Why does impotence happen

The choice may depend on:. There have been many studies to test the effectiveness of these medications. In general, at least two-thirds of men report having improved erections after taking one of these medicines. These medications are triggered by sexual stimulation, so you also need to be aroused for it to work.

PDE-5 inhibitors should be used with caution in men who have cardiovascular disease , such as coronary heart disease. However, sexual activity is also likely to be beneficial for your cardiovascular health. You should discuss the risks and benefits with your GP. PDE-5 inhibitors should also be used with caution in men who have anatomical problems with their penis, such as Peyronie's disease a condition that affects the tissue of the penis. Do not take PDE-5 inhibitors if you are also taking medicines or recreational drugs that contain nitrates.

The combination of the two substances can have a dangerous effect on your heart. Organic nitrates are often used to treat angina, and butyl nitrate is a recreational drug that is more commonly known as 'poppers'. A vacuum pump consists of a clear plastic tube that is connected to a pump, which is either hand or battery operated. You place your penis in the tube and pump out all of the air. This creates a vacuum that causes the blood to fill your penis, making it erect.

You then place a rubber ring around the base of your penis to keep the blood in place, allowing you to maintain an erection for around 30 minutes. It may take several attempts to learn how to use the pump correctly, but they are usually effective.

After using a vacuum pump, nine out of 10 men are able to have sex, regardless of the cause of their ED. You should not use a vacuum pump if you have a bleeding disorder or if you are taking anticoagulant medicines , which reduce the ability of your blood to clot. Side effects of vacuum pumps include pain or bruising, although these occur in less than a third of men.

Men who qualify for NHS prescriptions for erectile dysfunction treatments may be able to get a vacuum pump on the NHS see above for more details. However, some men will need to buy one. The Sexual Advice Association produces a number of factsheets, including one on vacuum pumps that provides details of companies that supply them.

If your erectile dysfunction doesn't respond to treatment, or you are unable or unwilling to use PDE-5 inhibitors or a vacuum pump, you may be given a medicine called alprostadil. This is a synthetic man-made hormone that helps to stimulate blood flow to the penis.

You may be trained to correctly inject or insert alprostadil. If your partner is pregnant, use a condom during sex if you are inserting alprostadil into your urethra.

Alprostadil will usually produce an erection after five to 15 minutes. How long the erection lasts will depend on the dose. In men who did not respond to PDE-5 inhibitors, alprostadil injections were successful in 85 out of men.

Alprostadil inserted into the urethra is successful for up to two-thirds of men. As with PDE-5 inhibitors, NHS prescriptions for alprostadil may only be available for men with particular health conditions or those receiving some types of medical treatments. If a hormonal condition is causing erectile dysfunction, you may be referred to an endocrinologist who specialises in the treatment of hormonal conditions.

Hormones are chemicals produced by the body. Many hormonal conditions can be treated using injections of synthetic man-made hormones to restore normal hormone levels. Surgery for erectile dysfunction is usually only recommended if all other treatment methods have failed.

It may also be considered in:. In the past, surgery was used if there was clear evidence of a blockage to the blood supply of the penis. The surgeon could unblock the blood vessels to restore a normal supply of blood. However, research now suggests that the long-term results of this type of surgery are poor, so it's unlikely to be used. Penile implants are not usually available on the NHS and inflatable implants may be very expensive.

However, around three-quarters of men report being satisfied with the results of this type of surgery. As with all types of surgery, having penile implants inserted carries a risk of infection. If you take preventative antibiotics, the rate of infection is around two or three in Mechanical problems with the implants may occur within five years in five per cent of cases.

If your erectile dysfunction has an underlying psychological cause then you may benefit from a type of treatment called sensate focus. If conditions such as anxiety or depression are causing your erectile dysfunction, you may benefit from counselling a talking therapy.

Sensate focus is a type of sex therapy that you and your partner complete together. It starts with you both agreeing not to have sex for a number of weeks or months. The idea is to explore your bodies knowing that you will not have sex. You can also begin to use your mouth to touch your partner, for example, licking or kissing, them.

This can build up to include penetrative sex. Psychosexual counselling is a form of relationship therapy where you and your partner can discuss any sexual or emotional issues that may be contributing to your erectile dysfunction. By talking about the issues, you may be able to reduce any anxiety that you have and overcome your erectile dysfunction.

The counsellor can also provide you with some practical advice about sex, such as how to make effective use of other treatments for erectile dysfunction to improve your sex life.

