Sexual Dysfunction

Sexual dysfunction includes desire, arousal, orgasmic and sex pain disorders (dyspareunia and vaginismus).

• Impotence (Erectile Dysfunction) : Impotence is the chronic inability to have an erection that is rigid enough, and that can be sustained for a long enough period, to complete sexual intercourse for at least half of the times sexual intercourse takes place. . Erectile dysfunction is a common, treatable condition.



Diagnosis & Tests

• Physical Impotence : may result from damage to the nerves or the blood vessels that control the flow of blood to the penis. It may also be caused by problems with hormones - substances in the bloodstream that affect or control the activity of some organs.


• Psychological Impotence : can be the result of fear, stress, worry, anger or frustration. Often, this type of impotence develops from 'performance anxiety' - a man's fear that he won't perform well during sexual intercourse. Stress caused by problems on the job, marital problems or financial difficulties can also lead to this type of impotence.



Other causes are due to defective blood flow or nerve function to the penis. Impotence can also be caused due to diabetes. The overall incidence of impotence in men with diabetes is two to five times higher than it is in the general male population. This does not mean that impotence is inevitable or permanent.

For many years, it was believed that 90% of impotent men had a psychological cause for their problem. However, as a result of recent medical research, it is now known that at least half of the men suffering from impotence can actually trace its origin to a physical problem.

If your erections do not become firm enough to allow for vaginal penetration, you have impotence. If your erections have the necessary rigidity, but are only firm for a brief period, you may have the problem. If your erection loses its strength upon penetration, you probably have the problem.

If any of these scenarios fit you, it may be time to admit it, and begin to move towards a treatment that can change your life.

Erectile dysfunction can occur in men at any age. The following measures can be taken to remedy erectile dysfunction:

Changing Habits and Medications

• Quitting Smoking and Changing Prescription Medications : may help address the condition.


• Hormonal Medications : Only 5% of erectile dysfunction cases are caused by irregular levels of sex hormones, such as low levels of testosterone or excess estrogen. There are medications that restore this balance.


• Professional Counselling : Because impotence can often result from a combination of psychological and physical factors, counselling can reduce anxiety. This therapy is often used in combination with other treatments as directed by a physician.


• Oral Medication : Yohimbine occurs naturally in the bark of evergreen trees and has been used as an aphrodisiac for centuries by Indians and Africans. It is believed that the drug works by enhancing nerve sensitivity in the penis Recently, a new drug, sildenafil citrate (Viagra), has been introduced, which acts to increase nitric oxide levels and other primary mediators of erection. Studies suggest that the drug is effective in selected groups of patients. However, the drug has to be used under medical supervision as it has been found to have known interactions with other drugs and should be used with caution in hypertensives.


• Injection Therapy : One of the newest forms of treatment involves the self-injection of a certain medication into the side of the penis. This relatively painless injection produces erections of good quality in about 70-80% of patients.


• Vacuum Therapy : This treatment enables an erection by increasing blood flow to the penis through negative pressure suction generated by the device used for this, treatment. In this way, the patient can obtain penile enlargement and rigidity for sexual intercourse.


• Surgical Treatment : This treatment is usually reserved for those patients whose blood flow has been blocked by an injury to the penis or pelvic area. For these select candidates, a surgery to correct a blocked artery or a leak in the pelvic veins is an option. The goal of this treatment is to correct the blockage of blood flow to the penis so that erections will occur naturally.


• Penile Prostheses : The most common surgical procedure to treat impotence is that of penile prosthesis implantation. This treatment involves the surgical placement of a device into the two sides of the penis, allowing erections as often as desired. These implants come in two forms - an inflatable device and semi-rigid rods. This treatment is recommended only after discussing with the patient all other available options. A prosthesis is a long-term solution, which is offered after careful consideration and discussion with the patient