$Unique_ID{BRK01429}
$Pretitle{Genitourinary System}
$Title{What Causes Impotence?}
$Subject{sex impotence causes treatment}
$Volume{J-15}
$Log{}

Copyright (c) 1991   Tribune Media Services, Inc.


What Causes Impotence?


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QUESTION:  Perhaps this question is too personal or difficult to answer, for I
have never seen anything about it in your column, but I certainly could use
some information about losing my sexual abilities.  It is not something you
can just go out and talk about, but I am sure there are many man who have
similar questions.  What causes this, and is there anything that can be done
to help?  I know you can assist us all if you would just try to.  Please
answer this question in your column.

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ANSWER:  Yes, this is a difficult question to respond to, not only because it
has a complicated answer, but because problems of a sexual nature should
always be treated on a very personal, one to one basis.  Each of us is very
special and unique, and there is no place in medical care where that is more
evident than in this area.  However, in the hopes that I can be of some help,
here are some important general considerations.  The causes of the inability
to perform a sexual act (or "impotence") fall into two main categories,
"psychogenic" and "organic".  Stated more simply, it means that the problem
can stem from the mind and how we think about things, or be the result of
physical changes in the body.  More often than not, there is a bit of both
involved.  The physical mechanism that allows a man to achieve an erection
followed by ejaculation involve both the central nervous system (the brain)
and the peripheral nervous system (the nerves that run throughout the body, in
this case, particularly those that lead to the penis.) The vascular system is
involved, both arterial and venous.  The endocrine system, which produces the
hormones in the body must function properly, and the penis itself must be
anatomically intact.  All of these systems can be tested in various ways to
assure their ability to function, and contribute to the desired action.  And
it requires a careful history with many questions about attitudes and feelings
to detect the state of the patient's mind.  More often than not, the man's
sexual partner should be consulted, for they too have important insights and
information to offer.  Most important is for the man to realize, that with
today's technologies, virtually every man with this problem can be helped in a
way that returns a satisfying intimacy to his life and his relationships.
When the diagnostic workup leads to the conclusion that there is something
organically wrong, the solution will depend upon the nature of that cause.
Medications may be appropriate to restore hormone levels to normal in
individuals whose problem results from levels that are too low.  External
vacuum devices are useful in many cases, and are used to create a negative
pressure around the penis, thus drawing blood into the sponge like erectile
tissues in the penis.  Once the penis has become erect, a constricting band
around the base of the penis helps to maintain rigidity.  In some cases the
patient can be taught to self inject certain medications into the sex organ to
initiate and erection.  In some cases, a penile prosthesis is the answer,
either semi-rigid rods, or inflatable devices which can produce the desired
rigidity, and allow a normal relationship.  In each case the needs, the
personal life style, and the specific diagnoses will be the factors that are
considered in the choice of treatments.  But all of this require you to take
the first step and consult your own physician.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
