Impotence - Causes, symptoms and treatment. MF.

Impotence( this is an outdated concept, at present the term erectile dysfunction is used) is a common problem among men, impotence is characterized by a permanent inability to maintain an erection sufficient for intercourse or inability to achieve ejaculation, or in both cases. Impotence can include a complete inability to achieve an erection or ejaculation, or a short-term maintenance of an erection.

The risk of impotence increases with age. He is four times higher in men than 60 in comparison with men, at the age of 40 according to a study published in the Journal of Urology( 2000; 163: 460-463).Men with a low level of education are more likely to experience impotence, perhaps because they lead a less healthy lifestyle, eat less healthy food, drinks and have many bad habits. Physical exercises, as a rule, reduce the risk of impotence.

Causes Impotence

• Alcohol abuse and alcoholism
• Depression
• Diabetes
• High blood pressure
• Renal failure
• Multiple sclerosis
• Prostate Cancer

• Smoking( How to quit smoking)
• Stress
• Atherosclerosis
• Injury orsurgery( penis, spinal cord, prostate, bladder and pelvis)
• Medications( both prescription and over-the-counter)

In what conditions does impotence occur:

Atherosclerosis
Hypertension
Hypogonadism( decrease in testosterone level)
Diabetes mellitus
Multiple sclerosis
Spinal cord injuries
Psychological problems

Sexual disorders and infertility in men - by studying their etiology and developing methods of treatment and prevention measures - are engaged in the field of medicine, urology or andrology. However, not all violations of sexual function in men are associated with diseases of the genitals - their causes can be the most diverse .

Causes of sexual dysfunction and infertility in men

The inability to perform a normal sexual intercourse with a man can depend on the organic or functional changes in the central or peripheral parts of the nervous reflex path, as well as on the pathological state of the endocrine apparatus. In this section, the most detailed will be considered disorders of sexual function associated with diseases of the genitals themselves, that is, those that fall within the competence of a urologist.

Impotence can be the result of functional brain diseases, in which, for one reason or another, the relationships between the processes of excitation and inhibition are disrupted. Such impotence is called cortical .Among its causes, a certain role is played by neuroses( neurasthenia, hysteria) accompanied by various kinds of states of insecurity and fear of intercourse( sexoneurosis).With the predominance of inhibitory processes in the cerebral cortex, cortical impotence may be manifested by a decrease in sexual excitability( decreased sexual desire and orgasm with the preservation of the erection), erection( erection disappears before the onset of sexual intercourse, there is no ejaculation, but sexual desire remains normal), ejaculatory function( normalsexual desire and correction in the absence of orgasm and ejaculation, although the pollutions may be).Cortical impotence, with the predominance of excitation in the cortex, manifests itself as a rapidly advancing erection, but with a premature eruption of the seed at the very beginning of the sexual act or before it. Sometimes ejaculation is not accompanied by an erection.

Spinal impotence is a consequence of the primary lesion( organic or functional) of the reproductive centers located in the spinal cord. The most common are functional disorders of these centers, which are accompanied by increased excitability of the erection and ejaculation centers( erection is normal, but frequent and rapid, premature ejaculation occurs), increased ejaculatory excitability and decreased erectile center excitability( rapid ejaculation with weakened erections), decreased excitability of both centers(violations vary widely - from excitability, close to normal, until it completely disappears, when the erection and ejaculationI completely stopped), the absence or decrease in excitability ejaculatory center in normal erectile function( libido and erections are normal, but there is no ejaculation and orgasm).

Impotence associated with diseases genital , can have three forms depending on the effect of three factors: disorders endocrine function testes, prostate gland and seminal tubercle, for purely mechanical reasons( due to defects, damage, or penile diseases).

The first of the forms of impotence has an endocrine origin: as a result of a lower production of testicles male sex hormone, there is a weakening and sexual desire. Violation of testicular function can be congenital( underdevelopment testes - hypogonadism) acquired in childhood( bilateral orchitis, especially after the pig, followed by scarring and wrinkling of the testes) or at an older age( orchitis, trauma testes and result in old age changes andold age).

In the event second forms of impotence leading role played by the disease of the prostate gland and seminal tubercle associated with either a deviation from normal sexual activity( sexual excesses, interrupted or artificially tighten intercourse, abuse of masturbation), or contracting infections from the outside( postgonoreyny, posttrihomonadnyand other forms of infectious prostatitis), or with other causes( congestion due to sedentary, inadequately active lifestyle, etc., prostate adenoma).The prostate gland and the seminal tubercle play an important role in the sexual function, regulating it mainly by a neuromuscular reflex. Both the prostate and the seminal tubercle are provided with an abundant network of nerve plexuses, nodes and receptors( ie, nerve endings that perceive irritation).Here we can not say that the acute prostatitis, even hard flowing, no effect on sexual function, while in chronic prostatitis prolonged inflammation, congestion, degenerative and scarring in the prostate gland affect the present in her numerous receptor nerve endings, which carry out impulses to the centers of erection and ejaculation of the spinal cord and transmit stimuli to these centers. The result is the depletion of these centers and the violation of sexual function: first premature ejaculation while maintaining the erection, and then weakening of the latter.

should be noted that in chronic prostatitis may vozninut and cortical, ie psychogenic impotence, as associated with the disease uncomfortable feeling or pain in the genital area is fixed on them sick note vayzyvaet his fear of sexual intimacy, lack of confidence in theiropportunities, fear of being untenable, and in connection with this, and a real violation of sexual function. At a later age, adenoma of the prostate gland may have an adverse effect on sexual function. Developing in the depth of prostate tissue, adenomatous nodes are pushed to the periphery and squeezed tissue of the gland, which leads to a violation of the function of the prostate, and then to its atrophy.

The third form of impotence is due to those abnormalities or diseases of the penis, which for purely mechanical reasons do not allow entering it into the vagina. For men of young age( up to 30 years) are more characteristic of the pathogenic forms of impotence;for middle age( 30-50 years) - neuroreceptor-spinal impotence associated with prostate disease, seminal tubercle and depletion of spinal cord centers controlling erection and ejaculation;for men over 50 years - impotence of the endocrine nature, associated with an age-related decrease in the hormonal function of the testicles.

With all these forms of impotence, alcohol and smoking abuse play an additional burdensome role. It is well proven that nicotine, causing the oppression of sexual centers in the brain, leads to a weakening of the erection. The harmful effect of alcohol on the sex glands( testicles, the prostate gland) is also well known. In animal experiments, chronic alcoholization caused fatty degeneration and atrophy of the gonads. These changes, as a rule, lead to a decrease or total extinction of sexual potency. Many clinicians note the phenomenon of feminization, that is, the woman's likelihood, in alcoholics( obesity by the female type, hair loss and under the arms, atrophy of the sex glands).Undoubtedly, the destructive effect of alcohol on the central nervous system also contributes to the development of impotence, both cortical and spinal. Essential role in this case is played by such consequences of chronic alcoholism as neuroses, depressive states, emotional-volitional instability, insecurity, anxiety, etc.

To what doctors to address, if there is an impotence

At the first symptoms of impotence it is necessary to address to the urologist or andrologu. The following doctors may be required:

Endocrinologist
Cardiologist
Traumatologist
Psychologist, sexologist