Causes of Impotence - Term Paper Example

 «Causes of impotence» One of the biggest issues with males in the present age is “impotence” which means their inability to develop and sustain an erection required for reaching orgasm and ejaculation. (Cooper, 1972). Impotence is the man’s greatest fear whether married or otherwise. It is an intrinsic feature of man to live up to his ego and express his masculinity in the most impressive manner, specially when he confronts the opposite sex. When it comes to sexual intercourse, man gains his satisfaction by displaying flawless performance that earns him complete satisfaction of his partner. Put it differently, man satisfies his ego by winning the sexual satisfaction of his partner and relishing the partner’s cravings for sex. Unfortunately, many men are not capable of achieving or delivering their maximum in the course of making love because of certain personal or natural reasons. Such a condition is referred to as impotence. Often, such circumstances destabilize the relationship between the couple and may either lead to a break-off straight away or else, decide a life-long slavery for the poor man. Although the issue once discovered, is extremely detrimental to the personal and social life of a man, things can be improved with the care, patience, determination and help of the impotent man’s sexual partner. Impotence in men is brings to them psychological torture and puts them into inferiority complex. This paper explains the various causes of erectile dysfunction in men and the possible treatment for the same. Impotence is a shameful condition caused by various biological and psychological upsets, yet the man’s sexual life can be improved manifolds if given the appropriate treatment. Causes of impotence The specific causal area of impotence discussed in this paper is erectile dysfunction. As a man steps into impotence, he experiences delays in penal response to sexual fantasies. Erectile dysfunction occurs when a man persistently fails to attain and maintain sufficiently rigid erections necessary for sexual intercourse. (Jardin & Reisner cited in Kampen et al., 2003). It so happens because of various biological reasons which include but are not limited to the man’s indulgence in unhealthy physical practices and unfavorable psychological underpinnings. Conceptually, the erectile dysfunction occurs as a result of reduced or inadequate flow of blood into the penis. Besides, erectile dysfunction can also be attributed to the damaged nerves. Erection is a matter related with human nervous and blood circulatory system. Within moments, brain sends impulses to the penis via nervous system and the circulation of blood plays a vital role in achieving the results. Any habit, condition or disease that interrupts with these bodily systems can result in erectile dysfunction. Logically, erectile dysfunction is simply powerlessness. (Doerfler, 1999). Depending on the fundamental cause of erectile dysfunction and the way the cause hinders the efficiency of systems involved in the process of erection, causes of erectile dysfunction can be broadly classified into three types as noted in (Cooper, 1972). The next paragraphs will discuss these causes in details. Organic impotence According to Cooper (1972) organic impotence counters for 5% of the total cases. It mainly happens because of some disease like diabetes or other neurological diseases that interfere with the central nervous system and the blood circulatory system causing reduced impulse and decreased supply of blood in the patient’s penis. The causes of erectile dysfunction are vascular disease, diabetes mellitus, drugs, hormone imbalances, neurologic conditions, pelvic trauma, surgery, radiation therapy, Peyronie's disease, venous leak and psychological conditions; they form part of psychogenic impotence (Healthcommunities.com, 2010). Arteriosclerosis is a condition in which the nerves become hardened and contracted. This causes a significant hindrance in the flow of blood to various parts of the body. Accordingly, blood circulation in penis is decreased like other organs of the body. “It is thought that a flow of 45 to 160 ml per minute is necessary to initiate erection.” (Michal and Kramar cited in Sharlip, 1981: 210). Reduced supply of blood in the penis because of Arteriosclerosis causes impotence in men. A vast majority of men affected by Arteriosclerosis are sexagenarians. This is particularly because Arteriosclerosis arises as a result of various age related diseases that include but are not limited to diabetes, obesity, blood pressure and exaggerated cholesterol level in the blood. Research has shown that about 0.4-0.8% decrease occurs in the testosterone level each year once a man crosses the age limit of 50 years (Phanjoo, 2000). The cholesterol level in blood is greatly enhanced by eating high fat foods. Red meat and starch consumed in excessive amounts in the