Men's Health - Men's Health Line

Impotence, or erectile dysfunction, is the persistent or recurrent inability to achieve and/or maintain an erection adequate for satisfactory sexual intercourse.

Impotence is related to many physical and psychological factors. The causes of impotence include:

Stress or anxiety

Certain diseases, e.g. diabetes mellitus, vascular diseases, nerve problems

Some medications, e.g. antipsychotic drugs, hypotensive drugs

Excessive alcohol intake

Smoking

Occasional impotence is normal. You may fail to get or keep an erection when you are tired or anxious. In fact, one of the most common causes of impotence in middle-aged men is lack of sleep.

You can lower your risk of having impotence by having a healthy lifestyle, including:

Do not smoke

Avoid excessive alcohol

Avoid drug abuse

Eat a healthy diet, take regular exercise, get enough sleep and rest, and develop better ways to deal with stress.

If you worry about your sexual functioning, you should talk to your partner and consult a doctor. The doctor may carry out some investigations, such as blood tests for laboratory examination.

Most cases of impotence can be treated.

Treatment for impotence may include oral medications (e.g. vasodilator or hormonal drugs), psychotherapy and sexual counseling, surgical implants and other methods (e.g. use of vacuum pump devices), alone or in combination. The doctor will find out whether the problem stems from physical or psychological causes and recommend the optimal treatment depending on the extent to which it affects the patient's life, and the presence of any other medical conditions.

Oral drugs such as Sildenafil work by dilating the blood vessels supplying the sponge-like tissues of the penis. They increase the blood flow resulting in erection, and are 70-80% effective. However, there are side effects and these drugs are contraindicated in patients with certain heart diseases and stroke. Therefore, do not use drugs without a doctor's prescription as wrong use of these drugs may lead to prostate problems or heart disease, or even death in severe cases.

If you fail to get an erection, there are other things you can do.

Talk about the problem with your partner and discuss the sexual needs as openly as possible.

Seek medical advice to find out the cause and treatment.

Change your sexual habits and practise other forms of sex that are enjoyable and satisfying, such as foreplay or mutual masturbation.

Remember, there are a variety of treatments for impotence. If you have any suspicions, you should seek medical advice.

Research shows that over 50% of men aged between 40 to 70 years experience some degree of impotence, and the prevalence increases with age.

Your risk of suffering from impotence can be reduced by quitting smoking.

One of the most common causes of impotence in middle-aged men is lack of sleep.

Don't be too upset if you experience occasional difficulty in achieving or maintaining an erection. In such situation, you can practise other forms of sex such as kissing or mutual masturbation.

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