The Science of Impotence

Before explaining the causes behind impotence or erectile dysfunction, it is important to understand how a healthy erection is achieved.

Successful erections require the coordinated actions of a healthy brain, pliable blood vessels, fully functional nerves, and certain hormones. Erotic stimulation, triggered by the five senses or by memory, begins the erectile process. The nervous system responds by sending chemical messages to and from the pelvic area.

These messages cause the smooth muscle tissue inside the penis to relax. The blood vessels dilate, allowing more blood to flow into the corpora cavernosa, the two erectile bodies within the penis. Like sponges, they capture more blood, swelling and lengthening the penis. When all of the spaces are occupied with blood, the organ becomes rigid. The enlarged corpora cavernosa take up so much space inside the penis that strong pressure is exerted against the penile veins, greatly reducing their outflow of blood.

At this point, the erect penis contains eight times more blood than the same flaccid or non-erect penis. As long as the sexual stimulation is continued, an erect stage can be maintained until orgasm and ejaculation.

What Causes Impotence?

Impotence is not a disease, but a secondary condition brought on by other, primary causes. It is a side effect, a symptom of something else. Thirty years ago, when men went to their doctors asking for help for erectile problems, they were told that there was no treatment because it was caused by aging, or it was all in their heads (psychological). A generation of research has been conducted in the intervening years. With more knowledge now, doctors divide this very common disorder into four general causes:

1. Psychological

2. Physical (Organic impotence)

3. Mixed origin-both psychological and physical

4. Unknown origin

About 85% of this problem is due to a physical (organic) cause. Slightly more than 10% is totally psychological, or "all in your head." The other 5% is unknown. The 85% figure includes a mixture of physical impotence with psychological involvement. Once a man fails to become erect a few times, he places more stress on himself to have an erection by sheer will power. When this too fails, he often begins to have a psychological problem.

The main point here is this: 85% of all impotent men are that way because something within the body, other than the penis, is malfunctioning.

Psychological Impotence describes the problem when physical causes cannot be found. Pure psychological impotence usually comes on suddenly. It can be caused by job stress, a troubled marriage, or financial worries. Any nagging everyday situation which occupies conscious and subconscious thoughts can cause impotence. Depression or concern over poor sexual performance can cause it.

It should be noted that every man experiences temporary periods of impotence at one time or another during his life. That's entirely normal, and you don't need treatment unless the problem is persistent.

Physical Impotence develops gradually and is characterized by any of these three basic functional problems:

1. Failure to initiate results from impaired release of the chemical messages sent by the nervous system. The inability to develop an erection is common in cases of hormonal insufficiency, spinal cord injury, radical pelvic surgery, multiple sclerosis and Parkinson's disease.
    

2. Failure to fill results from poor blood flow into the penis. The inability to develop an erection rigid enough for intercourse is caused by blockage in the arteries, common in cases of pelvic trauma, hypertension, smoking, diabetes and high cholesterol.
    

3. Failure to store results from venous leakage when blood escapes too quickly from the penis, leaking back into the body. This inability to maintain an erection rigid enough for intercourse is common in cases of hypertension, smoking, diabetes, high cholesterol and pelvic trauma.

The important thing to remember is that most causes of impotence are physical and often beyond your control. While it is not good to have these physical problems (diabetes, high blood pressure, stroke or prostate disease, etc.), they are conditions you can probably accept and feel comfortable about trying to correct.

• Diseases of the blood vessels (vascular disease) is the leading cause of impotence. Vascular disorders include arteriosclerosis (hardening of the arteries), hypertension, high cholesterol and other conditions which interfere with blood flow. If poor blood flow occurs in the heart, or coronary vessels, it causes heart attacks; when it occurs in the brain it causes strokes; and when it occurs in the penis, it causes impotence.
   

• Another problem, "venous leakage," occurs when the penile veins are unable to close off (constrict) properly during an erection. Constriction of the veins holds the blood in the penis to maintain the erection. When the veins "leak," blood escapes too quickly back into the body, and the erection fails.
   

• Diabetes is a very common cause of impotence. This disease can damage both blood vessels and nerves. When nerves are affected, the brain cannot properly transmit the sexual stimulus that creates an erection. About 50% of all diabetic men experience impotence after the age of 55.
   

• Radical pelvic surgery may also result in impotence. Surgical procedures involving the prostate gland the bladder or colon may sever the nerves involved in erectile response. Radiation treatment in this area can also affect the erectile process.
   

• Neurologic (nerve) disease is another cause of impotence. Neurologic disorders affect the nervous system and include multiple sclerosis, Parkinson's disease and spinal cord injury with paralysis.
   

• Deficiencies of the endocrine system are another source of erectile dysfunction. For example, low levels of testosterone or thyroid hormone often cause poor quality erections. Excessive production of prolactin by the pituitary gland may contribute to a low testosterone level and lack of desire. Diabetes is also considered an endocrine disease.
   

• Prescription drugs often cause Impotence as a side effect, and over 200 medications fall in to this category. Never change a dosage or stop taking a prescribed drug without the advice of your doctor.
   

• Substance abuse affects erectile function as well. Illegal drugs and the excessive use of alcohol or cigarettes can seriously damage the blood vessels and nerves involved in a normal erection.

Treatment for Impotence

1. Viagra
   In recent years, Viagra, or sildenafil citrate has grown in popularity as a temporary solution for erectile dysfunction and impotence. Viagra is an effective method with men reporting 66% - 88% satisfaction using this medication. Viagra requires a doctor's prescription. By taking one Viagra prior to sexual activity, men can experience very strong and long duration erections. Viagra costs about $13 per pill and must be taken prior to every sexual engagement. One fact about Viagra that is not known to a large portion of users, is that over extended use, Viagra can actually cause even more severe sexual dysfunction and may irreparably damage the penis.
    

2. Yohimbe and related sexual herbals.
   In recent years medical professionals have explored alternative methods for treating impotence. Herbals such as Yohimbe, Maca, Catuaba and Tribulus have been tested for their chemical properties and numerous clinical trials, with positive results have been performed. For men looking for a non-prescription, lower cost alternative to Viagra, herbal formulas containing all or some of the ingredients listed above can deliver excellent results over time. Unlike Viagra, however, herbals do not work overnight or within a few hours. The key to this type of treatment is consistent use over a period of 1 to 12 weeks. One plus about using this treatment method is the lack of side effects, as the product is completely natural.
    

3. Penile Injections
   Penile injections have been used for over a decade with about a 70% success rate, but many men express disdain for this treatment when they learn that it involves a needle stuck into the penis. However, there are many impotence clinics which specialize in this therapy. Ureathral Suppositories represent a different delivery of the drug Alprostadil. It involes inserting a small pellet of medication into the Ureathra. The success rate is less than that of Injections.
    

4. Implants
   Implanted devices, of course, involve surgery. Experts now believe that this treatment, once considered as the "gold standard" therapy, should only be done as a last resort, when the lesser invasive treatments have failed. The placement of an implant permanently alters the interior of the penis. If a pill is finally invented which cures impotence, it will surely require healthy corpora cavernosa in order to work. An implant prevents this part of the penis from being useful again.