youth costs a lot when a man reaches his middle age. (Powell, n.d.). However, the most significant cause of this condition is smoking that beside lung cancer, also contributes to the development of various other health disorders like impotence. Awareness about the cause and effect relationship between cigarettes and impotence has been around for long (Wang and Cumming, 1998). Large amount of sugar in blood caused by diabetes tends to cause considerable damage to the nerves. Once that happens, the damaged nerves do not support an efficient supply of blood in the penis that causes impotence in a similar way as done by other vascular diseases discussed above. According to an estimate, about 60% of the diabetic patients suffer from impotence (Healthcommunities.com, 2010). There is a large variety of drugs that is known to be responsible for impotence in men. These drugs range from medicines of everyday use like pain-killers and antidepressants to illegal narcotics as heroin and cocaine. These medicines and narcotics bring relief by meddling with the individual’s blood pressure and the individual has fair chances of getting exposed to impotence. In addition to this, alcohol when consumed in excessively large quantities can also render a man impotent. Psychogenic impotence As the name implies, this kind of impotence is caused by certain psychological factors that are not favorable for attaining a healthy sexual relationship. Psychological factors chiefly responsible for causing this impotence are fear, tension and hatred for the spouse. “Common causes of psychogenic erectile dysfunction include performance anxiety, a strained relationship, lack of sexual arousability, and overt psychiatric disorders such as depression and schizophrenia.” (Lue, 2000: 1803). Causes Factors like excessive anxiety and fear may add to the severity of condition. Many men fail to achieve erection merely because they feel they would not be able to make it. There may be cases when men might not achieve erection because of lack of confidence originated from the small size of penis. Anxiety interferes with the human nervous system and does not allow the process of erection to occur properly. The percentage of the psychiatric factors in ED like depressive disorders, anxiety disorders and OCD, psychotic disorders is 18-35%, 37% and 46-47% respectively. (Farre, 2004 cited in Burki, et al., 2004). Hatred and negative feelings for the spouse are common reasons for psychogenic impotence. This may be due to clash of personalities, differences of social status or the social circle of the two partners or simply distrust. This is one of the major causes of psychogenic impotence. Often, a man does not feel like making love to his wife only because he does not find interest in her. Instead, he might be sexually attracted to men or women who are quite older for him to have sex with. Homosexuals suffer from heterosexual impotence (Cooper, 1972: 549). Constitutional impotence: Constitutional impotence chiefly covers low sexual response shown by the impotent man. There could be a number of reasons for this to happen. The man might have been involved in excessive masturbation in the past. Constitutional impotence counts only up to 5% of the total diagnosed cases of impotence (Taylor, 2010). Causes: In a vast majority of cases, constitutional impotence occurs as a result of hormonal deficiency in the sex organs (Xavier, 2006: 16). This deficiency is often natural and there is very less contribution towards its creation on the man’s part. It is a common practice to test human fertility and the effects of drugs and other environmental factors by analyzing the sample of semen. (Hellstrom, 2006). This might happen because of a number of reasons. In a vast majority of cases, this happens because of insufficient number of sperms in the semen of the man. When the number of sperms in the man’s semen falls below a certain number, the chances of his infertility become high. (Yassin and Saad, 2008) have defined the male hypogonadism as a clinical syndrome that comes into being when the testes stop producing sufficient amount of testosterone. According to an estimate, 40% of men above the age of 45 years experience significant drop in testosterone level. (Mohamed et al., 2009). Symptoms of impotence in men What chiefly constitutes the impotence is the “erectile dysfunction” in men. There are many other forms of impotence. It is not necessary for a man to have erectile dysfunction to be impotent. A man might be impotent despite being able to show and maintain full erection. Alternatively, a man might not be impotent despite having erectile dysfunctions. In such cases, causes of the dysfunction are not purely physical but instead more psychological. A man might be sexually healthy but not have an erection because he might have lost interest in the partner, he might be fatigued, tense or mentally disturbed. When the