4845 Knightsbridge Blvd, Suite 200, Columbus, Ohio 43214 (614) 442-3000

Impotence

Erectile impotence is the inability to achieve or maintain a hard erect penis sufficient for sexual intercourse. Men with erection problems often retain other sexual functions. They may still have orgasms and ejaculate semen. A natural erection is the result of a complex process. First sensation that lead to erection may involve psychological factors, such as erotic fantasies or expectations that arouse sexual desire. Then sensory factors such as scent, a tone of voice or the sight of a sexual partner undressing, are often involved.

The nervous system sends these arousal signals to the nerves in the penis. The penile nerves may also stimulated by direct sensory contact, such as manual stroking and by the act of sexual intercourse itself, The nerve impulses cause relaxation of penile tissue, an expanding of arterial blood vessels. The corpora cavernosa are two cylinders side by side in the penis. As penis tissues relax, penile arteries expand, this allows blood to flow into the rection chambers. The penis swells in size, veins that drain the blood are compressed and the blood is then trapped making the penis hard and erect.

What problems can cause non-erection ?

In a process as complex as penile erection, problems can occur for many reasons. Often an erection problem will have more than one cause. These may be psychological or physical or a combination of both. Distinguishing between the causes is helpful because treatment may differ.

Psychological causes include stress and anxiety, possibly due to marital, financial or other external problems. A man may suddenly find himself unable to have an erection after an event such as losing his job. Its possible that the stress and anxiety interfere with the impulses from his brain to the penile nerves when he attempts intercourse. "Performance anxiety " is a common cause of erectile dysfunction. This means that because of anxiety about his ability to "perform" a man finds that he cant perform, which of course cause more anxiety . Psychiatric illnesses such as depression can also cause erectile dysfunction.

Physical cause of erectile dysfunction are usually related to nerve or blood vessel diseases. Vascular disease (blood vessel) may cause problems involving flow into the penis to make it erect, or it can cause problems with holding the blood in the penis to maintain the erection. Hardening of the arteries and other diseases that effect the vascular system are risk factors for erectile impotence.

Diseases that effect the nervous system, such as multiple sclerosis (MS) or alcoholism can also cause erectile dysfunction. Some diseases can effect both the vascular and the nervous system, such as diabetes. Erectile impotence can result from pelvic injuries such as fractures. The accident victim may have injured nerves or penile arteries that cant supply extra blood as is needed for erection. Spinal cord injuries are another  cause. Certain surgeries and radiation therapy, such as used for the prostate, bladder ,or rectal cancers, can increase the risk of erectile impotence. Certain medications might contribute to the problem, and the patient should review, with his doctor, all medications currently being taken.

The effect of low levels of the male sex hormone, testosterone, may be part of the problem.

The effects of aging have also been studied. Although the rate of erectile impotence in the male population increases with age, aging by itself does not appear to be the cause. The causes are usually associated illnesses such as vascular disease and diabetes that may develop with age.