Impotence

Erectile dysfunction (ED) is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance.

Causes:
Medications: Many common medicines produce erectile dysfunction as a side effect. Medicines that can cause erectile dysfunction include many used to treat high blood pressure, antihistamines, antidepressants, tranquilizers, and appetite suppressants. Examples of common medicines that can cause erectile dysfunction include propranolol (Inderal) or other beta-blockers, hydrochlorothiazide, digoxin (Lanoxin), amitriptyline (Elavil), famotidine (Pepcid), cimetidine (Tagamet), metoclopramide (Reglan), indomethacin (Indocin), lithium (Eskalith, Lithobid), verapamil (Calan, Verelan, Isoptin), phenytoin (Dilantin), and gemfibrozil (Lopid).

  • Drugs (anti-depressants (SSRIs) and nicotine are most common)
  • Neurogenic disorders (spinal cord and brain injuries, nerve disorders such as Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, and stroke)
  • Cavernosal disorders (Peyronie’s disease)
  • Psychological causes: performance anxiety, stress, mental disorders (clinical depression, schizophrenia, substance abuse, panic disorder, generalized anxiety disorder, personality disorders or traits), psychological problems, negative feelings.[not in citation given]
  • Surgery (radiation therapy, surgery of the colon, prostate, bladder, or rectum may damage the nerves and blood vessels involved in erection. Prostate and bladder cancer surgery often require removing tissue and nerves surrounding a tumor, which increases the risk for impotence)
  • Aging. It is four times higher in men in their 60s than in men in their 40s.
  • Kidney failure
  • Diseases such as diabetes and multiple sclerosis (MS). While these two causes have not been proven they’re 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.

Treatment:
Treatment depends on the cause.
Exercise, particularly aerobic exercise is an effective treatment for erectile dysfunction.

Medication:
Phosphodiesterase type 5 inhibitors
The cyclic nucleotide phosphodiesterases constitute a group of enzymes that catalyze the hydrolysis of the cyclic nucleotides cyclic AMP and cyclic GMP. They exist in different molecular forms and are unevenly distributed throughout the body.

One of the forms of phosphodiesterase is termed PDE5. The prescription PDE5 inhibitors sildenafil (Viagra), vardenafil (Levitra) andtadalafil (Cialis) are prescription drugs which are taken orally. They work by blocking the action of PDE5, which causes cGMP to degrade.

Alprostadil
Alprostadil in combination with the permeation enhancer DDAIP has been approved in Canada under the brand name Vitaros as a topical cream first line treatment for erectile dysfunction.

Another treatment regimen is injection therapy. One of the following drugs is injected into the penis: papaverine, phentolamine and prostaglandin.

Treatments for erectile dysfunction?
The following are treatments for erectile dysfunction:

  • Working with doctors to select medications that do not impair erectile function
  • Making life style improvements (for example, quitting smoking and exercising more)
  • Taking drugs to treat ED such as sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis)
  • Inserting medications into the urethra (intraurethral suppositories)
  • Injecting medications into the corpora cavernosae (intracavernosal injections)
  • Vacuum constrictive devices for the penis
  • Penile prostheses