Impotence describes a group of conditions that interfere with man’s ability to have a satisfying sex life. Hormone conditions, medications or psychological issues can cause decreased sexual interest, or libido. Difficulties controlling the timing of ejaculation may also contribute to impotence. Erectile dysfunction is a compromised ability to achieve or maintain an erection to engage in a satisfying sexual experience. Erectile dysfunction is the primary issue for most men who are troubled by impotence.
Testosterone Therapy
A low testosterone level can cause decreased libido and erectile dysfunction, reports the Cleveland Clinic. Testosterone replacement therapy options include daily skin patches or gels, and hormone injections. Prostate enlargement is a possible side effect of testosterone therapy, which may lead to urinary problems.
Erectile Dysfunction Medications
Phosphodiesterase type 5 inhibitors, or PDE-5 inhibitors, are medications that enhance penile blood flow to augment erectile rigidity. The medications do not activate penile blood flow unless sexual stimulation occurs. Medication options include tadalafil, sildenafil and vardenafil, which share the same mechanism of action but differ in the dosing instructions and duration of action. The American Urological Association reports that PDE-5 inhibitors prove effective in roughly 70 percent of men with erectile dysfunction-related impotence. Possible side effects include muscle aches, headache, facial flushing, stomach upset, nasal congestion and dizziness. PDE-5 inhibitors are not useful in treating decreased libido or ejaculatory problems.
Penis Pump
A penis pump, also called a vacuum erection device, is a noninvasive treatment option for men with erectile dysfunction. An erection occurs when blood fills chambers within the penis, causing rigidity. Decreased penile blood flow leads to insufficient erectile rigidity. A penis pump addresses erectile dysfunction by drawing blood into the penis through use of a vacuum device placed over the penis. Once a satisfactory erection is achieved, a band is placed around the base of the penis to retain the blood and maintain the erection. Blood flows out of the penis with removal of the band. MayoClinic.com states that a penis pump is safe for most men, but may not be an option for those taking blood thinners and men with sickle cell disease or other clotting abnormalities.
Penile Implants
Men with erectile dysfunction may opt for penile implants. These are permanent devices surgically placed into the penis. Malleable implants are semi-rigid rods placed within the penis. To participate in sexual activity, the rods are bent upward. Otherwise, the rods are manipulated into a downward resting position.
Inflatable implants involve fluid chambers placed into the shaft of the penis. The implants are attached to a fluid reservoir in the scrotum or abdomen. Erection is achieved by pumping fluid from the reservoir into the inflatable penile chambers. A release valve controls deflation of the implants. The American Urological Association notes that penile implants carry a potential risk for infection. Malfunction of the inflatable devices can also occur, which may require surgical replacement of the device.
References
- National Institute of Diabetes and Digestive and Kidney Diseases: Erectile Dysfunction
- American Urological Association: Erectile Dysfunction, Causes, Risks and Talking with Your Doctor
- American Urological Association: Erectile Dysfunction, Primary Treatment Options
- American Urological Association: Erectile Dysfunction, Secondary Treatment Options
- Cleveland Clinic: Testosterone Replacement Therapy
