What Causes Impotence?

Impotence or erectile dysfunction, often known as limpdick, is most often the result of some underlying physical (organic) condition. About 85% of all impotence is physical in origin, not emotional, as we thought about 10 years ago. Actually, less than 15% of impotence has a psychological origin. The most common medical conditions that cause impotence are:

Vascular disease - arteriosclerosis (hardening of the arteries), heart disease, high blood pressure and high cholesterol - is the major cause of impotence. Restricted blood flow in the heart can cause heart attacks; in the brain it can cause strokes; and in the penis, poor blood flow can cause impotence.

Diabetes is one of the most common causes of impotence and occurs in about 50% of all diabetic men after the age of 55. Diabetes causes damage to large and small blood vessels and can also affect the brain’s ability to transmit its impulses to the body.

Neurologic impairment may result from injuries to the spinal cord, brain, prostate or the groin area and may cause interruption of nerve impulses to the penis. Accidents, such as falling on the crossbar of a bicycle, can damage blood flow to the penis. Recent studies have also linked water sports, gymnastics and horseback riding to these types of pelvic injuries.

Multiple sclerosis (MS), a progressive disease of the nervous system, can also cause impotence. About 25% of men with MS experience impotence, due to nerve damage in the brain and spinal cord. Other neurological disorders, such as Alzheimer’s and Parkinson’s disease, may also contribute to impotence.

Pelvic surgery involving the prostate, bladder, rectum or colon can cause impotence if the blood vessels or nerve pathways used during erection are damaged. For instance, in prostate surgery where cancer is involved, surrounding tissue and nerves may need to be sacrificed to stop the spread of the disease.

Drug-related impotence - Over 200 prescription drugs are known to cause impotence as a side effect. The most common are diuretics and blood pressure medications, followed to a lesser degree by tranquilizers, antidepressants, sedatives, other psychiatric drugs and many over-the-counter medicines. (Note: Never stop taking your medication or change the dosage unless directed by your physician.) Long-term use of alcohol, nicotine and illegal drugs (cocaine, marijuana, LSD, etc.) can also lead to impotence.

Hormonal imbalances, such as testosterone deficiency, make up about 3% of physically caused impotence. Brain or pituitary tumors may cause buildup of a hormone called prolactin, which may lower testosterone and lead to loss of desire or libido.

Peyronie's disease is a relatively rare condition in which an inflammation within the penis causes scarring that leads to curvature. Erections can be painful and the bending of the penis may interfere with sexual activity. If surgery is required to repair severe curvature, insertion of a penile prostheses may be necessary to permit sexual intercourse.

Psychological impotence represents about 15% of cases. This type includes psychological or emotional problems such as depression or low self-esteem; anger or tension with one's associates or sexual partner; fear of failure after one or more unsuccessful attempts; or fear of contracting sexually transmitted diseases. Most physical impotence will eventually acquire a psychological overlay.

Since impotence is often a sign of a pre-existing medical disorder, every man who experiences erection problems should seek help from a qualified physician (family physician or urologist.) This assures proper and potentially life-saving medical diagnosis and treatment.

At the doctor’s office, your physician is responsible for finding the cause of your erectile dysfunction and in helping you and your partner choose a treatment option. A medical and sexual history will be taken during the examination. Other questions may relate to how you handle stress, anxiety, pressure and fatigue. It is also very important to list any medications that you are presently taking. Speak frankly with your doctor. Your history, physical condition, state of mind, previous surgeries, injuries and habits can be important in establishing the cause of your impotence and deciding on the best treatment for you.

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