Impotence

The inability to achieve or maintain erection, sufficient for satisfactory intercourse, is termed ‘Impotence’ (also known as erectile dysfunction). You may come across it occasionally, in which case there is nothing to be bothered about. However, if it is frequent and persistent then it can be a source of concern and stress. The normal process of arousal is a coordinated effort of the brain, emotions, nerves, blood supply, muscles and hormones. So a problem in any of these aspects can lead to erectile dysfunction. There are two types of impotence:

• Psychogenic – the disorder presents suddenly in a random manner. It varies with different situations and is usually seen in the younger age group.
  

• Organic – this type is related to physical problems with the blood supply of the penis. The onset is gradual, coming forth in almost all circumstances and generally seen in older individuals. 

Anxiety and stress form a vicious cycle with impotence. If one is tense or worried about something, it affects performance during intimacy and possibly disables adequate erection. This in turn heightens the anxiety and embarrassment, while lowering one’s confidence. Furthermore, depression, post-traumatic stress disorder, Widower’s syndrome and relationship problems are psychologically linked to the triggering mechanism.  On the other hand, here are some physical (organic) causes of erectile dysfunction:

• Heart or vascular disease​ – blood supply to the private organs may be diminished or blocked due to clogged blood vessels. This is known as atherosclerosis can result from smoking, high blood pressure, diabetes, high cholesterol and/or peripheral vascular disease  
  

• Neurological disorder – nerves of the male organ may be damaged by diseases such as multiple sclerosis, stroke, diabetes, spinal cord injury, Guillain-Barre syndrome, Parkinson’s disease or peripheral neuropathy.
  

• Trauma – Any injury or surgery of the pelvic region or spinal cord. Prolonged bicycling can also compress nerves and affect blood flow to the penis. This may lead to temporary or permanent erectile dysfunction
  

• Peyronie’s Disease – scar tissue develops inside penis
  

• Medication induced - antidepressants, antihistamines and remedies of high blood pressure, pain or prostate disease or radiation treatment for cancer
  

• Being overweight (obesity​) 
  

• Drug abuse – heavy drinkers of alcohol or long term street drug use

When to seek expert advice

It is important to understand that erectile dysfunction could be a symptom of an underlying illness, such as heart disease or diabetes. So if you have constant issues getting or maintaining an erection, do not hesitate to consult with a doctor at the Section of Urology.