Not many people know that, in most cases, it is physical rather than psychological causes which lead to erectile dysfunction, and it is most curable.

Erectile Dysfunction has been failed to be treated by all the branches of medicine due to the layout of their medical disciplines. It is the clinging to an old mindset which is responsible for this unfortunate situation.

The shortcomings of ignorance, myths, superstitions, stigma and taboos, which laymen relate to sexuality, are often believed to be the underlying cause. Compounding the problem is the old attitude of physicians who still believe that impotence is largely psychological in origin which prevents acceptable results.

These things are responsible for the fact that most cases of erectile dysfunction, as it is known by urologists, are not detected and the few which are detected are not properly managed. Surprisingly, many people hold the view that impotency is incurable due to their belief that the root cause is psychological in nature. This is very sad because most of the psychological causes of impotence cases are most curable.

Impotence, or Erectile Dysfunction, has always been considered a common disorder of middle-aged men. American studies suggest that 52% of men 40 to 70 years old have erectile dysfunction and yet only a fraction of them are diagnosed with the problem.

All or Nothing

Contrary to popular belief, the confusion is not an “all or nothing” matter. Laymen and even some doctors believe that a man can have trouble achieving an erection that is not good quality, or not at all. Nothing can be further from the truth. The majority of men who have erectile dysfunction can get an erection, but it is just not rigid or durable enough. Therefore, erectile dysfunction is a much better term (which refers to a partial disorder) than impotence (which means total failure). Many people are unaware that, in most cases, the problem also causes mental disorders and disturbances of potency.

However, this trend is changing slowly but surely. The change is largely due to the fact that, in recent years, advanced research in urology and andrology has shown that 80-90% of chronic disorders of potency were not a soul but a body disease. The reasons can be found in modern urology-andrology research which defined and often successfully treated individuals without using psychological methods.

In such an age where almost all branches of medicine are experiencing enormous progress, it is surprising that research concerning the male reproductive system is not so well known.

Primary Causes of Impotence:

Primary impotence (congenital – present at birth)

Secondary impotence (after years of normal sex)

Secondary Causes of Impotence:

Diabetes mellitus

Hypertension (high blood pressure)

Atherosclerosis

Kidney Disease

Heart failure

Neurological disorders, multiple sclerosis, stroke, paraplegia

Injury: Pool, Gati trauma

Injuries (chronic): Competitive cycling

Surgery, rectum, bladder, retroperitoneal fibrosis, spine, urethra, prostate, etc

Local changes: Peyronie’s disease

Medication: Hypertension drugs, gastric ulcers, central nervous system drugs

The History

Two determining factors for the erroneous thinking concerning impotence can be distinguished. Throughout history, most societies were patriarchal and structured around the dominant male. The male ego cannot admit that something is wrong. Ironically, these are the same men who explored the female reproductive system and helped develop the special field of gynecology which does not include looking at male sexual problems.

The second reason is that the teachings of Sigmund Freud were misunderstood. This led to the incorrect conclusion that man’s sexual problems are rooted in the soul.

Types of Impotence

Arterial Origin:

Arterial failure is when the penile arteries do not supply enough blood to create or maintain an erection. This is due to the narrowing of the arteries which commonly occurs in older people.

Hypertonic stress can result from diabetes or genital injury and afterwards the penis can be damaged arterially. This latter often occurs at a young age. The injury may be acute or chronic such as occurs in a car or a pool accident where a pubic bone fracture occurs. The latter is common in competitive bicycle racing. The pelvic and pubic areas receive constant irritation and micro trauma occurs. Scars are created which then cause erosion of the arteries in these areas.

Impotence of arterial origin is detected only later under thorough examination. It is only then that signs of the narrowing of the arteries are observed.

Venous Origin:

A penile erection cannot be completed due to the escape of blood via the draining veins. Normally, the veins of an erected penis are almost completely emptied of blood. This mechanism causes the blood to collect in the sinus of the penis, increasing the necessary pressure to develop an erection.

There are men whose potency is derived from venous disorders (primary) at birth. These men can never have a perfect erection in their lives. Other male potency disorders occur from venous origins after years of normal sex (secondary).

Neurogenic:

The nerve supply to the penis is very sophisticated and complicated. The proper flow of impulses is very important in causing erections and sustainability. These nerves trigger the arteries and veins of the circulatory system to change the rhythm of blood flow.

Nerve supply to the penis is a very fragile system. Spinal injuries, particularly if the spinal cord is affected, may interfere with potency. The same can occur from other physical damage to the penis nerves, i.e. after trauma.

Certain surgeries which are performed in the pelvic area might also result in either psychological or nerve damage. Erectile dysfunction and impotence can be caused by the resulting confusion. Such surgeries which may cause this condition are rectum, prostate, spine and radical bladder surgery.

Diabetes is an insidious disease that largely affects the nerves of the penis and causes erectile dysfunction. Low sugar is extremely common in potency disorders with their proportions reaching 50% of those having diabetes. Diabetes is a treatable but not curable disease in today’s medical world and it endures through the life of the patient. Therefore, diabetic impotence can only be treated but not cured (except for replacement).

Endocrine (hormonal) Origin:

This occurs when normal hormonal balance is swayed to an unbalanced ratio of sex hormones. Such a case occurs in 5-10% of impotence sufferers. Recent clinical research, however, has shown that hormone levels change because of the libido (sexual desire manifested in the mind) has a negative impact on an erection.

Mixed Factors:

Sometimes, several factors may be present in the same patient simultaneously. It should be noted that multiple disorders such as diabetes, liver or kidney problems and high blood pressure can work together in causing impotence.

Also, central nervous system medications used to treat secondary psychiatric disorders such as depression can cause erectile dysfunction.

Psychic Origin:

When no organic factor is present and the only problem is rooted in the soul, this is called psychic origin of potency disorder. However, urology and andrology techniques are necessary to exclude the presence of an organic cause prior to psychological treatment.