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Impotence is the inability to achieve or maintain an erection long enough to enjoy satisfying sexual intercourse. Men of any age can suffer from impotence but it becomes more prevalent as men age affecting up to half of all men over 40.
Causes and Symptoms
There are potentially many causes of erectile dysfunction, but most of them are characterized by inadequate blood flow to the penis. In a healthy male, sexual stimulation results in chemical messengers, called neurotransmitters, that signal the penis to relax and fill with blood. As a result, it enlarges and stiffens, causing an erection.
Impotence or erectile dysfunction can be caused by either psychological or physical factors, or even a combination of both. Psychological factors include stress, guilt, and anxiety.
Certain medications cause impotence as a side effect too. These include betablockers, antiulcer drugs, antihistamines, tranquilizers, antifungals, and antipsychotics. Lifestyle habits can be an issue too. Smoking, excessive alcohol consumption, and illicit drug use can all contribute to erectile dysfunction.
By far the most common treatment today is the prescription drug sildenafil citrate, sold under the brand name Viagra. Originally approved for impotence in 1998, Viagra was developed by scientists at Pfizer’s research facility in Sandwich, Kent. Viagra’s success rate is very high, with more than 60% of men benefiting from its use. The drug causes the blood vessels of the penis to widen directly facilitating the erection process.
Two further prescription drug treatments for impotence have been introduced since the arrival of Viagra. Vardenafil is produced by Bayer and sold under the brand name Levitra, and tadalafil is sold as Cialis by Eli Lilly. Both these medications work in the same way as Viagra and like Viagra are well tolerated by most men. Other medications under investigation as treatments for impotence are topical agents. Topical means that they are applied externally to the skin rather than being injected or taken by mouth. If approved, these drugs would provide a non-invasive alternative for men who cannot take oral medications for impotence.
A number of herbal remedies have been promoted as successful treatments for impotence. The most widely known are Coryanthe yohimbe and gingko (Gingko biloba), although neither has been shown to work in controlled studies. Gingko also has health risks of abnormal blood clotting and should therefore be avoided by men taking blood thinners. Other herbs promoted for treating impotence include true unicorn root, saw palmetto, and ginseng.
With proper diagnosis, impotence can nearly always be treated or managed successfully. Unfortunately, fewer than 10% of impotent men seek treatment.