A problem that affects many men but one that few care to admit to having is impotence. Also known as erectile dysfunction (ED), few men are willing to discuss the problem for fear that people will think that they are "less of a man."

It is very common to have an occasional bout of impotence and this should not cause a couple any worries. As men age, it is normal to have changes in the quality of erection and orgasm. However, when impotence remains a consistent problem, it may be necessary to seek professional help.

What Is Impotence?
While it is not a cause of infertility, ED can make conceiving a child next to impossible. Defined as the inability to achieve or maintain an erection, it affects an estimated 25 to 30 million men at some point in their lives. Although 10 to 20% of cases are explained by psychological factors, like depression, stress, or anxiety, 70% of chronic cases are caused by disease, like diabetes, kidney disease and alcoholism, which can impair blood flow to the penis.

Both illicit and prescription drugs, such as antidepressants and high blood pressure medication, can also lead to impotence. Spinal cord or brain injuries or other nerve disorders can result in a man’s inability to achieve an erection due to impaired nerve impulses that prevent the brain and penis from communicating properly. Men who have had radiation therapy, a pelvic injury or surgery may also find themselves dealing with chronic ED.

There are several ways to treat erectile dysfunction. If a prescription drug is causing the problem, changing to a different medication will often help. New methods of doing operations are being developed to help reduce incidents of impotency after surgery.

When impotence is the result of psychological factors like stress, counseling or therapy is often useful. Because ED can take a toll on a man’s self-esteem, sex therapy is increasingly being recommended as a form of treatment on its own or in combination with other medical remedies. It is a good idea for both partners to get involved with the sex therapy as it can help with communication and also deal with any tension between partners caused by the sexual dysfunction.

When impotence is the result of physical problems, there are a variety of medical treatments available. Oral medications have proven to be very helpful for a number of men. These pills aid in erectile function by suppressing certain enzymes while increasing others, thereby allowing the proper blood flow necessary for an erection. While Viagra™ is probably the best-known pill in this category, there are other oral medications men can take. The degree of effectiveness will vary from man to man, so it may be necessary to try different ones before finding one that works the best for you. There are also penile injections and urethral suppositories that men can use. Though they are administered differently, these work in much the same way as oral medications.

Penile implants are the most common type of surgery done for impotence. The implant consists of inflatable tubes or rods that can be pumped up when an erection is desired. The pump is located in the scrotum, while the reservoir of sterile liquid that will expand the tubes and cause the erection is implanted into the abdomen.

Vascular reconstructive surgery can also be done to help improve the flow of blood to the penis thereby helping a man achieve an erection. However, this type of surgery is seldom done and is therefore considered to be experimental. Potential long-term side effects of the surgery include damage to nerves and scar tissue, both of which can cause impotence.

Non-Medical Options
Men who would like a more natural way of achieving an erection may want to use a penile pump or vacuum. This device consists of a plastic tube that is placed over the penis. The tube sits right up against the base of the penis in order to create a seal. Using a hand pump, blood is drawn into the penis causing an erection after a few minutes. A rubber ring is then placed on the base of penis to maintain the erection.

Although it may be embarrassing, seeking help for impotence is necessary in order to restore fertility.

If a man has tried some of these options and he and his partner are still having difficulties getting pregnant, it may be a good idea to visit a fertility specialist.

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