– Depression.
– An obsession.
– …

In short, anything that might alter personal temperament and affect sexual performance in bed is considered a possible cause of erectile dysfunction.

Erectile dysfunction complicates your life

Impact of impotence on the coupleThe complications associated with impotence are significant and can affect your lifestyle. Erectile dysfunction can affect your psyche as well as your body, particularly in terms of :

– stress or anxiety ;
– embarrassment ;
– low self-esteem ;
– relationship problems ;
– dissatisfaction with your sex life.

What are the complications of erectile dysfunction?

As an essential part of life, sexuality is at the heart of the human development cycle. For a couple to reach their full potential, their sexuality must be satisfying. But when erections are a problem, a man’s sexual activity slows down.

This upsets the balance within a couple, and many men worry not only about their virility and health, but also about all the other problems that erectile dysfunction can cause. All these questions bring us to the heart of the matter, to understand erectile dysfunction and the complications it can cause.

Psychological complications keep him from standing at attention

Erectile dysfunction is a condition that can worsen your health by weakening you psychologically. Most people suffering from erectile dysfunction are unable to express themselves. Some only dare to broach the subject when their partner is trying to understand what’s wrong. Erectile dysfunction is an obstacle to a man’s sexual fulfillment. It can be at the root of many other problems. In fact, certain factors should not be overlooked:

– Alcoholism and smoking. This is a recurrent phenomenon among erectile dysfunction sufferers. It’s a means of consolation and comfort for these people, who seek to conceal the truth.

– Withdrawal, even isolation. These factors are not conducive to human development, let alone recovery from dysfunction. It eliminates any possibility of seeking treatment and, consequently, regaining his virility.

The burden of physiological complications

Physiologically, erectile dysfunction results from the malfunction of some of our organs. Ignored and misinterpreted, for most of us erectile dysfunction is often the result of diabetes.

In fact, two out of three men (2/3) suffering from erectile dysfunction also have diabetes. Diabetes contributes to the deterioration of general health. And, if not promptly treated, it contributes to the onset of other illnesses (necrosis, eyesight problems, etc.) and the worsening of impotence.

Moreover, the appearance of erectile dysfunction is often a sign of another underlying disease. These include cardiovascular disease. That’s why it’s so important to take care of your health and alert your doctor to any symptoms of erectile dysfunction.

In the absence of a cure, it is of course preferable to do everything possible to prevent the disease. So, how do you prevent a serious condition like erectile dysfunction? Is there an “anticipatory cure”?

What treatments are available for impotence?

How to treat impotenceErectile dysfunction is one of the most serious problems affecting men’s lives. It’s normal, since it affects the most critical aspect of a man’s life: his virility. When a man is confronted with a sexual disorder, he quickly enters a vicious circle! He suffers permanently and silently, because the subject is quite taboo. Few are able to talk openly about it, while the majority continue to assume the worst. This, of course, is a major obstacle to the treatment of impotence.

Impotence can be cured! It’s important to remember that anything can be cured, until proven otherwise! When an erectile dysfunction occurs, it should not be treated in the same way as a serious illness.

Erectile dysfunction can be cured if properly diagnosed and treated. From the use of specific medications to reconstructive surgery, penile extensors and intra-penile prostheses, several treatment methods exist. However, before considering any of these solutions, it’s perfectly possible to start by treating it yourself, at home.

A healthy lifestyle for a healthy penis

To treat impotence at home, it’s imperative to know what’s causing the problem. If you can pinpoint what may be causing your impotence, you can then attack the problem directly at source!

Today, we’re going to look at the lifestyle each of us adopts: maybe you’ve never thought about it, but… your lifestyle can easily be your number 1 enemy!

So, if you want to take radical action and give yourself the best chance of a successful treatment, you can (already) start by :

– Reduce or stop smoking for good;
– Reduce your alcohol consumption considerably;
– Getting plenty of rest (especially enough sleep at night, of course!);
– Maintain a healthy diet;
– Engage in regular physical activity to maintain your figure or lose weight if necessary;
– Talk to your partner about the problem, and quickly: it concerns her too, and she’ll help to solve the problem by first accepting it and then trivializing it.

The right diagnosis for the right treatment

From this point on, if no change is felt, it would be best to move up a gear: contact your doctor to determine the cause(s) of your erection problems. Your doctor will examine your penis, rectum and nervous system functions.

Your doctor may also ask you to undergo certain tests and examinations to be able to diagnose precisely what is altering your erections. These may include

– a complete blood count (CBC), a set of blood tests that check, among other things, for anemia (red blood cell count) ;
– hormone profiling (especially testosterone and prolactin);
– a nocturnal penile tumescence (NPT) test, or erection during sleep;
– ultrasonic sound waves to identify potentially damaged blood and muscle tissue;
– urine analysis to measure protein and testosterone levels.

Once your doctor has determined the cause of your erectile dysfunction, he or she will suggest the appropriate impotence treatment. Treatment options may include the resolution of an underlying health problem, or the doctor may propose an intervention to drastically reduce erectile dysfunction.

Treatment options for erectile dysfunction may include:

– Drugs injected into the penis, including prostaglandin E1 (alprostadil) and papaverine ;
– Drugs injected into the urethra (alprostadil (MUSE));
– Oral erectile dysfunction drugs such as sildenafil (Viagra) or tadalafil (beware of side effects); or natural remedies with no significant side effects;
– Reconstructive surgery ;
– Penis suction devices or penis pumps.

Other treatments are still being developed. Indeed, science never stops searching for any form of solution capable of overcoming this type of sexual disorder that threatens men’s well-being!

Interested? You can already consult our Solutions for Impotence treatment section. Virility.

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