Cognitive behavioural therapy CBT is another form of counselling that may be useful if you have erectile dysfunction. CBT is based on the principle that the way you feel is partly dependent on the way you think about things. CBT helps you realise that your problems are often created by your mindset. It is not the situation itself that is making you unhappy, but how you think about it and react to it.

Your CBT therapist can help you to identify any unhelpful or unrealistic thoughts that may be contributing to your erectile dysfunction — for example, to do with:. Your CBT therapist will be able to help you to adopt more realistic and helpful thoughts about these issues. Some studies have suggested that, in a few cases, it may be beneficial to exercise your pelvic floor muscles. These are a group of muscles around the underside of the bladder and rectum, as well as at the base of the penis.

Pelvic floor muscle exercise involves strengthening and training the muscles used to control the anus back passage and urinate. If your GP feels this type of exercise could be beneficial, then you may want to discuss it with a physiotherapist to learn it correctly. By strengthening and training these muscles, you may be able to reduce the symptoms of erectile dysfunction. Some complementary therapies, such as acupuncture, have claimed to treat erectile dysfunction. However, there is little evidence they are useful.

In some cases, they may even include ingredients that could interact with other medications and cause side effects. Home Illnesses and conditions Sexual and reproductive Erectile dysfunction impotence. Erectile dysfunction impotence See all parts of this guide Hide guide parts 1. About erectile dysfunction 2.

Symptoms of erectile dysfunction 3. Causes of erectile dysfunction 4. Diagnosing erectile dysfunction 5. Treating erectile dysfunction. About erectile dysfunction Erectile dysfunction ED , also known as impotence, is the inability to get and maintain an erection.

Where is my nearest GP? Why does erectile dysfunction happen? Physical causes include: narrowing of the blood vessels going to the penis — commonly associated with high blood pressure hypertension , high cholesterol or diabetes hormonal problems surgery or injury Psychological causes of ED include: anxiety depression relationship problems Sometimes erectile dysfunction only occurs in certain situations.

Erectile dysfunction can also be a side-effect of using certain medicines. The man cannot get or maintain an erection. The medical term is erectile dysfunction ED. A man with impotence has either a problem getting an erection or difficulty maintaining one. This usually interferes with sexual activity. To continue reading this article, you must log in.

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However, a person should be cautious when doing so. Before ordering, a person should check that their online pharmacy is licensed in the U. People can check whether the pharmacy is licensed using the list of Verified Internet Pharmacy Practice Sites. The FDA also offers tips for spotting the dangers of an unsafe website, including watching out for the following:. These illegal sites may send drugs of unknown quality and origin. They may even send the wrong drug or a dangerous product. Vacuum erection devices are a mechanical way of producing an erection for people who do not want to use drug treatments or find they are not working.

A person makes their penis rigid by using a vacuum pump sealed around it that draws up blood. The use of an accompanying band then prevents this blood from then leaving the penis. The lack of spontaneity with vacuum devices means that many people with ED find other treatments preferable. However, other treatments, such as oral medications, can also reduce spontaneity.

Vacuum devices may also be susceptible to mechanical faults that affect their efficacy, such as poor seals. There are several surgical treatment options available to patients, including penile implants. In this procedure, a doctor inserts a malleable or inflatable device into the penis. This surgery may help a patient reach and maintain erections if drug-based treatments have not worked.

Typically a doctor will only recommend surgery only after exhausting all other treatment avenues. No guidelines followed by doctors, nor any established sources of evidence, support the use of dietary supplements such as herbal pills. In addition to there being no evidence in favor of non-prescription alternatives for ED, alternative supplements and treatments may be harmful, and in some instances , fatal.

People may not always successfully achieve an erection. If this happens occasionally, it is not considered a medical problem. However, if a person is consistently unable to achieve an erection, then they may have ED. There is no defined length of time frame over which a person must experience ED to receive a diagnosis. Some professionals suggest 6 months is suitable. However, ED does not only refer to a complete inability to achieve an erect penis.

Symptoms can also include struggling to maintain an erection for long enough to complete intercourse or an inability to ejaculate. There are often emotional symptoms, such as embarrassment, shame, anxiety, and a reduced interest in sexual intercourse. Research suggests that strengthening pelvic floor muscles through exercise can be a beneficial treatment for people with ED.

Learn more about pelvic floor exercises here. Aerobic exercise, such as a jog or even a brisk walk, can also help the blood circulate better and can help improve ED in men who have circulation issues. The numerous potential causes of ED mean that a doctor will typically ask many questions and arrange blood tests. Such tests can check for heart problems, diabetes, and low testosterone, among other things.