IMPOTENCE


How Is Impotence Diagnosed?



Patient History

Medical and sexual histories help define the degree and nature of impotence. A medical history can disclose diseases that lead to impotence. A simple recounting of sexual activity might distinguish between problems with erection, ejaculation, orgasm, or sexual desire.

A history of using certain prescription drugs or illegal drugs can suggest a chemical cause. Drug effects account for 25 percent of cases of impotence. Cutting back on or substituting certain medications often can alleviate the problem.

Physical Examination

A physical examination can give clues for systemic problems. For example, if the penis does not respond as expected to certain touching, a problem in the nervous system may be a cause. Abnormal secondary sex characteristics, such as hair pattern, can point to hormonal problems, which would mean the endocrine system is involved. A circulatory problem might be indicated by, for example, an aneurysm in the abdomen. And unusual characteristics of the penis itself could suggest the root of the impotence for example, bending of the penis during erection could be the result of Peyronie's disease.

Laboratory Tests

Several laboratory tests can help diagnose impotence.

Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. For cases of low sexual desire, measurement of testosterone in the blood can yield information about problems with the endocrine system.

Other Tests

Monitoring erections that occur during sleep (nocturnal penile tumescence) can help rule out certain psychological causes of impotence. Healthy men have involuntary erections during sleep. If nocturnal erections do not occur, then the cause of impotence is likely to be physical rather than psychological. Tests of nocturnal erections are not completely reliable, however. Scientists have not standardized such tests and have not determined when they should be applied for best results.

Psychological Examination

A psychosocial examination, using an interview and questionnaire, reveals psychological factors. The man's sexual partner also may be interviewed to determine expectations and perceptions encountered during sexual intercourse.

Impotence Aids /Treatment For Impotence

It's important to remember that over the past few years there have been major advances in the treatment of impotence and the majority of sufferers can now be treated effectively.

Discuss the problem with your partner - a problem shared is a problem halved. For example, it may be your partner is unintentionally putting pressure on you to "perform". Discussing the problem with them may relieve this pressure and enable you to have an erection again.

Look at your lifestyle. Are you a heavy smoker? Do you drink a lot of alcohol? Do you suffer from stress and anxiety? Cutting down on your alcohol intake or giving up smoking could make all the difference. Try to reduce stress and anxiety by finding ways to relax.

If the problem persists, see your GP. You could also ask to be referred to a clinic that deals with sexual dysfunction. You can get a list of your local clinics from the Sexual Dysfunction Association.

Psychosexual therapy. When psychological factors or relationship problems are considered to be the cause of your impotence, a course of sex therapy or couples therapy might be recommended. Therapy's very useful in helping you to re-establish a sexual relationship with your partner when there's been a long period without sex.

Vacuum pumps. A device involving a plastic cylinder and pump is used to make blood rush to your penis, enlarging it in a similar way to an erection. When you remove the pump, the erection is sustained by slipping a tension ring around the base of the penis.

Injections. You or your partner will be taught by a nurse or doctor to inject a drug directly into the shaft of the penis when you want an erection. An erection usually follows within 15 minutes. The procedure is easy to learn.

Transurethral therapy (Muse). This involves taking a small pellet of a drug, about half the size of a grain of rice, via the urethra (the tube through which urine is passed) using a special disposable applicator. The drug is absorbed through the urethra directly into the erectile tissue of the penis, giving an erection within five to ten minutes.

Viagra. This drug is taken in tablet form one hour before sexual activity. It then remains active for three to four hours. Viagra won't work without sexual stimulation. It's not an aphrodisiac and doesn't increase sexual desire.

Uprima. Uprima is a tablet which is taken under the tongue. You place the tablet under your tongue and wait for it to dissolve, which can take about ten minutes. It acts within 15 to 25 minutes and can be effective for up to two hours. Uprima won't work without sexual stimulation. 

Cialis. This drug comes in tablet form and can be taken from 30 minutes before sexual activity. With sexual stimulation Cialis may be effective for up to 36 hours after taking the tablet. Like Viagra, it's not an aphrodisiac and doesn't increase sexual desire.

Levitra. This tablet should be taken ten minutes to one hour before sexual activity. With sexual stimulation Levitra can be effective up to 12 hours after taking the tablet. Like Viagra and Cialis it is not an aphrodisiac and does not increase sexual desire.

Hormone treatment. Only a small proportion of cases of erectile dysfunction are caused by hormone abnormalities. The most frequent hormone abnormality is a reduced level of the male sex hormone testosterone which can be restored by appropriate hormone replacement. It's unwise to take testosterone preparations unless you've had tests that confirm a deficiency.

Penile prosthesis. You shouldn't consider a prosthesis (implant) until other forms of treatment have been tried. There are two types of implant. The semi-rigid type keeps the penis rigid all the time but lets you bend it downwards when you're not having sex. The hydraulic type is more sophisticated and causes the penis to stiffen when a pump (implanted in the scrotum) is activated.

Surgical treatment. A few cases of impotence are caused by abnormalities in blood flow in and out of the penis and can be treated with surgery.

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