An
Information Guide For
Men with Erectile Dysfunction
What is
Erectile Dysfunction?
Erectile dysfunction refers to problems
with achieving and maintaining an erection for
satisfactory sexual intercourse impotence,
or problems with “ejaculating too early”
premature ejaculation.
Of all the
conditions men face, erectile dysfunction is
the most personal. It is extremely common,
afflicting an estimated 30 million North
American men. This does not mean that erectile
dysfunction is inevitable or permanent, and
today, there are many modern treatments
available. No matter how long a man has been
experiencing these problems, he can be treated
successfully. |
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Impotence
What is Impotence?
Impotence, or erectile dysfunction, means a man is
not able to obtain or maintain an erection firm
enough for successful sexual intercourse. Overall,
between 10% and 30% of men of all ages will suffer
from impotence on a recurring or ongoing basis.
Most men will experience the problem at some stage
in their lives, with the incidence of impotence
increasing with age.
What Causes Impotence?
There are two types of impotence: physical
impotence and psychological impotence.
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Physical impotence may result from
damage or deterioration to nerves or blood
vessels of the penis. It may also be caused
by problems with hormones like Testosterone.
Many drugs, and alcohol, can cause impotence
as a side effect. Smoking can also damage
the arteries in the body and cause
impotence. Nerves damaged by spinal cord
injuries, multiple sclerosis, or surgery can
give rise to impotence.
-
Psychological (or emotional) impotence
arises from fear, stress, worry, anger or
frustration. It may also develop from
"performance anxiety" (a man's fear that he
won't perform well during sexual
intercourse), or from the embarrassment of
premature ejaculation.
Can
Impotence be Prevented?
In some cases, yes. Reducing stress, or
sharing concerns with your partner or doctor
can help psychological impotence. Physical
impotence can be avoided by following a
prudent diet and lifestyle that includes
cutting back on alcohol and smoking. Diabetics
must control their blood sugar levels with
normal ranges.
How
is Impotence Diagnosed?
On taking the patient's history, the physician
may ask how the impotence developed.
Generally, physical impotence develops over
months or years, starting with a gradual loss
of firmness in the erection. Over time, it
takes longer to have an erection and is more
difficult to maintain one. The physician
conducts a thorough examination and may select
tests to differentiate between physical and
psychological impotence.
Is
an Impotent Man Infertile?
No! An infertile man does not produce enough
effective sperm to conceive a child. An
impotent man can be perfectly fertile, so
being impotent does not mean a man can not
have children. Often impotence is easier to
treat than infertility.
How
is Impotence Treated?
Many treatment options are available,
depending upon the cause of impotence. With
psychological impotence, a psychologist or
counsellor may be recommended. Counselling is
particularly successful when both partners
participate openly. Counsellors may recommend
special exercises which emphasise tenderness
and enjoyment rather than performance.
Sometimes, stress reduction exercises are
required. |
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Impotence
caused by hormone problems may be treated with
medication. If impotence is a side effect of
medication, an alternative drug may be prescribed.
Never reduce or change any medication without the
permission of your physician. In diabetic men,
diet, medication and exercise are essential, as
poor blood sugar control may increase the severity
of impotence.
Impotence
due to permanent damage of the blood vessels or
nerves can also be treated. Options include vacuum
devices, injection therapy, oral medication,
vascular surgery or penile implants.
- A vacuum
device involves placing a hollow tube over the
penis and inducing an erection with a vacuum
pump. The erection is maintained by placing a
band at the base of the penis.
-
Self-injection therapy involves inserting
erection causing medication into the penis with
a very fine needle and syringe. The medication
is easily and painlessly self-injected before
sex, creating a firm and sustained erection.
Restoration of normal erections can often
follow. This treatment is chosen most by
patients because of its high success rate.
- Oral
medication has been developed which is effective
in treating many men. After an examination, the
physician will advise the patient as to whether
he should pursue this option.
- Vascular
surgery involves tying off leaking or damaged
blood vessels in the penis or increasing the
blood supply to the penis that has an arterial
deficiency.
- Penis
implants involve surgically placing a semi rigid
or inflatable rod in the shaft of the penis.
- A
urethral suppository involves gently inserting a
tiny medicated pellet into the urethra (the
normal pathway for urine). The medication
dissolves into the penile tissue causing an
erection.
Premature
Ejaculation
What is Premature Ejaculation?
Premature ejaculation means, ejaculating
before you want to. Most men should be able to
hold out as long as they wish, but
unfortunately, some need help in learning
techniques to do this successfully.
What Causes Premature Ejaculation?
If a man is able to have a normal erection,
premature ejaculation may be caused by either
physical or psychological problems.
- The
physical problem in premature ejaculation is
over-sensitivity of the penis. In these
cases, the man responds far more rapidly to
normal sensations, resulting in ejaculation
which is sooner than is expected, or
acceptable.
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- In
psychological cases, the main problem is
"performance anxiety" - anxiety relating to
sexual intercourse. The man focuses only on
the process of ejaculation, and not on the
enjoyment of sexual intercourse, leading to
increased tension and usually premature
ejaculation. Men may actually avoid sex
because they fear not satisfying their
partner. Performance anxiety may also lead
to impotence.
How
is Premature Ejaculation Treated?
The main problem in premature ejaculation is
loss of control. The aim of treatment is to
improve the patients control, generally
through medication and exercise, enabling him
to last longer and satisfy his partner. This
therapy improves his sexual confidence and
helps him to eventually control the erections
on his own, without medication.
- To
reduce over-sensitivity, creams containing local
anaesthetic can be applied to the penis,
allowing the man to hold out longer. Sometimes
these creams may also numb the partner, thus
decreasing the partner's sensation.
- Sexual
counselling is important in the treatment of
premature ejaculation. Counselling may include
the use of special exercises, where the man will
start and then stop thrusting during
intercourse, to enable him to learn how to hold
out for a longer period of time. Psychotherapy
may be required to explore deep-seated anxieties
of sexual relationships.
-
Self-injection therapy is often used as the core
treatment in premature ejaculation, and may be
used together with sexual counselling. This
therapy ensures a prolonged erection, regardless
of whether the man ejaculates or not, thus
providing a sense of control. Sexual tension
diminishes as the pressure to perform is no
longer "in the way." Men develop improved
self-esteem and confidence, allowing full
attention to penile sensation which is essential
in controlling ejaculation. As the man develops
control of his body, dependence on medication is
reduced and eventually eliminated. For some men
it may take a few weeks, and for others it may
take a few months.
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