Impotence

Erectile dysfunction (ED) or male impotence is defined as the inability of a man to achieve and maintain an erection sufficient for mutually satisfactory intercourse with his partner. Sexual health and function are important determinants of quality of life.

Sexual dysfunction is often associated with disorders such as diabetes, high blood pressure, heart disease, nervous system disorders, and depression. Erectile dysfunction may also be an unwanted side effect from medication. In some men, sexual dysfunction may be the symptom of such disorders that brings them to the doctor's office. The successful treatment of impotence has been demonstrated to improve intimacy and satisfaction, improve sexual aspects of quality of life as well as overall quality of life, and relieve symptoms of depression.

Erectile dysfunction can be caused by any number of physical and psychological factors. In general, ED is divided into organic (having to do with a bodily organ or organ system) and psychogenic (mental) impotence, but most men with organic causes have a mental or psychological component as well. Erection problems will usually produce a significant psychological and emotional reaction in most men. This is often described as a pattern of anxiety and stress that can further interfere with normal sexual function. This "performance anxiety" needs to be recognized and addressed by your doctor.

Diagnosis:
Schedule enough time with your doctor to conduct a full interview and physical examination. The first step in the medical management of erectile dysfunction is taking a thorough sexual, medical, and psychosocial history. Erectile dysfunction is a delicate topic, and your doctor should be sensitive and caring to make you comfortable about sharing these intimate details of your private life. Your doctor will ask if you have difficulty obtaining an erection, if the erection is suitable for penetration, if the erection can be maintained until the partner has achieved orgasm, if ejaculation occurs, and if both partners have satisfaction. You will be asked about current medications you are taking, about any surgery you may have had, and about other disorders (history of trauma, prior prostate surgery, or radiation therapy, for example).

The doctor will want to know all medications you have taken during the past year, including all vitamins and other dietary supplements. Tell the doctor about your tobacco use, alcohol intake, and caffeine intake, as well as any illicit drug use. Your doctor will be looking for indications of depression. You will be asked about libido (sexual desire), problems and tension in your sexual relationship, insomnia, lethargy, moodiness, nervousness, anxiety, and unusual stress from work or at home. You will be asked about your relationship with your partner. The doctor will pay particular attention to the genitals and nervous, vascular, and urinary systems. Your blood pressure will be checked because several studies have demonstrated a connection between high blood pressure and erectile dysfunction. The physical examination will confirm information you gave the doctor in your medical history and may help reveal unsuspected disorders such as diabetes, vascular disease, penile plaques (scar tissue or firm lumps under the skin of the penis), testicular problems, low male hormone production, injury, or disease to the nerves of the penis and various prostate disorders.

Treatment:
Currently, virtually any man who wishes to have erectile function can obtain it, regardless of the underlying cause of his problem. Many reasonable treatment options exist. Sex counselling is an important part of erectile dysfunction management. Many professional sex counsellors are skilled in working with patients with ED, but your primary care doctor and urologist may also serve in this capacity to some degree. Options include sex counselling, medications, external vacuum devices, hormonal therapy, penile injections or intraurethral suppositories. In highly selected cases under the supervision of a urology specialist in ED, combination therapy using several of these methods together can be used. If none of these therapies is satisfactory, penile prosthesis implants can be considered.

Anxiety and stress can often be related to impotence and in many instances the causes are mental and emotional. External stresses and anxieties such as finance, health, work or redundancy can have a depressing effect which can affect the sexual area and also previous bad experiences such as a failed marriage or a bad sexual encounter may cause the man to struggle in this area. Some suggestions to try may be Reserve time for non-sexual intimacy with one's partner. Detach sex and affection, so that neither person is afraid to be affectionate on a daily basis, fearing that it will be interpreted as an invitation to proceed to intercourse. Regularly reserving "prime time," before exhaustion sets in, for both talking and sexual intimacy may encourage closeness and sexual desire. Far too often, couples do not make time for each other earlier in the evening when they have the energy for physical intimacy.

Alternative Therapies can sometimes aid in a variety of ways. Counselling can help to get to the root of past traumas or fears and confront them; alternative therapies such as massage and spa treatments can help the man to grow in confidence and sometimes a therapist can be a listening ear.

Aromatic baths before bed offer a means of using essential oils in a natural way. Sandalwood is the best oil to try for this.  Another good idea is if the partner of the man can give a massage diluting Sandalwood in carrier oil. Try to just enjoy the massage and not be pressured by feeling it must lead to sexual intercourse so that each person can truly relax. Jasmine is another essential oil which can help to restore confidence and Neroli can complement this very well if the cause of the impotence is anxiety. Clary Sage is very relaxing and all of these oils are reputed to have “aphrodisiac” qualities.