reasons are psychological, the erectile dysfunction is occasional and might not be there another time. Long story short, a man is impotent if he is “consistently” not able to undergo a sexual intercourse satisfactorily. In other words, the biggest symptom of impotence in men is when they “never” experience erection. There is nothing alarming in occasional dysfunctions but repetitive disorders speak of the need to consult a therapist or physician. It is not that the impotent man does not naturally feel the desire to have sex with his partner. Instead, it is that he does not have an erection that would be sufficient to penetrate the penis into the vagina or in other cases, the penis might be erect in the start, but the erection would go away before the partner would reach orgasm. Despite having normal sexual fantasies, an impotent man cannot make love in the usual way. These are the symptoms that are quite noticeable. It does not take long for a man to realize he does not have a healthy sexual life because of lack of sufficient penal erection. A man gets alarmed and can know it is the time to get medical help. However, there can be cases where a man can be impotent without a slightest idea of the same. This happens when despite having indulged in a healthy sexual intercourse with his spouse, the couple cannot make babies. More often than not, it so happens that women are suspected for infertility. However, the medical reports do not always suggest the same. Even a man suffering from constitutional impotence could be responsible for it despite having a normal sexual profile. Therapeutic treatment Detailed examination of the patient’s sexual history and clinical reports is carried out to identify the potential areas of defect leading to impotence in the patient before suggesting appropriate therapeutic exercises to help improve the sexual activity of the patient. Important information related to past sexual life includes but is not limited to past sexual experiences, frequency and intensity of sex, sexual orientation, masturbation profile, experiences of puberty, first indication of impotence and the present sexual status of the patient. The analysis of above factors is followed with a detailed physical examination and blood and urine tests. In addition to that, the patient’s psychology and sexual concerns are studied in detail in order to reach the most pertinent cause and remedy for the present condition of the patient. The treatment not only requires the physician to counsel the patient psychologically but also the physician has to prescribe appropriate therapies to the patient. It is a complete psycho-physiologic therapy (Cooper, 1972) has evaluated the complete treatment for the treatment of psychogenic impotence and suggested three key components namely optimal sexual stimulation, superficial psychotherapy and thirdly, sexual education. One of them is discussed as follows: Optimal sexual stimulation In this technique, the man’s optimal capacity to enjoy the sex psychologically and physically is identified. In order to gain complete benefit from this kind of therapeutic approach towards resolving the issue, man is required to go against his intrinsic mood and be on the receptive side while his spouse identifies his comfort level and offers him the optimum level of stimulation that would satisfy his cravings for sex. The spouse needs to indulge in relaxed erotic conversation with the man and understand his psychological underpinnings as he responds to her both verbally and physically. In the psycho-physiologic treatment, both partners are required to peep into each other’s sexual fantasies. The recovery plan requires both partners to be patient and consistent and believe that the practice would serve to enhance their sexual relationship. It is imperative that neither of the two partners feels obsessed or irritated with the practice. The couple should only go for stimulation that feels soothing and only for as long as it brings pleasure. It is important for the couple not to develop new ways of gaining sexual pleasure until both of them are fully aroused sexually and are ready to indulge in an innovative sexual practice. However, there remain chances that the anticipated pleasure might not have materialized as a result of practicing the new art. In such circumstances, the couple should wisely revert to a relatively practiced and enjoyed sexual act. The role of female in therapeutic treatment is very critical. The woman has to invite the man towards sex in the start and be patient and understanding in the course of his response to her invitation. With regular practice, the man gradually discovers comfort in the practice and slowly moves to dominate the woman. The woman should not oblige the man to give her a certain level of pleasure and instead, leave it for him to decide the intensity of sex. Conclusion: Impotence destroys a man’s ego. Lack of sexual