The most important organic causes of impotence are cardiovascular disease and diabetes, neurological problems (for example, trauma from prostatectomy surgery), hormonal insufficiency and drug side effects.
Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility; this is somewhat less frequent but can often be helped. In psychological impotence, there is a strong response to placebo treatment.
Erectile dysfunction (ED) Causes :
Erectile dysfunction is characterized by the regular or repeated inability to obtain or maintain an erection.
- Medications (antidepressants, such as SSRIs, and nicotine are most common)
- Neurogenic disorders
- Cavernosal disorders Peyronie’s disease
- Hyperprolactinemia (e.g., due to a prolactinoma)
- Psychological causes: performance anxiety, stress, and mental disorders Aging.
- It is four times more common in men aged in their 60s than those in their 40s Diseases such as diabetes mellitus and multiple sclerosis (MS) While these two causes have not been proven they are likely suspects as they cause issues with both the blood flow and nervous systems.
- Lifestyle: Smoking is a key cause of erectile dysfunction. Smoking causes impotence because it promotes arterial narrowing.
ED can also be associated with bicycling due to both neurological and vascular problems due to compression. The increase risk appears to be about 1.7-fold.
Erectile dysfunction (ED) Diagnosis :
It is analyzed in several ways:
- Obtaining full erections at some times, such as nocturnal penile tumescence when asleep (when the mind and psychological issues, if any, are less present), tends to suggest that the physical structures are functionally working.
- Other factors leading to erectile dysfunction are diabetes mellitus (causing neuropathy).
Impotence is also related to generally poor physical health, poor dietary habits, obesity, and most specifically cardiovascular disease such as coronary artery disease and peripheral vascular disease.
A useful and simple way to distinguish between physiological and psychological impotence is to determine whether the patient ever has an erection.
If never, the problem is likely to be physiological; If sometimes (however rarely), it could be physiological or psychological.
Duplex ultrasound is used to evaluate blood flow, venous leak, signs of atherosclerosis, and scarring or calcification of erectile tissue. Injecting prostaglandin, a hormone-like stimulator produced in the body, induces the erection. Ultrasound is then used to see vascular dilation and measure penile blood pressure.
Penile nerves function
Tests such as the bulbocavernosus reflex test are used to determine if there is sufficient nerve sensation in the penis. The physician squeezes the glans (head) of the penis, which immediately causes the anus to contract if nerve function is normal. A physician measures the latency between squeeze and contraction by observing the anal sphincter or by feeling it with a gloved finger inserted past the anus.
Other test used to diagnose ED
- Nocturnal penile tumescence (NPT)
- Corpus cavernosometry
- Magnetic resonance angiography (MRA)
Osho clinic is fully equipped with all the treatment modalities except surgical interventions.
Osho Clinic (Psychiatry & Psychology)