Sexual impotence is perhaps the most poorly understood and mismanaged of all medical disorders. Two factors are responsible for this unfortunate state of affairs.
Ignorance, myths, superstition, guilt and the stigma and taboo attached to anything sexual in the minds of the people.
Abysmal sexual ignorance : on account of which people continue to believe that impotence is something that is largely psychological in origin.
Impotence, or erectile dysfunction (ED, E.D.), as andrologists prefer to call it, has always been and continues to remain an extremely common disorder. It is said to afflict as much as 10 percent of the male population. Above the age of 40, nearly 52 % of men are affected. Despite this staggering incidence, few cases come to light.
In an era where so many advances have been made in nearly all other branches of medicine, it is surprising that male reproductive system research has remained so woefully neglected and backward. For instance, the branch of obstetrics and gynecology (the female analogue of andrology) which deals with disorders of the female reproductive system has been with us for several decades now and is a well recognised specialty. In fact, so advanced is the understanding of the subject that today, in most countries, gynecologists restrict themselves to sub-specialty areas within their subject such as gynecological oncology, high-risk pregnancies, female infertility etc. because it is so difficult to keep pace with all the developments in the subject.
It may be of interest to our readers to deliberate in passing the reasons for this delayed understanding of the subject.
Clinical States associated with impotence
Primary Impotent since birth
Secondary Impotence sets in after years of normal sex
Causes of Secondary Impotence
- Diabetes mellitus
- Hypertension (high blood pressure)
- Renal (kidney) failure
- Heart disease
- Neurological disorders – multiple sclerosis, stroke, paraplegia, spinal cord lesions, Parkinsonism, etc.
- Injuries – sudden – e.g. pelvic and perineal
- Injuries – gradual – as in bicycle-riders etc.
- Surgery-operations on bowel, rectum, bladder, rectroperitoneum, spine, urethra, prostate etc.
- Local e.g. Peyronie’s disease
- Medication e.g. drugs administered for duodenal ulcer, hypertension, mental disease etc.
Two factors are predominant. The first of these is male chauvinism. Throughout human history, most of our societies have been patriarchal and male-dominated. Men’s egos would not let them admit that there could be something wrong with their ‘jewels of manhood’. Ironically, it is these very men who researched the female reproductive system and helped develop the branch of gynecology and obstetrics. But they refused to look into themselves.
The second reason is a misinterpretation of the teachings of Sigmund Freud. This led to the erroneous conclusion that most male sexual problems had their roots in the mind.Men with increasingly severe impotence problems are wise to take immediate heart-healthy steps. That is because a new health breakthrough found that impotence is linked to a higher risk of heart disease and even death.
Published last week in PLOS Medicine, the large-scale study shows that the risk of future cardiovascular disease and death rises as erectile dysfunction (ED) becomes more severe. This is the case even for men with no history of heart problems. This is the first study to show that severity of impotence corresponds to a higher risk of heart disease hospitalization and all-cause mortality.
Australian researchers examined the link between severity of self-reported impotence and those issues in 95,000 men over the age of 45. It included more than 65,000 men without known heart disease, and more than 29,000 men with heart disease.
Most importantly, men who are experiencing significant impotence problems are wise to get some testing to assess their risk for heart disease. Meanwhile, making lifestyle changes to promote heart health is an important step.