Impotence is usually a result of:
- Vascular abnormalities
- Nerve abnormalities
- Penile abnormalities
- Psychological problems that affect sexual desire.
Physical causes are more common in elderly men; whereas psychological problems are more common in younger men. The more a man ages, the more impotence occurs, even though impotence is not part of the aging process but is a result of diseases often found in old age. About 50% of men are 65 years old and 75% of 80-year-old men experience impotence.
In order to be upright, the penis requires adequate blood flow. Therefore vascular disease (such as atherosclerosis) can cause impotence. Impotence can also occur due to blood clots or due to blood vessel surgery which causes disruption of arterial blood flow to the penis.
Damage to nerves leading to and leaving the penis can also cause impotence. This nerve damage can occur due to:
- Diabetes mellitus
- Multiple sclerosis
- Lower spine disease
- Rectal or prostate surgery.
Approximately 25% of cases of impotence are caused by drugs (especially in older men who consume a lot of drugs). Medications that can cause impotence are:
Sometimes impotence occurs due to low testosterone levels. But decreasing male hormone levels (which tend to occur due to the aging process), usually more often causes a decrease in sexual arousal (libido).
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Some psychological factors that can cause impotence:
- Fear of intimacy
- Concern about gender.
Patients are unable to start and maintain an erection.
Diagnosis is based on symptoms. Physical examination is done to look for changes in male sexual characteristics, such as breasts, testicles and penis size, and changes in hair, sound and skin. To find out if there are abnormalities in the arteries in the pelvis and groin (which supply blood to the penis), blood pressure measurements are carried out in the legs.
Other checks that might need to be done:
- General check up
- Examination of blood sugar for diabetes
- Examination of TSH levels
- Penile ultrasound.
Impotence can usually be treated without surgery. The type of treatment depends on the cause. Special exercises carried out by impotence sufferers due to psychological problems, namely the so-called 3-stage sensation concentration technique.
This technique encourages intimate relationships and emotional warmth, which focuses more on building a relationship:
- Stage I: making out, couples concentrate to please each other without touching the pubic area.
- Stage II: couples start touching the pubic area or other erotic areas, but have not yet had intercourse.
- Stage III: having intercourse.
Each achieves comfort at each stage of intimacy before continuing to the next stage. If the technique does not work, maybe the patient needs to undergo psychotherapy or therapy for sexual behavior. If the patient is depressed, anti-depressants can be given.
Sildenafil is a drug that can increase blood flow to the penis. This medicine is taken 30-60 minutes before sexual intercourse, only effective if accompanied by sexual arousal. It should not be taken together with nitrates because it can cause serious side effects.
If impotence or loss of sexual arousal occurs due to low testosterone levels, patients should undergo hormone replacement therapy. Testosterone is injected every week or given in the form of plaster. Side effects are enlargement of the prostate and excess red blood cells that can cause strokes.
Binding or suction devices are often used to achieve and maintain an erection, but this tool should not be used by people with bleeding disorders or patients who take anticoagulant drugs. A binding device (in the form of a rope or ring made of metal, rubber or leather) is installed at the base of the penis to slow blood flow from the penis.
The suction device (in the form of a hollow box and pump) is mounted on the penis. Vacuum pressure helps drain blood into the penile artery. When the penis is erect, a binder is installed to prevent blood flow from the vein. The combination of these two devices can maintain an erection for 30 minutes. Sometimes binding devices cause problems when ejaculating, especially if tied too tight. For the sake of security, it is better after 30 minutes the device is released. If you use it too often, a vacuum can cause bruising.
Impotence can also be treated with special drug injections carried out by the sufferer himself. This drug is injected directly into the erectile tissue of the penis (corpus cavernosa. Erection occurs within 5-10 minutes after the drug is injected and can last for 60 minutes. The side effects are bruising and pain. In addition, injections can also cause priapism (erections that persistent and painful).If impotence does not respond to various treatments above, penile transplantation or prosthesis (artificial penis) can be done. One tool that is grafted is a solid stem inserted into the penis to cause a permanent erection. Another tool is a balloon that is inserted into the penis and blown before the patient has sexual intercourse.
Articles Sources: https://bathmatesystem.com