Impotence (or erectile dysfunction)

It is often a problem that is not openly discussed, but it affects many thousands of couples each year. The causes of impotence can be wide-ranging including physical or psychological problems.

Psychological causes may include:

• Anxiety
• Stress
• Depression
• Problems with your relationship
  

Physical causes may include:

• High blood pressure
• Diabetes
• Side effects of certain medication
• Hormonal imbalance
• Narrowing of blood veins in the penis
• Problems with the nerves in the penis
• An injury or surgery
• Heart disease
• Peyronie’s disease
  

In addition, some neurological conditions such as multiple sclerosis or Parkinson’s disease can cause erectile dysfunction.

Although erectile dysfunction may be embarrassing for you, it is important to get a correct diagnosis. In many cases symptoms are temporary.

How is erectile dysfunction treated?

If the cause of your erectile dysfunction is psychological you and your partner may benefit from counselling.

Physical causes are usually treated by addressing the condition directly. In some cases, lifestyle changes such as losing weight, exercising and change in diet can be helpful. Reducing alcohol consumption and stopping smoking may also be beneficial.

Medication in tablet form to temporarily increase the flow of blood to the penis may be prescribed. The type and strength of your medication will depend on your own situation.

An alternative for patients who can not take medication may be a vacuum pump. This device is placed over the penis creating a vacuum that causes blood to flow into the penis. A rubber ring is placed at the base of the penis to trap the blood and maintain an erection.

A synthetic hormone called alprostadil stimulates the blood flow to the penis. This can be injected directly or inserted as a suppository in your urethra (the tube that carries urine from you bladder to your penis). Other hormone treatment may be prescribed if the cause of your erectile dysfunction is found to be hormonal imbalance.

If conservative treatments for erectile dysfunction are not successful your consultant may recommend penile prosthetic surgery. A penile prosthetic is an implant that allows men with erectile dysfunction to have an erection. Prosthetics may also be used for patients with Peyronie’s disease. There are several types of penile implants. Your consultant will assess your own situation and recommend the implant that meets your needs.