health makes a man undermine his masculinity and shatters his confidence. Unable to defend his position in the war between sexes, man looses to woman and ultimately becomes her psychological slave to gain the partner’s satisfaction in an unnatural way. Sexual intercourse requires the partners to be in an efficient psycho-physiologic condition. “Optimal male sexual function requires a host of psychological, hormonal, vascular and neurological agents acting in concert.” (Sikiru et al., 2009, p. 53). Although the effects of impotence are quite detrimental to the life of the impotent person, yet the condition stays because many men are not aware of the therapeutic treatments that are available in the present age to address the issue. Different medical procedures that include but are not limited to radiation, ultrasound, laser therapy and shock wave lithotripsy have been developed to be adopted as required over the years. (Grasso, et al., 2008). Besides, various therapeutic approaches are often adopted and are found effective. There are different treatment options depending upon the category which the impotence relates to. If the category of impotence is discovered to be organic, the patient’s condition is improved chiefly by prescribing him medicines that would help reduce the diabetes and its effects in the patient. However, the treatment procedure for psychogenic impotence is comprehensive and consumes time and requires dedication and commitment not only on the part of the suffering man but also his sexual partner. With proper treatment and medication, erectile dysfunction in men can be reasonably improved. References: Burki, M. H., Masood, M. and Adhmi, S. (2004). From Premature Ejaculation to Erectile Dysfunction via Depression. International Journal of Impotence and Research,16 (4), 334-340. Retrieved from: http://www.wpanet.org/uploads/Education/Contributions_from_ELN_Members/from-premature-ejaculation.pdf Cooper, A. J. (1972). The causes and management of impotence. Postgraduate Medical Journal,48, 548-552. Doerfler, E. (1999). Male Erectile Dysfunction: A Guide for Clinical. Management. Journal of the American Academy of Nurse Practitioners, 11(3), 117–123. Grasso, M., Lania, C., Fortuna, F., Blanco, S. and Piacentini, I. (2008). Preservation of Cavernosal Erectile Function after Soft Penile Prosthesis Implant in Peyronie’s Disease: Long-Term Followup. Hindawi Publishing Corporation. doi:10.1155/2008/646052 Healthcommunities.com, Inc. (2010). Causes of Impotence. Retrieved from http://www.urologychannel.com/erectiledysfunction/causes.shtml Hellstrom, A. J. G., Overstreet, J. W., Sikka, S. C., Denne, J., Ahuja, S., Hoover, A. M., Sides, G. D., Cordell, W. H., Harrison, M. and Whitaker, J. S. (2006). Semen and Sperm Reference Ranges for Men 45 Years of Age and Older. Journal of Andrology. 27(3). DOI: 10.2164/jandrol.05156 Kampen, M. V., Weerdt, W. D., Claes, H., Feys, H.,Maeyer, M. D. and Poppel, H. V. (2003). Treatment of Erectile Dysfunction by Perineal Exercise, Electromyographic Biofeedback, and Electrical Stimulation. Journal of the American Physical Therapy Association, 83(6), 536-543. Retrieved from http://ptjournal.apta.org/cgi/content/full/83/6/536 Lue, T. F., (2000). Erectile Dysfunction. The New England Journal of Medicine. 342, 1802-1813. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJM200006153422407 Mohamed, O, Freundlich R. E., Dakik, H. K., Grober E. D., Najari B., Lipshultz L. I. and Khera M. (2009). The quantitative ADAM questionnaire: a new tool in quantifying the severity of hypogonadism. International Journal of Impotence Research, 22, 20-24. doi:10.1038/ijir.2009.35 Phanjoo, A. L. (2000). Sexual dysfunction in old age. Advances in Psychiatric Treatment, 6, 270-277. Powell, R. (n.d.). Eating Alkaline Food May Improve Erectile Dysfunction. Retrieved from http://www.eating-veggies.com/erectiledysfunction.htm Sharlip, I. D. (1981). Penile Revascularization in the Treatment of Impotence. The Western Journal of Medicine, 134, 206-211. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1272604/pdf/westjmed00223-0057.pdf Sikiru, L., Shmaila, H. and Yusuf, S. (2009). Erectile Dysfunction in Older Male Stroke Patients: Correlation between Side of Hemiplegia and Erectile Function.” African Journal of Reproductive Health, 13(2). Retrieved from http://www.bioline.org.br/pdf?rh09020 Taylor, J. (2010). Impotence - Desire Deceased. Retrieved from http://www.buzzle.com/editorials/3-16-2006-91258.asp Wang, S. L. and Cumming, N. (1998, November 9). How Impotence Became Weapon Against Smoking. The Wall Street Journal. Retrieved from http://www.junkscience.com/nov98/impotent.html Xavier, G. F. (2006). Yoga For Health & Personality. Delhi: Pustak Mahal. Print. Yassin, A. A. and Saad, F. (2008). Testosterone and Erectile Dysfunction. Journal of Andrology. Retrieved from http://www.andrologyjournal.org/cgi/rapidpdf/jandrol.107.004630v1.pdf Read More