Impotence is when someone is having a recurrent problem of getting or maintaining an erection. But if someone has it from time to time, is not necessarily a cause for concern.

One of my patients was emotionally devastated, with lack of self-confidence by his recurrent problem. So, he was making different excuses with his wife, to avoid any sexual relations.

To achieve a good erection in males, we need a normal Testosterone hormone, intact nerves, normal blood circulation in the penis and most importantly emotions and mental health. An issue in any of these, can cause impotence especially stress and psychological matters which can play a significant role, and it is one of the most common causes of impotence.

An example for this, is a common condition called performance anxiety. A patient of mine had it after his wedding night, so he started to overthink and worry a lot about whether he can perform well, before every sexual relation, which worsened his condition and caused chronic anxiety and low self-esteem.

Other medical causes for this condition, are diseases that can block the circulation in the male organ. like having high cholesterol, high blood pressure or Diabetes for a long time. Also, it could happen from the side effects of certain medications, such as anti-depressants or some older blood pressure medications like Beta Blockers, which are used less now a days.

Another cause for impotence, is after prostate surgery for cancer, or in a condition called, male menopause, which is rare but happens in older men, with a very low testosterone level in the blood.

I remember a 70 years old patient of mine, who was sexually inactive for five years after his wife's death. He was later ready to have a relationship, but he could not perform well, in the sexual relation. This caused him to become embarrassed with lack of confidence. So, he specifically asked me if taking the blue pill Viagra can help his condition.

In this case, we have to differentiate the cause of his problem, between medical or psychological. So, I did several blood tests and Ultrasound to check the blood flow. All the results were normal. So, his case was purely psychological, and the good news was that, he was extremely happy after the treatment.

In general, if someone has an erection during their dreams or when they wake up, then we can almost say that it is psychological and not from a medical issue. You can now understand, that any combination of medical and psychological issues, can cause impotence.

So, what is the treatment? First, if we discover a medical problem, then we have to treat it. For example, controlling blood pressure and Diabetes or replacing testosterone, if the level was low. For the psychological impotence, the treatment might take a long time, and needs a lot of patience and understanding, for both the individual and his partner until he can build his confidence back.

Most of the medications involve increasing the blood flow to the male organ. It can be given as a suppository, injection or a pill form. In general, patients prefer taking the pills, which can be taken as needed 2-3 hours before the planned act. But another and better option, is to take a smaller dose of the medicine on a daily basis.

Another point, you should be aware of some uncomfortable side effects of these medication pills, such as headaches, flushing, dizziness, nasal congestion, and blurry vision.

For patients with Angina or heart problems, they should avoid it, especially if they are using Nitroglycerine medicine, which can cause a severe Blood pressure to drop.

Patients with severe impotence that are not improving with the pills, Urologists can recommend a vacuum device or even a surgical implant.

My final advice: 1) if you have impotence, don't be embarrassed and let it affect your relationship and life. Please talk to your doctor and seek help.
2) I have been asked about herbal medications for this condition. Actually, there are no proven medical studies to confirm its efficacy.
3) The best way to prevent this problem is to make healthy lifestyle choices either physically by doing regular exercises and managing existing health conditions or mentally by avoiding stress. Finally, taking these pills by a normal person without impotence will not make them like a superman.

http://www.amerhelbaoui.com
Video shot and edited by: Fadi Helbaoui